Medicare will spend $511 billion less between now and 2020 than was predicted two and a half years ago, according to the latest number crunching by the Center On Budget and Policy Priorities. More importantly, this drop occurred completely separate from any changes in government policy — rather, it resulted from an overall slowdown in the growth of health care costs.

The last time the Congress and the President actually altered Medicare policy in order to bring down the program’s spending was when they passed health reform in March of 2010. By comparing the Congressional Budget Office’s projections from August of that year with their projections from earlier this month, and by leaving out the the SGR cuts and the Medicare cuts in sequestration, the CBPP was able to isolate how much Medicare’s spending is anticipated to drop due purely to changes in the health care markets. And the drop is considerably larger than the proactive cuts in Medicare spending the Simpson-Bowles plan was calling for back in December of 2010:

According to the CBO itself, its projections for Medicare and Medicaid spending between now and 2022 dropped 3.5 percent since its previous projection in August of 2012.

Spending on Medicare and Medicaid is the main driver of the country’s long-term debt problem. But because the programs buy health care, larger economic forces in the health care market that drive up costs also drive up their spending, regardless of any specific policy enacted by lawmakers. Conversely, if health costs begin to slow, that will bring spending down — and there’s evidence that’s exactly what’s happened over the last few years.

Between 2009 and 2011, all spending in the health care system, both public and private, grew at 3.9 percent — the lowest annual rates we’ve seen in 52 years. 2012 looks like it will turn out to be similarly sluggish. Some of this is certainly due to the recession and ongoing depression. But an increasing number of economists and experts are convinced a big piece of the slowdown is also a more permanent restructuring of the way health care markets buy, sell, and deliver care.

No small part of that change may be due, in turn, to the passage of Obamacare, which put in place a host of new incentives and reforms to move health care delivery in a more efficient direction. And if Obamacare’s reforms continue pushing the health care system to adapt, then the United State’s fiscal future could continue to improve without lawmakers having to cut a dime.

Scientists may be close to finding a cure for sickle cell anemia, a blood disease that disproportionately affects African-Americans.

One in 500 African descendants born in the United States suffer from sickle cell; one in 12 carry the gene for it. The disease can cause symptoms as minor as fatigue, or as major as organ damage. A person suffering from sickle cell has defective hemoglobin that leads to abnormally shaped red blood cells, which get caught in the veins and cause circulation issues.

But a long-term experiment run out of the University of Michigan Medical School found that doctors might be able to treat these symptoms by using an antidepressant:

Their study, which includes more than 30 years of research, found that the antidepressant tranylcypromine, or TCP, may essentially reverse the effects of the disorder.[...]

But while U-M scientists say it’s too early to test out TCP as a treatment for sickle cell disease, they’re confident their findings hold promise.[...]

The first clinical trial on TCP and its affect on sickle cell is now being planned with researchers at Wayne State University in Detroit. Further information will be available later this year if it receives approval to go forward.

African-Americans disproportionately struggle to access the health care they need. Socioeconomic and environmental reasons — and the root cause, racism — are, of course, the reason for the disparity. Ultimately, the lack of care for back communities might funnel down to the research level. It’s suspected that less funding is awarded for research toward diseases that affect black people at a higher rate than white.

More than 800 man-made chemicals found in everyday products — in your household cleaners, makeup, electronics, canned food, and clothing — are becoming “a global threat that needs to be resolved,” according to a new report from the World Health Organization and United Nations Environment Program. Research links these hormone-disrupting chemicals to a host of medical problems, including certain cancers, birth defects, and other diseases.

These chemicals include phthalates and BPA, which are both used in plastics. The U.S., Canada, and parts of Europe have banned them in some products for children, but Endocrine Distrupting Chemicals (called EDCs) still lurk in the hundreds of thousands around the world. “The vast majority of chemicals” in common use have not even been tested for safety, report authors wrote.

The report takes a more urgent tone on EDCs than a 2002 WHO report that found evidence of man-made chemicals’ harm to be “weak.”

Since then, the link between everyday chemical exposure and health problems has become clearer. A separate study last year showed that exposure can be harmful to humans even in small doses. The Food and Drug Administration and Environmental Protection Agency continue to study BPA’s dangers in low doses.

“Frankly, for BPA, the science is done. Flame retardants, phthalates … the science is done,” WHO report co-author Thomas Zoeller told Environmental Health News. “We have more than enough information on these chemicals to make the reasonable decision to ban, or at least take steps to limit exposure.”

But one major hurdle to addressing and regulating toxic chemicals in the U.S. involves battling industry groups like the American Chemistry Council and the U.S. Chamber of Commerce, which have waged campaigns against Environmental Protection Agency oversight of toxic chemicals.

