A report Tuesday from accounting and consulting giant PwC projects lower overall growth in medical costs for next year, even as the economy gains strength and millions of uninsured people receive coverage under President Barack Obama's health care law.

If the calculations are correct, cost spikes because of the new health care law should be contained within a relatively narrow market segment. That would come as a relief for Democrats in an election year during which Republicans plan to use criticism of "Obamacare" as one of their main political weapons.

"There are some underlying changes to the system that are having an impact, and we can expect lower increases as we come out of the recession," said Mike Thompson of PwC's Health Research Institute, which produced the study. Cost "is still going up, but not as much as it used to."

The report comes with a caveat that sounds counterintuitive at first: Self-employed people and others who buy coverage individually could well see an increase in premiums in 2014.

The reasons have to do with requirements in the health care law. For example, starting next year insurers must accept patients with pre-existing medical problems, who cost more to cover. Also, new policies have to provide a basic level of benefits more generous in some cases than what's currently offered to individual consumers.

About 160 million workers and family members now have job-based coverage and are less likely to be affected. The individual market is much smaller, fewer than 20 million people. Still, it's expected to grow significantly over the next few years as a result of the health care law, which will also provide tax credits to help many people afford their premiums.

The U.S. spends more than $2.7 trillion a year on health care, well above any other developed country. But quality is uneven, there's widespread waste and fraud, and the system still leaves about 45 million people uninsured.

For years U.S. health care spending has grown much faster than the overall economy and workers' wages, but since the recession those annual increases have slowed dramatically. The debate now is whether that's a continuing trend. The answer will be vitally important, not only for companies and their employees, but for taxpayers who foot the bill for government programs such as Medicare, Medicaid and Obama's coverage expansion.

PwC's report forecasts that direct medical care costs will increase by 6.5 percent next year, one percentage point lower than its previous projection. The cost of care is the biggest component of premiums, followed by administrative expenses and overhead.

Cost-shifting to workers and efficiency measures from employers got most of the credit for slowing growth. PwC also said the health care law's push for hospitals and doctors to be more accountable may be starting to have an impact.

Four big factors were seen as pushing costs down next year:

Patients seeking more affordable routine services in settings like clinics springing up in retail stores, as opposed to a doctor's office or the emergency room.

Major employers contracting directly with hospital systems that have a proven record for complicated procedures such as heart surgery and certain back operations.

The government ramping up penalties on hospitals that have too many patients coming back with problems soon after being discharged.

Employers' ongoing effort to shift more costs to workers through higher annual deductibles, the amount people must pay each year before insurance picks up.

By using such shifting, PwC estimates that employers may be able to drive their share of next year's cost increase even lower than 6.5 percent.

On the other hand, two big factors will push costs upward:

The high price of new "specialty" drugs to treat serious chronic illnesses such as autoimmune diseases and some types of cancer.

Industry consolidation, with big hospitals buying up smaller ones, as well as medical practices and rehab centers. The downside of the demand for greater efficiency by employers and government is that it may be fostering new health care monopolies.

Only one of the 156 companies listed on the all-share index gained value. All 155 others fell.

Heavyweight Saudi Basic Industries Corp (SABIC), the world's biggest petrochemical company, fell 2.13 percent, while Al Rajhi Bank, the kingdom's largest listed lender, lost 4.5 percent. (Reporting By Angus McDowall; Editing by Susan Fenton)

Mom was a smoker and now she has cancer. I keep thinking if she hadn't smoked, she wouldn't be in this fix, and neither would I. I always visit her and try to do everything she asks of me, and yet I think I'm starting to hate her. I dread going to the hospital, sitting there and waiting for test results, etc. What kind of daughter has feelings like this? -- WORST DAUGHTER ON EARTH

DEAR DAUGHTER: Please stop beating yourself up. Your feelings are normal. You have a right to be angry that your mother is sick. At 23, you have had an unusual amount of responsibility thrust upon you for someone your age. That her disease has taken over your life is also a reason to be angry.

However, please stop blaming her for her illness. Right now, you need each other. And nonsmokers get cancer, too. The American Cancer Society has support groups where family members can safely share their feelings. Please check them out.

DEAR ABBY: I'm 43 and went back to school the nontraditional way. I will graduate soon with my master of human services degree. I will be the first person in my immediate family to have a degree.

