Late Friday afternoon the United States budget standoff continued, with the threat of a partial government shutdown still looming (share your shutdown worries here).

If the government shuts down, here's what it will mean for three key agencies that affect your health:

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The White House is saying “Happy Birthday” to the Patient Protection and Affordable Care Act , signed into law by President Obama one year ago today. But you might not hear many celebrations.  Legal challenges were once considered a longshot, but more than two dozen states have signed on to lawsuits to try to overturn the PPACA, winning victories in Florida and Virginia. The Supreme Court seems likely to have the final word.

More subtly, some states – especially those led by Republicans – are simply refusing to implement parts of the law. In Georgia last month, Gov. Nathan Deal killed an effort to start developing a health insurance “exchange” – an organized marketplace to make comparison-shopping easy – even though the PPACA requires an exchange in every state by 2014.

Even among supporters, the birthday celebration is muted because it’s too soon to tell whether the law is a success.

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 In an effort to improve the communications between doctors and patients, the American Society of Clinical Oncologists (ASCO) just released a new policy statement and a patient guide for conversations about the time when treatment options run out.

"While improving survival is the oncologist's primary goal, helping individuals live their final days in comfort and dignity is one of the most important responsibilities of our profession," says ASCO president, Dr. George W. Sledge, Jr.   The organization is urging its members to make the first move and initiate these very difficult conversations.

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Electronic medical records,  also known as EHRs, often touted as a powerful antidote for uncoordinated and ineffective medical care, do little to help patients outside the hospital, according to a new study.

Researchers from Stanford University analyzed federal data on more than 255,000 patients, about a third of whom had health information carried electronically. The researchers compared the care of those patients to the care of patients without EHRs, on 20 different measures of quality – for example, whether proper medication was prescribed for patients with asthma or simple infections, or whether smokers were counseled on ways to quit. On 19 of the 20 measures, there was no benefit from having an EHR. The one exception was dietary advice: Patients at high-risk for illness were slightly more likely to receive counseling on a proper diet.

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Most Americans - 85% of adults - say they use seat belts regularly - an all-time high,  according to a new report from the Centers for Disease Control and Prevention. And while this is strong improvement compared with  only 11% wearing seat belts in 1982, more can be done, says the CDC's director, Dr. Thomas Frieden.

"Not wearing seat belts is costing us lives and money," Frieden told reporters Tuesday. According to the agency's newest report on seat belt use and nonfatal car accidents among adults, auto crashes are the leading cause of death in the United States for people ages 5 to 34.
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Along with noisemakers, hangovers and second-tier bowl games, the new year rolls in changes to health insurance rules that stand to save Americans – especially those over age 65 – a lot of money in 2011. The Affordable Care Act (ACA) – “Obamacare,” to critics – was signed into law in March but was built to take effect in stages. Several key provisions take effect on Saturday.

The most prominent change will shrink the so-called “doughnut hole.” Up to now, seniors hit the doughnut hole once they and their insurer have purchased $2,800 worth of medications. The next chunk – up to a $4,550 out-of-pocket maximum – cannot be reimbursed by insurance. Under the ACA, the gap will be closed in increments over the next 10 years. It starts Saturday; in 2011 Medicare will pick up half the cost of brand-name medications for patients in the dreaded doughnut hole.

Another 2011 change is a federal requirement that health insurers pay at least 80 percent of the total premiums they collect, on small plans. Plans for large employers, which cover most Americans, will have to pay out at least 85 percent of premiums. Those who don’t will have to offer rebates. Insurers who raise rates more than 10 percent will have to justify the increase to state and federal regulators. FULL POST

Editor’s note: This week, The Chart is taking a closer look at the most important health stories of 2010. Each day, we'll feature buzzwords and topics that came to the forefront over the past year.

The Patient Protection and Affordable Care Act. Who could be against something with a name like that?

At times in 2010, it seemed the answer was “everyone.”

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Lindsay Lohan apparently had an "incident" at the Betty Ford Center, where the actress allegedly assaulted an employee. Authorities in Palm Desert, California, said they are investigating this claim.

And the employee, Dawn Holland, was fired after information leaked to the media. The center issued a statement, but did not identify Holland:

"When patients come to the center for treatment, they come to a safe place where their identity is protected, where anonymity is safeguarded," the center said. "Regrettably, on December 21, 2010, one of our employees violated strict confidentiality guidelines and laws by publicly identifying patients in a media interview and by disclosing a privileged document. That employee has been terminated by the Betty Ford Center."

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Health insurance companies trying to bump up rates by more than 10 percent will have to answer to federal regulators, according to a new plan announced by Health and Human Services Secretary Kathleen Sebelius Tuesday.  The proposed rule explains how the government will oversee insurers as required by the massive health care bill – the Affordable Care Act – that was signed into law this spring.

After 2011, regulators will decide on a state-by-state basis which rates will be reviewed.

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There has long been mystery surrounding how much, and to whom, drug companies give money.

Now, ProPublica has put together all of these disclosures that have been appearing recently on the Web. The resulting project, called Dollars for Docs reveals that about $258 million worth of compensation from seven companies went to health care providers in 2009 and 2010.

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