This week’s issue of Time Magazine takes a deep dive into Americans’ medical bills and the roots of the U.S. health care industry’s rampant inflation — costs that force one in four American seniors into bankruptcy and over one in three Americans to forgo care.

The investigative piece highlights the exorbitant costs of the most commonplace procedures and medications, and how insurance coverage often falls through for Americans who encounter unaffordable out-of-pocket costs due to the rising price of health care technology and services. Furthermore, it is often impossible for patients to ascertain why they are being charged what they are for care — a pricing opacity that is truly unique to the service-centered health care industry. Here are the three biggest takeaways from the Time exposé on the unsustainable foundations of American health care costs — and some ideas for shifting the U.S. medical landscape towards a more equitable system:

The American Academy of Family Physicians and 16 other medical groups released a list today of 90 common tests and procedures that are frequently ordered unnecessarily and can even inflict more damage on a patient.

Unnecessary procedures include using feeding tubes for dementia patients, C-section deliveries for healthy women before 39 weeks of pregnancy, ultrasound tests for ovarian cysts, and CT scans for minor headaches. The list builds on a project initiated last year by the Choosing Wisely campaign, which seeks to trigger informed conversations about treatment between doctors and patients. Choosing Wisely asked each specialty group to come up with a list of 5 tests and procedures they feel were overused. Twelve other medical societies are expected to release more lists of questionable procedures later this year.

The list released today includes:

• Routinely performing annual PAP tests for women 30 to 65 years old.

• Prescribing antipsychotic medication as a first choice to treat behavioral and psychological symptoms of dementia.

• Prescribing testosterone in men with erectile dysfunction and normal testosterone levels.

• Screening healthy people — with no symptoms — for cancer using a PET/CT scan.

• Treating an elevated PSA in men with antibiotics when no other symptoms are present.

• Prescribing Xanax, Valium, Ativan, and other drugs known as benzodiazepines in older patients as a first choice for insomnia, agitation or delirium.

Alerting patients and doctors to dubious procedures not only helps fine-tune patient care, but could also go a long way toward trimming America’s intimidating health care costs. Even though Americans spend more on health care than any other developed nation ($2.7 trillion each year), the quality of care they receive often falls short. A recent analysis indicated that hospitals that spend more money on their patients are not necessarily giving them better treatment. As Dr. Christine Cassel, President of the American Board of Internal Medicine Foundation, observes, roughly one third of health care costs are wasted on unnecessary tests and procedures.

Furthermore, doctors are traditionally not trained to consider the financial costs of the tests they order, and usually omit financial factors when discussing treatment options with patients. Patients who actively seek out a procedure’s cost estimate have been stymied by wildly ranging prices, from $10,000 to $125,000 for a hip surgery, or $500 to $5,000 for an MRI.

The full list will be updated on Choosing Wisely’s website.

Nearly ten percent of the hysterectomies in the U.S. are now performed with robot-assisted technology, according to the results from a new JAMA study. Recent years have seen a dramatic increase in the number of women who are opting for the new technology, which can help make the procedure slightly less invasive than a traditional surgery — just about one in 200 hysterectomies were performed with surgical robots in 2007, and that figure jumped to almost one in 10 in 2010. But while medical advances now allow a woman to choose to have a robot remove her uterus, the anti-abortion community has ensured that women can’t take advantage of innovations in technology for every aspect of their reproductive health.

Robot-assisted hysterectomies are just one example of the way that science is evolving to give women more options for their reproductive health care. Although the authors of the study caution that those type of surgeries are more expensive than traditional hysterectomies, and may not be worth the cost, they still confirmed that the technique — which was approved by the FDA in 2005 — is just as safe as having a doctor perform the procedure. And as robot surgery is becoming increasingly common, other advances in reproductive care, like allowing doctors to consult with women remotely to prescribe an abortion pill via video technology, seem tame in comparison. But that doesn’t matter to the abortion opponents who will stop at nothing to restrict women’s reproductive rights.

Abortion consultations via video technology can help expand reproductive access for low-income women in rural areas, who often don’t live near an abortion clinic and can’t afford the transportation to travel to the closest one. But anti-choice activists have launched a campaign to ban the emerging technology, claiming that “webcam abortions” are an unsafe medical practice despite significant evidence to the contrary.

Taking the abortion pill doesn’t require the presence of a medical professional. Even when women make an in-person trip to a doctor’s office to get a prescription for the RU-486 abortion pill, they often return to their own homes to take the pill in privacy. To ensure there are no complications, women schedule follow-up visits with their doctors several days later — and studies have shown there is no difference between the women who visit a clinic for their follow-up and women who simply call their doctor on the phone. The use of video technology to allow doctors to consult with their patients from afar is a standard medical practice, one that the federal government uses to treat chronically ill veterans, and abortion services are the only area of health care where it’s restricted.

