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In a June 11, 2012, photo Dr. Glen Stream prepares to examine patient Pete Forsyth in Spokane, Wash. Health care spending has eased up recently, a welcome respite for government and corporate budgets. “Far and away it is related to economic issues,” Stream said. “I see people who have medical conditions who I should be seeing every three months. They tell me they can only afford to come in every six months or once a year.”

Nicholas K. Geranios / AP Photo