As most health care providers are already working to deliver care more efficiently while following the goals of the Obama administration’s Affordbale Care Act (ACA), the American Board of Internal Medicine Foundation (ABIM) has recently launched a new initiative in an effort to aid them in the process. “Choosing Wisely” aims to identify medical interventions — most often in the form of tests, procedures, drugs, and even surgery — that are frequently overused without benefit to patients and “whose necessity should be questioned and discussed” between physicians and their patients.

In an op-ed for The Huffington Post, Don Berwick, the former head of the Centers for Medicare & Medicaid Services (CMS) and a senior fellow at the Center for American Progress, explains that the initiative could be a veritable “game changer,” in that it identifies a number of ways in which health care wastes countless premium dollars on services that do not help anyone, while avoiding toxic cuts in benefits or coverage:

The specialty societies are not guessing; their lists of procedures contain copious scientific citations supporting the claims of overuse. Their advice earns further trust because, in many cases, by suggesting that physicians and patients think twice before using certain tests and treatments, the specialty societies are speaking against their own economic self-interest, which in fee-for-service payment attaches income to volume.

ABIM has identified “Five Things Physicians and Patients Should Question” in each specialty in order to encourage open dialogue between patients and physicians. Such an approach could help patients take charge of their own health care decisions and dissuade providers from offering unnecessary care.

– Fatima Najiy

The individual mandate is the most controversial part of the health care law, despite the fact that several top Republicans once supported it. But a new report indicates that its impact will be less far-reaching than opponents have claimed.

The Kaiser Family Foundation released a study last month examining how many people would have to buy health insurance or pay a penalty under the mandate. In addition to Americans who already have insurance through their employer or other means, who would not be affected, the foundation also noted that the law offers a variety of exemptions for people facing hardships:

The mandate’s exemptions cover a variety of people, including: members of certain religious groups and Native American tribes; undocumented immigrants (who are not eligible for health insurance subsidies under the law); incarcerated individuals; people whose incomes are so low they don’t have to file taxes (currently $9,500 for individuals and $19,000 for married couples); and people for whom health insurance is considered unaffordable (where insurance premiums after employer contributions and federal subsidies exceed 8% of family income).

In simulations prepared for Kaiser, Jonathan Gruber of the Massachusetts Institute of Technology estimates that about 40% of those who would be uninsured in the absence of the ACA would be exempt from the mandate. That means almost 9 in 10 non-elderly people would either satisfy the mandate automatically or be exempt from it.

While some polls show opposition to the mandate, most people support it when they learn that coverage offered by their employer would satisfy the requirement. Studies also indicate that an overwhelming majority would rather comply with the individual mandate and purchase insurance than pay the far less onerous penalty for forgoing it.

-Zachary Bernstein

Gov. Scott Walker (R-WI) quietly signed three controversial bills on the eve of a holiday weekend to significantly limit access to abortion services and sex education. Walker “signed the bills Thursday but didn’t announce the move until midday Friday, when his office released a list of more than 50 bills he signed Thursday and Friday,” the Associated Press reports. The measures include:

– A ban on abortion coverage in policies obtained through a health insurance exchange, set to be created under the federal health care reform law starting in 2014. The only exceptions would be in cases of rape, incest or medical necessity.

– A woman seeking an abortion must undergo an exam and consult with a doctor alone, away from her friends and family. The doctor must determine whether someone is pressuring the woman into the procedure. Doctors who break the law could be charged with a felony.

– Teachers in schools that offer sex education must stress abstinence as the only sure way to prevent pregnancy and sexually transmitted diseases. Declares that sex education teachers do not have to address contraception. That’s a dramatic shift from current state law, which requires teachers to instruct students on birth control options.

Among the 47 other bills, Walker approved the repeal the state’s Equal Pay Enforcement Act, which had offered individuals legal recourse to fight wage discrimination based on race, age, disability, religion, sexual orientation or other factors. According to the Daily Beast, “in the two years the law was in effect, not a single equal-pay lawsuit was filed,” but employers responded to the law by increasing their workplace diversity. In 2009, Wisconsin ranked 36th for gender-parity. A year later, “it had climbed to 24th,” as the gender pay gap narrowed significantly, the U.S. Department of Labor found.

Walker, who could be recalled from office in the next two months, may also be considering a presidential bid. During a recent interview with the Christian Broadcasting Network, he said that “God’s got a plan for us” that may include “bigger things” than his current job. “Who knows where it might be, beyond just serving as Governor of this state,” Walker told David Brody.