My best friend thinks I'm foolish because I posed for graduation photos and ordered a class ring. She said I am too old to be having graduation pictures and a ring. I was thrilled to have them, but now I'm wondering if I really am being foolish. Am I trying to recapture the "would have/could have/should have" years? -- ED IN LOUISIANA

DEAR ED: Shame on your friend for raining on your parade. With a best friend like this, you should never forget to bring an umbrella.

You're celebrating the fact that as a nontraditional student you have earned your master's degree. That's a laudable accomplishment and deserves to be celebrated in any way you would like. Please accept my sincere congratulations, graduate!

DEAR ABBY: I love to read. I have kept every book I have read, so I probably have close to 600 books in my library, which is actually a small room, overflowing with books and nothing else.

Why do you think I can't let go of them? I lend them out to only a select few, and I always make sure they are returned. I could do lovely things with this room if my books weren't in the way, but I can't seem to part with them. -- BOOKWORM IN NEW YORK

DEAR BOOKWORM: It's probably because your books have become an extension of yourself. Because you would like to do something else with the space they occupy, sort through them and keep only the most precious ones. If there are titles you would like to read again one day, do as many others are doing -- read them on an e-reader.

Dear Abby is written by Abigail Van Buren, also known as Jeanne Phillips, and was founded by her mother, Pauline Phillips. Write Dear Abby ator P.O. Box 69440, Los Angeles, CA 90069.

Abby shares more than 100 of her favorite recipes in two booklets: "Abby's Favorite Recipes" and "More Favorite Recipes by Dear Abby." Send your name and mailing address, plus check or money order for $14 (U.S. funds) to: Dear Abby, Cookbooklet Set, P.O. Box 447, Mount Morris, IL 61054-0447. (Shipping and handling are included in the price.)

Spanish doctor Eufemiano Fuentes, the central figure in the trial, was given a one-year prison term for endangering public health and the judge also ordered the evidence, including bags of blood possibly belonging to athletes from sports other than cycling, to be destroyed.

Her decision not to release evidence to anti-doping authorities for further investigation damaged hopes that the case would unmask other athletes involved in illegal doping, and prompted widespread condemnation.

"WADA has carefully considered the decision rendered by the Criminal Court in Madrid in relation with the Operation Puerto," the agency's director general, David Howman, said in a statement on the agency's website (playtrue.wada-ama.org).

"The decision to order the destruction of all the blood bags is particularly disappointing and unsatisfactory for WADA, and the whole anti-doping community," Howman added.

"Access to this evidence motivated WADA's involvement in this case.

"This would ensure appropriate sports sanction processes against the cheats who used Dr Fuentes's services."

The Spanish anti-doping agency (AEA) has already said it will appeal against the judge's ruling to destroy the evidence and Howman said WADA might follow suit.

"WADA is currently fully reviewing the decision and any possible appeal or other action with its Spanish legal advisors, and the Spanish National Anti-Doping Organization (AEA)," he said, adding that the appeal deadline was May 17.

WADA, the AEA, the Spanish cycling federation (RFEC), the International Cycling Union (UCI) and the Italian Olympic Committee (CONI) were all represented in the three-month trial in Madrid.

Fuentes, who denied doping, said in his opening testimony that he had clients in cycling but also in sports including soccer, tennis, athletics and boxing.

Spain has been hoping the trial will help to dispel the impression that the nation was soft on doping and boost Madrid's bid to win the right to host the 2020 Olympic Games.

The country is pushing updated anti-doping legislation through parliament which the government says will bring Spain into line with international norms.

(Reporting by Iain Rogers, editing by Clare Fallon)

The list is compiled using data from independent and chain bookstores, book wholesalers and independent distributors nationwide.

Hardcover Fiction Last Week

1. "Whiskey Beach" by Nora Roberts - (Putnam, $27.95)

2. "Daddy's Gone a Hunting" by Mary Higgins (Simon & Schuster, $26.99) 1

3. "Talking Eve" by Iris Johansen - (St. Martin's, $27.99)

4. "Starting Now" by Debbie Macomber (Ballantine, $26.00) 3

5. "Don't Go" by Lisa Scottoline (St Martin's, $27.99) 2

6. "Six Years" by Harlan Coben (Dutton, $27.95) 5

7. "Unintended Consequences" by Stuart Woods (Putnam, $26.95) 4

8. "Gone Girl" by Gillian Flynn (Crown, $25.00) 7

9. "Life After Life" by Kate Atkinson (L.B./Reagan Arthur, $27.99) 6

10. "The Burgess Boys" by Elizabeth Strout (Random House, $26.00) 9

Hardcover Nonfiction

1. "Lean In" bySheryl Sandberg (Knopf, $24.95) 1

2. "LeaderShift" by Orrin Woodward & Oliver DeMille (Grand Central/Business Plus, $25.99) -

