The amount spent on health care in the U.S. has been slowing for the last few years. In May, the growth in health care costs was the lowest in 20 years, and total health care expenditures have stabilized at around 18 percent of the economy since 2009. But the New England Journal of Medicine has published a new report from researchers at the Center for Sustainable Health Costs suggesting that the slowdown in health care spending started well before the recent recession. As the researchers explain:

Excess growth decreased from more than 3% during 2003 to less than 1% starting in July 2005 and continuing, for the most part, until near the end of the recession in June 2009. Excess growth exceeded 1% during the post-recession period, until May 2011, when it again dropped below 1%, going negative during the latter part of that year. If we use 1% as a threshold to denote moderation in excess health care spending, these data show that July 2005 marked the onset of moderation. Although the level of excess spending was above 1% for a few months in 2006, that was the year in which Medicare Part D prescription-drug coverage began and prescription-drug spending was a major driver of excess spending.

Here’s their chart:

As Wonkblog’s Sarah Kliff points out, the decline in medical spending might have more to do with delayed medical care rather than people completely forgoing treatments. The Wall Street Journal reports today that health care companies are seeing an uptick in checkups and outpatient visits, although hospitals stays are not increasing. And reforms included in Obamacare to make preventive services available without a co-pay could help encourage more people to visit their doctors before a serious problem arises.

Even with the reforms in the Affordable Care Act, health care costs as a whole in the U.S. are growing at an enormous rate and is projected to make up 40 percent of federal spending by 2037. It’s unclear if the low growth in spending will be low enough, according to the report’s authors, and “the answer depends on what we’re willing to pay in taxes and what we spend on items not related to health care.”

Medicare has just launched a new three-year pilot program to work to revise a policy that often sticks seniors with large medical bills, potentially helping to save seniors thousands of dollars in outpatient care.

Current Medicare rules make a distinction between inpatient care and outpatient care — requiring patients to spend at least three days in the hospital as an inpatient to gain Medicare coverage for their follow-up care in a nursing home — which can lead those seniors who have been classified as “outpatients” to be surprised with charges that Medicare won’t cover. Under the pilot program, however, participating hospitals will be allowed to rebill Medicare for more coverage for outpatient services.

The Washington Post reports that many seniors aren’t informed of their status as outpatients while they’re in the hospital, so they run up large bills without even realizing it:

Though many seniors stay in the hospital for several days and are in a regular hospital room while being treated, they don’t always know that the hospital has classified them as an observation patient, which is considered outpatient care.

Under Medicare rules, patients must have at least three days in the hospital as an inpatient — not just for observation — to qualify for follow-up care in a nursing home. In addition to generally higher hospital co-payments, hospital observation patients can be billed any amount by their hospital for the routine maintenance drugs they need. Some have reported charges of $18 for one baby aspirin and $71 for one blood pressure pill that costs 16 cents at a local pharmacy.

Medicare officials hope the pilot program will allow more flexibility for hospitals, which can feel pressured to stick to outpatient care despite the fact that it’s more expensive for seniors. Under the current policy, if Medicare decides that a hospital has billed it for inpatient treatment for a senior who could have been given outpatient treatment instead, the hospital can lose the entire Medicare payment — potentially prompting hospitals to play it safe and put too many people in the outpatient category. In fact, the number of patients in outpatient care for over 48 hours more than doubled between 2006 and 2010, Medicare said.

Some health care officials, such as Toby Edelman at the Center for Medicare Advocacy, think the inpatient and outpatient classifications are “arbitrary” and need to be scrapped altogether. Since those categories currently still factor into the health care sector, however, the pilot program is a small step to address the seniors who struggle to pay thousands of dollars in follow-up care.

Reforms to the Medicare program under the health reform law have already begun to significantly benefit seniors. A report from the Centers for Medicare And Medicaid Services reports that, as of the end of last month, seniors had already saved $4 billion in prescription drug costs thanks to Obamacare. A recent study from the Commonwealth Fund also found that seniors are more satisfied with the quality and affordability of their care when they are covered under the Medicare program.

On Tuesday, Missouri GOP Rep. Todd Akin notched his party’s nomination for Senate to face Claire McCaskill in November. As ThinkProgress has documented, Akin — a Tea Party favorite poised to benefit from millions of dollars of outside money — has a long history of making inflammatory remarks. This time, Akin took to KCMO talk radio Wednesday to decry the morning-after pill, arguing that it should be banned “totally, for everyone”:

HOST: I wanted to get to the actual morning-after pill. So are you saying that you would like that to be banned for everyone, or do you have exceptions for rape and incest?

AKIN: As far as I’m concerned, the morning-after pill is a form of abortion, and I think we shouldn’t have abortion in this country. [...] The life of the mother, the situation there is one where what you want to do is optimize life, you try to save the mother’s life, you try to save the child. [...]

HOST: Just to be clear, though, you would like to ban the morning after pill totally for everyone?

AKIN: Yeah. I think that is a form of abortion and I don’t support it.

Progress Missouri has the audio:

Akin has a fundamental scientific misunderstanding of what the morning-after pill actually does. Essentially, the pill works by delaying ovulation rather than acting after fertilization. Studies show that the drug prevents pregnancy in women who take the pill before ovulation, while women who have already ovulated become pregnant at the same rate as if they had not taken the drug at all.

Despite the conclusive scientific evidence, many hard-liners like Akin have conflated the fertilization-blocking morning-after pill with fertilization-ending abortion. But if Akin believes that life begins when an egg is fertilized, the morning-after pill poses no friction to his worldview whatsoever.

Emergency contraception prevents pregnancy. Abortion ends pregnancy. It seems the distinction won’t slow Akin down.

– Steven Perlberg