As 2013 nears to a close, the year's top health news story -- the fumbled debut of the Affordable Care Act, often dubbed Obamacare -- continues to grab headlines.
The Obama administration had high hopes for its health-care reform package, but technical glitches on the federal government's HealthCare.gov portal put the brakes on all that. Out of the millions of uninsured who stood to benefit from wider access to health insurance coverage, just six were able to sign up for such benefits on the day of the website's Oct. 1 launch, according to a government memo obtained by the Associated Press.
Those numbers didn't rise much higher until far into November, when technical crews went to work on the troubled site, often shutting it down for hours for repairs. Republicans opposed to the Affordable Care Act pounced on the debacle, and a month after the launch Health and Human Services secretary Kathleen Sebelius told Americans, "You deserve better, I apologize."
Also apologizing was President Barack Obama, who in November said he was "sorry" to hear that some Americans were being dropped from their health plans due to the advent of reforms -- even though he had repeatedly promised that this would not happen.
However, by year's end the situation began to look a bit rosier for backers of health-care reform. By Dec. 11, Health and Human Services announced that nearly 365,000 consumers had successfully selected a health plan through the federal- and state-run online "exchanges," although that number was still far below initial projections.
And a report issued the same day found that one new tenet of the reform package -- allowing young adults under 26 to be covered by their parents' plans -- has led to a significant jump in coverage for people in that age group.
Another story dominating health news headlines in the first half of the year was the announcement by film star Angelina Jolie in May that she carried the BRCA breast cancer gene mutation and had opted for a double mastectomy to lessen her cancer risk. In an op-ed piece in The New York Times, Jolie said her mother's early death from BRCA-linked ovarian cancer had played a big role in her decision.
The article immediately sparked discussion on the BRCA mutations, whether or not women should be tested for these anomalies, and whether preventive mastectomy was warranted if they tested positive. A Harris Interactive/HealthDay poll conducted in August found that, following Jolie's announcement, 5 percent of respondents -- equivalent to about 6 million U.S. women -- said they would now seek medical advice on the issue.
Americans also struggled with the psychological impact of two acts of horrific violence -- the December 2012 Newtown, Conn., school massacre that left 20 children and six adults dead and the bombing of the Boston marathon in April of this year. Both tragedies left deep wounds on the hearts and minds of people at the scenes, as well as the tens of millions of Americans who watched the carnage through the media.
Indeed, a study released in December suggested that people who had spent hours each day tracking coverage of the Boston bombing had stress levels that were often higher than some people actually on the scene.
Major changes to the way doctors are advised to care for patients' hearts also spurred controversy in 2013. In November, a panel from the American Heart Association and the American College of Cardiology issued guidelines that could greatly expand the number of Americans taking cholesterol-lowering statin drugs.
One month later, an independent panel of experts issued its own recommendations on the control of high blood pressure -- guidelines that might shrink the number of people who take blood pressure drugs. Both recommendations ignited controversy as to their validity, and debate on these issues is likely to continue, experts say.
Contraception is another medical issue that's no stranger to controversy. In June, the U.S. Food and Drug Administration sparked both applause and outrage when it moved the Plan B "morning after" pill to over-the-counter status, with no age restrictions in place. The move came after protracted legal battles, led by the Obama administration, to prevent such access.
