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For competition to revolutionize the insurance market, enrollees have to actually force insurers to compete for their business. Happily, that's exactly what enrollees did. (Ezra Klein, 4/14)

A large national payer recently announced the opportunity for Accountable Care Organizations (ACOs) to share in 100 percent of the savings they create for the payer’s largest book of business. Providers will have complete autonomy in how they manage the health of their population, and the payer will ensure the timely flow of datasets needed to support care improvement activities. The payer will pre-define the ACO’s population and its spending benchmark, which will be adjusted for the risk of the ACO population. Consumers aligned to the ACO will be offered supplemental benefits and financial incentives to seek care from the ACO’s network. (Chris Dawe, Nico Lewine, and Mike Miesen, 4/15)

How would you react if you sent your sputtering car to the auto mechanic, and they stopped trying to diagnose the problem after 15 minutes? You would probably revolt if they told you that your time was up and gave back the keys. Yet in medicine, it’s common for practices to schedule patient visits in 15-minute increments—often for established patients with less complex needs. Physicians face pressure to mind the clock while they examine you. (Peter Pronovost, 4/15)

We were recently involved in a new report that analyzed prevention measures across all 50 states. It looked at prevention through the lenses of access to health care, immunizations, and efforts to prevent chronic disease. The final report, United Health Foundation’s America’s Health Rankings Spotlight: Prevention, released in partnership with the American College of Preventive of Medicine, revealed troubling disparities in access to recommended preventive care. (Reid Tuckson and Daniel S. Blumenthal, 4/15)

In newspaper ads across America, an entity calling itself the American Action Network encourages seniors to call their congressmen and voice their opposition to a bill that would, supposedly, harm Medicare beneficiaries. The American Action Network is not a grassroots of organization of seniors, although you might think that from the ads, one of which has appeared in The Des Moines Register. They depict seniors and use the phrase, “Don’t Cut Our Medicare!” (4/14)

The United States should be a land of opportunity in which every child born into poverty has a fair chance to succeed in life. Yet a major study published in the Journal of the American Medical Association provides insight into why there is a growing gap between a person's income and life expectancy. Even with these findings, the report can guide how future health care policies address these inequalities. (Ezekiel J. Emanuel and Topher Spiro, 4/14)

The briefs are in -- and the Supreme Court’s extraordinary effort to bring about a compromise in a contraceptive care case looks like a bust. Instead of finding a mutually agreeable solution, religious groups and the federal government appear to have only hardened their positions. (Noah Feldman, 4/13)

As much fun as it is to start fiddling with a new gadget right out of the box without looking at the manual, it’s nice to know there is a manual if I just can’t get the thing to do what I want. Kids, though. Eesh. My wife and I are blessed with boys we can take just about anywhere, but there are still times they won’t do what we want. They draw on the wisdom of “Star Wars” to explain what’s wrong when the other one isn’t minding: “He has a bad motivator.” Indeed. And unlike an R2 unit, the boys didn’t come with manuals that say how we might get them moving. (Richard Espinoza, 4/14)

Cancer is the leading disease-related cause of death in children in the United States. Yet pediatric cancer is often left behind when it comes to funding research and developing new drugs. Not only does this give short shrift to children with cancer, but it also threatens to rob us of advances that could benefit cancer patients of all ages. (David Williams, 4/14)

Hospitals continue to struggle with long-standing patient safety issues, such as leaving sponges and towels inside of patients having surgery and failing to create a culture where staffers speak up about mistakes. That's according to the third annual report on the year's top patient safety issues from the ECRI Institute, a not-for-profit health research agency. (Sabriya Rice, 4/13)