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"The movement is across all medical disciplines with 6.8 percent of all physicians planning to stop taking insurance in favor of concierge-style medicine or so-called 'direct primary care.'.... "Already, one in five physicians is restricting the number of Medicare patients in their practice and one in three primary care doctors - the providers on the front lines of keeping the cost of seniors' care low - are restricting Medicare patients.... "Under direct primary care, doctors contract directly with patients to provide all of their primary care needs free of insurance interference at a price generally between $50 and $60 a month per patient. It's what the New York Times last spring called 'concierge for the masses' because it was much cheaper than the historically high cost of concierge medicine some Congressional investigators found to be $5,000 to $15,000 a year or more."

The federal Agency for Healthcare Research and Quality's Questions to Ask Your Doctor campaign is based on the idea that doctors "know a lot about a lot of things, but they don't always know everything about you or what is best for you." The website offers a list of 10 general questions you should ask, along with questions to ask before, during, and after appointments. It also has an interactive page that lets you build your own list of questions. The independent, nonprofit Joint Commission accredits more than 20,000 health care organizations and programs in the United States. Its Speak Up Initiatives offer free brochures and videos to help make the most out of visits to the doctor.

". . . seniors with lower cognition and lower basic math abilities were less likely to enroll in Medicare Part D, and less likely to apply for the subsidy if they did enroll in Part D. . . . . . Those who qualify for Medicaid and are also in Medicare are automatically enrolled and get the subsidy without needing to take any action on their own. Other low-income adults must apply for the benefit, and estimates suggest that more than 2 million people who would qualify for a benefit fail to apply. . . . [T]his is not 'Here's thirty plans, pick the best one.' This is, 'Here's free money, do you want it?'" . . . . . "Choice is generally a good thing, but options in health care can be very complex and consumers can have great difficulty identifying the best one," McWilliams said. "To improve decisions and enhance competition, the government and exchanges may need to play more active roles. Expecting the availability of choices and information for consumers alone to cure our health care system is unrealistic."

Mobile health technology has substantial potential for improving access to health care in the developing world and in remote regions of developed countries, states an article in CMAJ (Canadian Medical Association Journal).

"What we've seen is this federal money really has made a big difference," said lead study author Julia Adler-Milstein, an assistant professor in the U-M School of Information and School of Public Health. [The big problem will occur] ". . after the government grant money runs out in January 2014." A full 74 percent of the exchange programs reported that they're struggling to develop a sustainable business model. Over the years, some organizations have closed their doors when grants ended. Adler-Milstein offers one explanation why: "The health care providers are not willing to pay for the service at the level needed," she said. "They don't see enough value, and that's because much of it doesn't accrue to them. It goes to patients and to health insurance companies. The central challenge is that the incentives and the business model are not aligned yet for this to really work."

"The United States spends more than the rest of the world on health care and leads the world in the quality and quantity of its health research, but that doesn't add up to better health outcomes," said Dr. Christopher Murray, IHME Director and one of the lead authors on the study. "The country has done a good job of preventing premature deaths from stroke, but when it comes to lung cancer, preterm birth complications, and a range of other causes, the country isn't keeping pace with high-income countries in Europe, Asia, and elsewhere."

Along with other walk-in retail clinic chains such as Kroger's Little Clinic and Walgreen's Take Care Health, MinuteClinic is gearing up for an anticipated swell of newly insured people come Jan. 1, 2014, when the Patient Protection and Affordable Care Act is fully implemented.

A landmark immigration bill passed by the Senate would create new pathways to citizenship and provide a much-needed boost to the U.S. economy but would do little to ease immigration-related disparities in health care, according to a new report.

"Public insurance makes a real difference in the health of children. Those who are covered are significantly more likely to have a usual source of care than those who are uninsured, which is strongly associated with better outcomes. "The Affordable Care Act (ACA) changes Medicaid into a universal program for all people, children and adults alike, in families with incomes below 138 percent of the federal poverty line. This is not an insignificant change. About half of the more than 30 million currently uninsured who are expected to get coverage under the ACA will do so through the Medicaid expansion. Many of the people who will get coverage are parents. . . . "Although a debate might continue in the political sphere, the evidence is quite clear that expansion of the program has many benefits for states and their low-income residents. . . ."

"If 14 states decide not to expand Medicaid under the Affordable Care Act as intended by their governors, those state governments collectively will spend $1 billion more on uncompensated care in 2016 than they would if Medicaid is expanded. "In addition, those 14 state governments would forego $8.4 billion annually in federal payments and an additional 3.6 million people will be left uninsured, according to findings published in the June edition of the journal Health Affairs."

Continued downward pressure is expected for the health sector, mainly because of aggressive and creative steps taken by employers, elements of the ACA (Affordable Care Act), and new locations and models for delivering care.

"Insurers hope that clinicians will be so hassled by authorization procedures that they won't seek admission for their patients, saving insurance companies money," he said. "Placing profits ahead of the health of patients when mental illness makes them vulnerable is immoral. A single-payer Medicare-for-all health care system would represent a great leap forward for patients and providers alike."

Ironically, licensing statutes are enacted based on the states' constitutional power to protect the health, safety and welfare of the public. Yet these CAM practice acts actually increase public vulnerability to unsafe and ineffective health care practices.... 1. Practice acts grant CAM practitioners a broad scope of practice, including legalization of scientifically implausible and unproven (or disproven) diagnostic methods, diagnoses and treatments.

"As part of the Obama administration's work to make our health care system more affordable and accountable, data are being released that show significant variation across the country and within communities in what hospitals charge for common inpatient services."

The $10 million sponsorship from AstraZeneca will allow the ACC to create a Patient Navigator Program that will support a team of caregivers to help patients overcome challenges during their hospital stay and in the weeks following discharge when they are most vulnerable. The ultimate goal will be to create a program that supports a culture of patient-centered care that can be implemented in other hospitals.

Less than 25% of newly qualified doctors go into primary care, and just 4.8% move into rural areas, the authors added. This serious problem will only get worse unless some fundamental changes are introduced.