Considering that the United States spends more than any other developed nation on its health care — the U.S. spent almost $2.6 trillion, nearly 18 percent of its GDP, on health services in 2010 — Americans might hope they’re getting some bang for their buck. But since the U.S. health care system is ranked a distant 37th compared to other countries around the world, that doesn’t seem to be the case. And a new study suggests that national trend might hold true on a smaller level as well, since the hospitals that invest more money in their patients aren’t necessarily providing them with any better treatment.

In an attempt to discern an overall trend, a Virginia-based nonprofit research institution analyzed more than 60 studies comparing health care spending with health care quality. The studies ranged in scale from individual hospital to state-wide data, and they each measured “quality” by tracking information like whether hospitals that spent more money on their patients had fewer in-hospital deaths, whether the doctors and nurses working in those hospitals followed guidelines better, or whether states that spent more money on their Medicare programs did a better job of treating their older residents’ conditions.

But the researchers didn’t find any common thread between the dozens of studies. “The bottom line was that no matter how you drill down into the results, at every level the results are just all over the map,” researcher Peter Hussey told Reuters Health.

Hussey explained that, in order to figure out which areas of our health care system can be cut without threatening to sacrifice the quality of Americans’ care, the U.S. needs to do more research on the patient outcomes that are likely directly related to specific types of health spending.

Better communication between doctors and patients could also help health costs from continuing to rise. Patients don’t always understand the cost and quality comparisons between different types of medical treatment, and sometimes agree to unnecessary, costly measures that they believe will safeguard their health. As a Kaiser Health News reporter’s struggle to discern the cost of her doctor-recommended MRI scan illustrates, even the savviest patients often can’t figure out how expensive their procedures are. And one doctor from Harvard Medical School told Reuters that many medical professionals are also part of the problem, since most of them don’t have any idea what the drugs they prescribe or the tests they order actually cost their patients.

According to the Guttmacher Institute’s annual report on state-level abortion legislation, anti-choice lawmakers enacted the second highest number of new abortion restrictions in 2012 since the organization began tracking the annual data in 1985.

This past year, 19 states passed 42 different provisions intended to restrict women’s access to abortion services — second only to the record-breaking 92 anti-abortion provisions that were passed in 2011:

Guttmacher’s analysis tracked abortion-related “provisions” rather than laws, since states passed women’s health laws that often contained several relevant provisions — contributing to the fact that the new anti-abortion legislation was highly geographically concentrated. Twenty three of the new restrictions, over half of the total number of anti-abortion restrictions passed in 2012, were enacted in just six states.

Arizona topped the list by enacting seven abortion restrictions, including a stringent 20-week abortion ban that currently has the unfortunate distinction of being the harshest law in the nation. Not to be outdone, Kansas, Louisiana, Oklahoma, South Dakota and Wisconsin each enacted at least three pieces of anti-abortion legislation to limit their residents’ reproductive rights as well.

Most of the new anti-choice provisions enacted in 2012 restricted abortion access by banning later-term abortions, denying insurance coverage for abortion services in the health exchanges created under Obamacare, and limiting the availability of medicine-induced abortions. On the other hand, exactly zero laws were enacted in 2012 to improve women’s access to abortion, increase the availability of family planning services, or expand comprehensive sexual education programs.

A new study from reproductive health researchers in Oakland, CA finds that the majority of countries ease women’s access to reproductive health services by making birth control pills available over the counter. The United States is one of 45 countries that still require women to obtain a prescription for oral contraceptives.

The lead researcher of the study, Dr. Daniel Grossman, noted that a pattern emerged along economic lines — perhaps because countries that tend to have residents with lower incomes have invested more in family planning services:

“The patterns we saw were interesting,” said Grossman. “Higher income countries — western Europe, Australia, Japan and North America — generally require a prescription.”

Grossman told Reuters Health he couldn’t explain why these patterns have emerged.

“Perhaps in places like China and India that have pills available over-the-counter formally without a prescription might be consistent with strong national family planning programs,” he speculated.

But ensuring robust family planning programs and accessible contraceptive services is a smart economic policy for wealthier countries as well. Women here in the U.S. report that having readily available access to birth control is essential to helping them achieve their economic goals, since family planning resources allow them to delay having children until they are financially prepared to support dependents. And studies show that eliminating barriers to effective forms of contraception lowers the rates of unintended pregnancy — which cost taxpayers an estimated 11 billion dollars annually in public insurance coverage.

New guidelines from the American College of Obstetricians and Gynecologists recommend that the U.S. amend its policy to allow women to purchase birth control pills without a prescription. Oral contraceptives are the most popular form of birth control, but the outdated practice of requiring women to visit the doctor to obtain a prescription leads some women to take their pills less regularly and compromise the method’s effectiveness.

The last-minute compromise negotiated to avert the so-called “fiscal cliff” provides some immediate solutions for enacting tax policies, but simply punts other fiscal questions — most notably, an agreement on raising the national debt limit — further down the line. The deal also prioritizes short-term fixes for cutting health care spending over more permanent solutions that would help safeguard the futures of the Medicare program and its beneficiaries.

