HCR Update from Mark Sanna: Tomorrow is the long-awaited kickoff for President Obama's signature health care law, when millions of Americans can start signing up for new insurance options. Yet across the country, officials are issuing warnings that despite fevered efforts, their new insurance exchanges — online markets where people can shop for health plans and see if they qualify for federal subsidies — will not be fully operational for weeks or even months.

HCR Update from Mark Sanna: Two-thirds of the public are not aware when the new online marketplaces open to allow people without employer coverage to shop and purchase their own health policies, according to a poll by the Kaiser Family Foundation. These exchanges open Tuesday. Despite outreach efforts by the Obama administration and supporters of the law, the poll found the number of uninsured unaware of the opening date is even greater than the public at large, with three out of every four not knowing the marketplaces are supposed to open in October.

HCR Update from Mark Sanna: According to a report in ProPublica, during the last decade, more than 1,500 Americans died after accidentally taking too much of a drug renowned for its safety: acetaminophen, one of the nation's most popular pain relievers. Acetaminophen – the active ingredient in Tylenol – is considered safe when taken at recommended doses. Tens of millions of people use it weekly with no ill effect. But in larger amounts, especially in combination with alcohol, the drug can damage or even destroy the liver.

HCR Update from Mark Sanna: Injecting steroids into the area around the spinal cord, known as an epidural, is the most commonly used treatment for back pain, but a new review of studies suggests that injecting any liquid, even plain saline solution, works just as well. Researchers pooled the results of 43 studies involving more than 3,600 patients who got various kinds of injections for back pain. The study, published online in Anesthesiology, found that there was little difference between the amount of relief provided by steroidal and nonsteroidal epidural injections.

HCR Update from Mark Sanna: Federal officials often say that health insurance will cost consumers less than expected under President Obama’s health care law. But they rarely mention one big reason: many insurers are significantly limiting the choices of doctors and hospitals available to consumers. From California to Illinois to New Hampshire, and in many states in between, insurers are driving down premiums by restricting the number of providers who will treat patients in their new health plans.

HCR Update from Mark Sanna: A group seeking to persuade young people to "opt out" of President Obama’s health care law posted videos on YouTube Thursday that show young patients on exam tables recoiling in fear as a character the group is calling "Creepy Uncle Sam" appears out of nowhere and looms over them. The group, Generation Opportunity, said in a news release that the videos were part of a new, six-figure campaign to educate people between the ages of 18 and 29 about "alternatives to expensive and creepy Obamacare exchanges".

HCR Update from Mark Sanna: A new study published on Thursday in The New England Journal of Medicine provides the best evidence yet that wearing a back brace will slow the progression of the most common form of scoliosis in adolescents, helping them avoid painful spine surgery. Researchers analyzed data on 242 patients at 25 sites across the United States and Canada. The children were all aged 10 to 15 and still growing, and they all had a spinal curvature of 20 to 40 degrees. The rate of treatment success was 72% among children with bracing. The benefit increased the longer bracing was worn. More than 90% of the children who were successfully treated wore their braces more than 13 hours a day.

HCR Update from Mark Sanna: The White House warned consumers on Wednesday to beware of possible fraud by con artists taking advantage of the new insurance marketplaces being set up under President Obama’s health care law. White House officials said that consumers should be suspicious if anyone asked them for money to enroll in a health plan offered through an insurance exchange. Legitimate insurance counselors and “enrollment assisters” will not ask for money, they said.

HCR Update from Mark Sanna: Federal health officials reported Monday that at least two million Americans fall ill from antibiotic-resistant bacteria every year and that at least 23,000 die from those infections, putting a hard number on a growing public health threat. It was the first time that federal authorities quantified the effects of organisms that many antibiotics are powerless to fight.

HCR Update from Mark Sanna: The case for regulating electronic cigarettes grew even stronger this month when the Centers for Disease Control and Prevention reported a notable increase in their use by high school and middle school students. A national survey found that the percentage of high school students who had ever smoked e-cigarettes jumped to 10% in 2012 from 4.7 percent in 2011; for middle school students (grades six to eight), the figure rose to 2.7% from 1.4%.

HCR Update from Mark Sanna: This week JAMA Pediatrics published the results of the first home-based study to address key household routines related to obesity risk among preschool-aged children. Families in the study were taught to increase their children’s sleep duration and reduce their children’s TV viewing on weekends. The result? Children who participated in the study decreased their BMI a key measure of obesity.

HCR Update from Mark Sanna: Bearing a child is still one of the most dangerous things a woman can do. It's the sixth most common cause of death among women age 20 to 34 in the United States. If you look at the black-box warning on a packet of birth control pills, you'll notice that at most ages the risk of death from taking the pills is less than if you don't take them—that's because they're so good at preventing pregnancy, and pregnancy kills. ... In the United States today, about 15 women die in pregnancy or childbirth per 100,000 live births.

HCR Update from Mark Sanna: No one joins Facebook to be sad and lonely. But a new study from the University of Michigan psychologist Ethan Kross argues that that's exactly how it makes us feel. Over 2 weeks, researchers sent text messages to 82 Ann Arbor residents 5 times per day. The researchers wanted to know a few things: how their subjects felt overall, how worried and lonely they were, how much they had used Facebook, and how often they had had direct interaction with others since the previous text message. They found that the more people used Facebook in the time between the two texts, the less happy they felt—and the more their overall satisfaction declined from the beginning of the study until its end. The data, they argue, shows that Facebook was making them unhappy.

HCR Update from Mark Sanna: Small business owners who thought they were off the hook for ObamaCare regulations until 2015 may be in for an expensive wake-up call next month. Beginning Oct. 1, any business with at least one employee and $500,000 in annual revenue must notify all employees by letter about the Affordable Care Act’s health-care exchanges, or face up to a $100-per-day fine. The requirement applies to any business regulated under the Fair Labor Standards Act, regardless of size. Going forward, letters are to be distributed to any new hires within 14 days of their starting date, according to the Department of Labor.

HCR Update from Mark Sanna: The promise from President Obama was straightforward enough: "If you like your health care plan, you can keep your health care plan. Period. No one will take it away," he said. That was four years ago, during the build-up to the passage of the Affordable Care Act. Just months before several major provisions of the law take full-effect, many Americans still aren't sure whether to believe him. And for good reason. Wildly conflicting predictions are being reported almost daily.

HCR Update from Mark Sanna: The FDA announced Friday that it had found no evidence that current levels of arsenic in rice pose an immediate health risk. The finding comes 2 months after the agency proposed new limits on arsenic in apple juice. The agency tested more than 1,300 types of rice and rice products, like rice cakes and infant cereals, and found that arsenic levels ranged from 3 to 7 micrograms per serving, amounts that the agency said were not hazardous to human health in the short term. Arsenic is a carcinogen when consumed in large enough quantities. It occurs naturally in the environment, but it can also be an effect of industrial contamination.

HCR Update from Mark Sanna: Something unusual happened just before Congress left for its summer break. The House Energy and Commerce Committee voted 51-0 for a bill that would overhaul the way Medicare pays doctors. The bill would, among other things, repeal something called the sustainable growth rate formula, or SGR, and eventually replace it with a system that would pay doctors based on how healthy they keep their patients.

HCR Update from Mark Sanna: The number of physicians accepting new Medicare patients rose by 1/3 between 2007 and 2011 and is now higher than the number of physicians accepting new private insurance patients, according to a Department of Health and Human Services report. In 2007, about 925,000 doctors billed Medicare for their services. In 2011, that number had risen to 1.25 million, according to the report.