Nevertheless, the primary concern of some people is whether it will evolve into a gatekeeper for reimbursement and/or rationing ultimately, and eventually hamper the margins and R&D efforts of innovators . The special survey, ‘U.S. Healthcare Sector Legislative and Regulatory Register – Fall 2009′ is currently offered by.. Affordable HEALTHCARE Act to increase number of insured Us citizens by 36 million According to Fitch Rankings’ Fall U.S.24 in the Canadian Medical Association Journal. ‘It’s quite common to assume that more specialized or higher-volume health care can lead to improved outcomes,’ wrote researcher Dr. Kris Aubrey-Bassler, an associate professor of family medicine in the principal Healthcare Research Unit at Memorial University of Newfoundland in St. John’s, Canada. ‘The obstetric literature offers consistently shown that outcomes for high-risk newborns and mothers are best at higher-volume, more specialized hospitals; however, findings from the literature on low-risk deliveries are variable,’ Aubrey-Bassler explained in a journal information release.