During last month’s back-and-forth negotiations, earlier proposals from President Obama included a permanent repeal of the “doc fix” — an short-term funding patch that is negotiated annually to make up the difference between the current formula for calculating Medicare reimbursement rates and the money needed to keep doctors’ salaries stable. But the final deal doesn’t, falling back on the temporary doc fix to delay addressing the issue for another year:

The tentative deal shaping up would solve one problem — temporarily. Doctors are facing a nearly 27 percent cut in Medicare payments in January — another yearly collision with the flawed payment formula known as the Sustainable Growth Rate, or SGR. The fiscal cliff package being negotiated would include another one-year “doc fix.” [...]

Congress’s ad hoc yearlong solutions don’t alleviate the uncertainty physicians face as they make decisions about, for instance, whether to take new Medicare patients. Nor does a one-year fix resolve the annual crisis created by the broken formula in the first place.

Rather than relying on a quick fix to address a perennial problem, Congress could help keep Medicare costs down by reforming the payment structure altogether, and particularly by eliminating fraud and administrative waste in the program. Hospitals are already receiving as much as $33 billion in excess Medicare payments, and the program currently pays disproportionate rates for specialty services compared to the payments that primary care physicians receive. Addressing these issues will cut down on Medicare spending without compromising seniors’ benefits or shifting costs onto elderly Americans.

A proposal from the Center for American Progress estimates that making serious reforms to Medicare reimbursement rates — ultimately bringing them more in line with the actual costs of health care — would result in $88.6 billion in savings. The fiscal cliff compromise, on the other hand, seeks to collect about $25 billion in Medicare savings to offset the cost of the temporary doc fix for another year.

Global health experts worry that a new breed of malaria that has arisen in South Asia could reverse trends in the fight against the disease, since it has proven resistant to the drugs usually used to treat malaria infections.

Cases of malaria are currently treated with a drug called artemisinin, which typically clears the Plasmodium parasite that causes malaria’s symptoms from humans within about 24 hours. However, a new strain of the disease has sprung up on the Thailand-Myannmar border that has shown the ability to cling to its host for three days or more after the administration of treatment. Should this form of malaria spread, the results could be catastrophic:

“We know what will happen in Africa when resistance is bad because we’ve been there before in the 1990s with chloroquine (another anti-malarial drug) … millions of deaths,” [malaria researcher Dr Francois Nosten] warned.

“We must prevent artemisinin resistance reaching Africa, but we also need to control it for the people in Asia – for their future.”

Twenty years passed between the evolution of a strain of malaria resistant to the then-prevelant treatment of choloroquine in the same South Asian region before it migrated to Africa. While the disease does eventually fall to arteminsin treatment still, the inability of the patient to find relief from malaria’s high fevers is likely to raise the mortality rate among those infected with the new strain. In 2010, malaria caused the deaths of an estimated 660,000 people, with Africa having the highest infection rate of any continent.

That number has fallen in recent years, thanks to a concerted effort to halt the spread of malaria and other diseases by programs such as the Global Fund and the United States’ PEPFAR. However, the gains that have been made since a funding surge from 2004-2009 are proving fragile as budgets have leveled off. The World Health Organization’s World Malaria Report 2012 warned of the potential for backsliding as funding for anti-malarial bed nets, the best prevention for infection, has frozen.

Researchers in the region continue to strive towards new and improved drugs to treat malaria amid the uptick in new cases. Whether the research will yield results in time to halt the progress of new malarial strains is yet to be seen.

On the Friday between the Christmas and New Year’s holidays, Gov. Bob McDonnell (R-VA) quietly approved new, stringent regulations intended to target abortion clinics. Virginia’s Board of Health adopted the new anti-abortion rules in September, and the governor’s certification is the next step toward making the regulations permanent — and potentially forcing many of the state’s 20 abortion clinics to close their doors.

A spokesperson for McDonnell explained the governor advanced the anti-abortion rules because he believes “these common-sense regulations will help ensure that this medical procedure takes place in facilities that are modern, safe and well-regulated, in order to help ensure the safety and well-being of all patients.” But women’s health advocates designate this type of legislation as the “Targeted Regulation of Abortion Providers” (TRAP) because — rather than doing anything to ensure women’s safety — they actually over-regulate abortion providers as an indirect method of restricting women’s reproductive rights. TRAP laws force many abortion clinics to close when they find themselves unable to comply with complicated, expensive standards.

Even though Virginia’s Board of Health is intended to operate as a nonpartisan medical body, the fight over enacting the new clinic regulations has become intensely political — a growing trend among state-level boards, which anti-abortion advocates are increasingly using to advance their anti-choice agendas.

When the Board considered the new rules before their final vote, protesters and women’s health advocates were barred from speaking during the hearing, and only a limited number of people were even permitted to enter the room. And it turned out State Attorney General Ken Cuccinelli (R) was essentially threatening Virginia’s Board — which ended up approving the TRAP laws by a 13-2 vote — by warning members they could be denied state-funded legal services if they voted to relax the clinic regulations. In October, Virginia health commissioner Dr. Karen Remley resigned from her position on the Board in protest of the regulations, citing her disapproval of the proposed TRAP laws as the primary reason she could no longer serve “in good faith.”

Now that McDonnell has approved the regulations, they will be sent back through the process of review by the Board of Health following a 60-day public comment period. According to the Richmond Times-Dispatch, the permanent regulations are expected to be adopted by this summer.