Health affairs
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Medical care and primary care were at one time synonymous. All health care was primary. ⋯ The essential point is that "primary care" was born out of tension with other forms of medical care. In the future, primary care will be reinvented, and changes will be caused by the sorts of external social, political, and economic forces that previously led to systemic transformation.
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The concept of accountable care organizations (ACOs) has been set forth in recently enacted national health reform legislation as a strategy to address current shortcomings in the U. S. health care system. ⋯ We seek to clarify definitions and key principles, provide an update on implementation in the context of other reforms, and address emerging issues that will affect the organizations' success. Finally, building on the initial experience of several organizations that are implementing accountable care and complementary reforms, we propose a national strategy to identify and expand successful approaches to accountable care implementation.
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Taxes on sugar-sweetened beverages have been proposed to combat obesity. Using data on state sales taxes for soda and individual-level data on children, we examine whether small taxes are likely to change consumption and weight gain or whether larger tax increases would be needed. ⋯ We do find, however, that subgroups of at-risk children--children who are already overweight, come from low-income families, or are African American--may be more sensitive than others to soda taxes, especially when soda is available at school. A greater impact of these small taxes could come from the dedication of the revenues they generate to other obesity prevention efforts rather than through their direct effect on consumption.