Anti-choice lawmakers decry remote abortion consultations as “robo-skype abortions,” a misleading way to describe doctors prescribing pills over a video chat. But there’s no similar outcry about the reproductive health services that are actually performed with robot technology — like robot-assisted hysterectomies, a procedure that conjures up scenes from science fiction movies. The message is clear: despite the fact that abortion is a constitutionally-protected aspect of women’s health care, abortion opponents have been incredibly successful at creating a double standard for abortion services. Advances in other areas of reproductive health are acceptable, but advances in abortion care are shut down before they can even begin to start helping women across the country.

An abortion pill, officially known as RU-486, is the earliest available abortion option for a woman. A patient could be as little as one week pregnant and take the pill to terminate. But despite the incredibly early stage at which the pill is administered, a new bill proposed in the Indiana State Senate would require women to undergo a transvaginal ultrasound before they are permitted to simply swallow the medication.

Indiana’s effort follows a sweeping national trend to mandate the medically unnecessary and invasive procedure as a way to create barriers to abortion access. And theirs goes a step further, by also forcing clinics that administer the pill to meet all of the same requirements as a surgical abortion clinic:

The provision is included in Senate Bill 371, which also would require any clinic that dispenses the drug — known as RU-486 — to meet the same requirements as a clinic that performs surgical abortions, though physicians’ offices would be exempt.

Those requirements, opponents say, potentially would force the Planned Parenthood clinic in Lafayette to close. That clinic offers the abortion pill but does not perform surgical abortions. If the bill passes, the clinic would have to widen hallways and doorways to meet state specifications for surgery and install anesthesia, surgical and sterilization equipment.

Twelve states already have unnecessary ultrasound laws on the books, and over a dozen more are being considered in state houses across the country. But the theory that legislators are peddling — that such laws might change a woman’s mind — ignore the simple fact that 90 percent of women feel very confident about their decision to get an abortion before seeing a doctor. A transvaginal ultrasound may cause a woman discomfort and cost her more money, but it’s unlikely to change her constitutionally-protected decision to get an abortion.

American children are still consuming far too many calories from fatty foods, even as U.S. adults have made modest cuts in their caloric intakes, according to a new report by the Centers for Disease Control (CDC).

Between 2009 and 2010, American adults cut back on eating pizzas, french fries, and other greasy fast foods by about two percent — and while children also reduced their caloric consumption in the aggregate, they still received a high share of their daily calories from saturated fats during that time period:

Recommended U.S. guidelines suggest that no more than 10 percent of one’s daily calories should come from such fat, but American youth took in between 11 percent and 12 percent from 2009 to 2010, data from the CDC’s National Center for Health Statistics showed.

Americans’ diets and weight is a source of constant scrutiny and research in a country where two-thirds of the population is considered overweight or obese. According to the CDC, 36 percent of U.S. adults, or 78 million, and 17 percent of youth, or 12.5 million, are obese. Another third are overweight. [...]

Still, Americans lead the world in calorie consumption. Portion sizes also have increased over the years, coupled with an increasingly sedentary lifestyle, have added up to extra pounds. Complications from obesity include diabetes, heart disease, arthritis and some cancers.

What is particularly worrying about the report is the fact that “those who are already obese” are among the groups that consumed the most unhealthy foods, highlighting the fact that not only does America remain ill-equipped to prevent obesity in its nascent stages, but is also failing to improve obese Americans’ health after the fact. That doesn’t bode well for national health expenditures, considering that somewhere between 10 and 12 percent of all health insurance spending is driven by obesity-related conditions.

Furthermore, the obesity epidemic is disproportionately impacting black Americans, who are more likely to excessively consume fatty and sugary foods. That isn’t just a coincidence — the food industry is notorious for its efforts to undermine public health with misleading ad campaigns and product information opacity, and those efforts are often targeted in low-income, racially diverse communities. Soda advertising campaigns in particular take aim at poor, young black Americans, contributing to a status quo where low-income black youth are far more likely to consume calories from sugary drinks.

Of course, that doesn’t mean there hasn’t been any progress in the war on American obesity. Public health advocates have successfully lobbied major food companies to cut back on sodium in their products, and are now asking the Food and Drug Administration (FDA) to pass rules cracking down on sweeteners in foods and drinks. The FDA has also taken efforts to eliminate fatty foods from school lunch menus. Still, the FDA and American food manufacturers could — and should — do much more, as historical evidence shows that localities with aggressive nutrition policies experienced significant drops in childhood obesity.