Angelina Jolie’s announcement that she underwent a double mastectomy to protect against a genetic form of breast cancer inspired widespread surprise and admiration. With her op-ed revelation in the New York Times, she put herself forward as a role model for millions of women who face a similar dilemma. Such candor and forthrightness are rare among celebrities.

Yet, she is extremely fortunate in one respect. She has the financial resources to afford both the testing that found her heightened risk and the consequent surgery. As she noted in her op-ed, many women do not.

The test can cost more than $4,000 and the surgery many times that. Insurance coverage varies widely. Many women do not find out they have a defective gene because they cannot afford to. And if they do find out, they cannot afford protective steps like surgery.

Not so easy, is it?

Childhood obesity affects 1 in every 3 children, but most parents are uncomfortable talking with their children about weight, not knowing what to say or how to say it. For many of us, questions about a child’s weight are particularly difficult to answer, since feelings about overweight and obesity are often complicated by both personal issues and the conflicting messages communicated about weight through media and society at large. In fact, a WebMD/Sanford Health survey found that parents of teens find it more difficult to talk about weight with their child than talking about sex, drugs, alcohol or smoking.

The issue is compounded by the fact that there are limited resources to help parents respond to their children’s questions about weight. Parents looking online or in a local library for information on how to address a child’s weight would be hard pressed to come up with something that is useful or goes beyond the basic rhetoric about eating less and exercising more.

The Health Insurance Portability and Accountability Act (HIPAA) was enacted in part to protect private patient health information from disclosure to unauthorized sources. The confidentiality section of HIPAA provides severe penalties in response to most unauthorized disclosures.

However, the law provides exceptions for disclosing patient health information in certain circumstances, including “to avert serious and imminent threats to health or safety.” But many health care providers are so concerned with the consequences of a HIPAA violation that they are overly cautious and refuse to disclose patient information, even when permitted by an exception.

According to a government memo describing a recent House Energy and Commerce Subcommittee on Oversight and Investigations hearing aimed at exploring “how HIPAA may interfere with patient care and public safety, either through misunderstanding, or proper application, of the law,” some healthcare providers “apply HIPAA regulations overzealously” preventing family members and law enforcement from obtaining needed information.

In recent months, I have been witness to a genuine groundswell of interest in improving the methods in which patient safety measures are taught, across the board, in medical education.

In January, there was the release by the Association of American Medical Colleges (AAMC) of “Teaching for Quality,” a report on integrating quality improvement and patient safety across the continuum of medical education.  The report articulates a broad vision for health care delivery, offers a strategy to increase faculty capacity, and makes three core recommendations focused on quality improvement and patient safety. I have been on the steering committee at the AAMC since the inception of this program, therefore I can vouch that the report addresses the need to increase the capacity of the academic medical centers, teaching hospitals, and medical schools of the U.S. to meet the challenges of health care in the 21^st century. These challenges are numerous and include healthcare redesign, accountable care, cost containment, and the quality of care gap.

On top of “Teaching for Quality,” there was the announcement that the American Medical Association (AMA) will award $10 million in grants over five years to a group of medical schools to engage in a broad range of teaching innovations, including new ways of teaching and assessing core competencies, individualized learning plans, and a greater focus on patient safety, quality improvement and health care financing.

They tried to vote it down in Congress. Then they tried to convince the Supreme Court that it violates the Constitution. Then they tried to convince the voters to elect a president who would repeal it. Then they tired to convince Congress to repeal it.

So far, they have lost every time. But they haven’t given up.

Obamacare opponents are, yet again, intensifying their efforts to block implementation of the law. This time, they are appealing to the court of public opinion.

Vaccines save lives. It has been proven time and time again for diseases ranging from polio to measles to the flu. The more people a community has who are vaccinated, the healthier it is.

Those who remain unvaccinated leave themselves susceptible to serious infectious diseases. This puts everyone else at risk. That is why every state mandates that children receive vaccinations against a number of diseases, including polio and measles, as a condition of entering school.

If vaccination rates were to significantly decline, the United States could face a public health crisis.

Curt Schroder is the regional executive, Delaware Valley Health Care Council of HAP, the association for southeastern Pennsylvania hospitals.

Pennsylvania is in the midst of a discussion about whether to expand Medicaid under the health reform law to cover residents up to 138% of the federal poverty level. Because Medicaid covers care for many of the commonwealth’s neediest patients, hospitals have a lot at stake. But so does the economy of the entire state.

To get a better idea of what expanding Medicaid would mean, we commissioned a study by a major national research organization, RAND Health. Their report has been followed in the last week or so by two similar studies released by respected research groups in Pennsylvania—the Pennsylvania Economy League, and the commonwealth’s Independent Fiscal Office. 

The saying “There is no such thing as a free lunch” has been popular for decades. But in the case of physicians using Groupons, there may be another applicable saying, “There is no such thing as a good deal.” From both the patient and physician perspective, offering daily deals for medical procedures can be risky.

Groupon and other daily deal sites became popular several years ago as buyers saw benefit in buying a coupon that would allow them to pay for services at typically half the retail cost. While most daily deals are offered for restaurants, haircuts, and vacations, some physicians, particularly plastic surgeons, have offered deals for noninvasive procedures.

In a typical Groupon transaction, a business (or medical practice) agrees to sell its product or service at a discount to the public and Groupon offers the discounted product or service through online media. Individuals pay Groupon directly, and Groupon reimburses the business half of the amount it collects. The discounted service is typically 50 percent off retail to begin with, which means that a plastic surgery practice that participates in Groupon receives about 25 percent of its normal retail charges.

The Supreme Court hearing yesterday on whether human genes can be patented cuts to the heart of law, science, and even philosophy. Should a firm have the exclusive right to use the genetic code in your cells?

Patients, researchers, and much of the life sciences industry have a lot at stake.

But beneath it lies a deeper issue that may be more important in the long-run. Who should own the aggregated information that companies compile though gene patents? The issue was not raised in the hour-long hearing by the lawyers or the justices, but it's critical.