Several U.S. health-care groups delivered to President Obama Monday a plan for slashing some $2 trillion in costs to the public over the next decade. “We are committed to doing our part to make the system more affordable and effective for the nation,” the coalition of groups, representing doctors, private insurers, hospitals and the pharmaceutical industry, wrote to the president. While many of the proposed savings can be activated immediately, some will rely on “good public policy” in a proposed health industry overhaul that Obama wants Congress to enact by the end of the year. Among the ideas for saving big bucks are streamlining the way insurance claims are processed (about $700 billion), tightening the delivery of administrative services, better managing chronic illness ($350 to $850 billion) and avoiding unnecessarily treatments and duplications ($150 to $180 billion). According to the American Medical Association, billions can be saved by following evidence-based treatment guidelines. As an example, the group cites the fact that more and more births are the result of induced labor, which is not always consistent with treatment guidelines. Births by caesarean section are responsible for almost half of the more than $79 billion in annual hospital charges for childbirth, the AMA notes. But not everybody is convinced that the savings will amount to as much as the medical profession suggests. “I’m skeptical that these proposals will add up to anywhere near $2 trillion,” said Sen. Charles Grassley, the top Republican on the Senate Finance Committee which is helping write the overhaul.

Patients who have suffered chronic heart failure can feel better with moderate exercise, and it’s safe, according to two articles published in the Journal of the American Medical Association. Even though fewer than half of patients in the study group were complying fully with the recommended exercise regimen – the equivalent of brisk walking or stationary cycling for about two to three hours a week – the benefits shouldn’t be overlooked, given the poor quality of life many chronic heart failure patients have, says Clyde Yancy, M.D., medical director of the Baylor Heart and Vascular Institute in Houston. “Having any strategy that’s reasonable, that has the potential to help even a little bit, is pretty important,” says Yancy, who was not involved in the research. “The real gain might be in helping our patients feel better.” Some 5 million people in the United States have chronic heart failure, in which the heart becomes too weak to pump blood through the body effectively. Not too long ago, bed rest was the standard treatment for these patients, who suffer from fatigue, difficulty breathing, and swelling of the legs, among other symptoms. But for the past 20 or 30 years, evidence has been trickling in to show that these patients can actually benefit from being active, says Kathryn E. Flynn, Ph.D., of Duke University School of Medicine in Durham, North Carolina.