3. "The One Thing" by Gary Keller (Bard Press, $24.95) 13

4. "The Fast Metabolism Diet" by Haylie Pomroy (Harmony, $26.00) 2

5. "It's All Good" by Gwyneth Paltrow (Grand Central, $32.00) 3

6. "The Duck Commander Family" by Willie & Korie Robertson (Howard Books, $23.99) 4

7. "The Athena Doctrine" by John Gerzema & Michael D'Antonio (Jossey-Bass, $27.95) -

8. "Life Code" by Dr. Phil McGraw (Bird Street Books, $26.00) 5

9. "Man 2.0 Engineering the Alpha" by John Romaniello & Adam /Bornstein (HarperOne, $27.99) -

10. "Relish" by Daphne Oz (William Morrow, $27.50) -

Week ended April 21, 2013, powered by Nielsen BookScan (c) 2012 The Nielsen Company.

(Editing by Chris Michaud and Bill Trott)

The envisioned talks could help rebuild avenues of inter-Korean cooperation that were obliterated in recent years amid hardline stances by both countries, though the key issue isolating the North from the world community its nuclear program is not up for debate.

The North's Committee for the Peaceful Reunification of Korea, in a statement carried by state media, said it is open to holding talks with Seoul on reopening the Kaesong complex just north of the Demilitarized Zone separating the countries. The complex closed this spring.

It also proposed talks on resuming reunions of families separated by war, and on resuming South Korean tours to a mountain resort in the North.

Pyongyang offered to let the South set the time and venue, and hours later South Korean Unification Minister Ryoo Kihl-jae proposed meeting on all three topics in Seoul on June 12.

South Korean President Park Geun-hye welcomed the North Korean agreement to government-level talks that Seoul had proposed in April.

"I feel it's fortunate that the North accepted the proposal for government-level talks even though (the acceptance) came late," she said, according to her presidential office.

The agreement to meet could represent a change in North Korea's approach, or could simply be an effort to ease international demands that it end its development of nuclear weapons. Pyongyang has committed a drumbeat of provocative acts since April 2012, when it scuttled a nuclear and humanitarian aid deal with the U.S. by launching a rocket that was viewed as an effort to test its long-range missile technology.

The isolation of the authoritarian country has grown following a satellite launch in December and a nuclear test in February. Pyongyang was enraged by the United Nations Security Council sanctions those actions brought, and further angered by U.S.-South Korean military drills that the allies call routine but that the North claims are invasion rehearsals. Pyongyang earlier this year threatened nuclear attacks on Seoul and Washington.

Lee Ji-sue, a North Korea specialist and professor at Myongji University in Seoul, said Pyongyang has been forced to pull back in large part because of China, its neighbor and ally.

North Korea's economy relies heavily on China, which like the U.S. wants North Korea to give up its nuclear ambitions. Under American urging to pressure the North, Beijing has tightened inspections on cross-border trade, and its state banks have halted business with North Korea's Foreign Trade Bank.

Pyongyang's statement came after Choe Ryong Hae, a North Korean military official and confidant of leader Kim Jong Un, met with Chinese President Xi Jinping in Beijing in late May and said that Pyongyang was "willing to accept the suggestion of the Chinese side and launch dialogue with all relevant parties."

"North Korea has reached critical mass for talks," Lee said. "Even its ally China is cutting off bank dealings. Nothing is working out for the North. It needs a breakthrough now."

Lee said it still remains to be seen whether North Korea's overtures are genuine. "If North Korea starts accepting South Korean conditions one by one in future talks, we can then say it is really serious," he said.

China welcomed the Koreas' impending talks. "We hope they will cherish this hard-won momentum of dialogue, actively promote easing the situation and remain committed to peace and stability in the Korean Peninsula," Foreign Ministry spokesman Hong Lei said in Beijing.

Xi is meeting President Barack Obama in California on Friday, and Koh Yu-hwan, a North Korea expert at Seoul's Dongguk University, said Pyongyang's announcement is timed for those talks.

"North Korea is making it easier for China to persuade the U.S. to get softer on Pyongyang," Koh said.

Xi is also scheduled to meet with Park later this month.

Ryoo, the unification minister, asked Pyongyang to follow through on its offer to restore its Red Cross communication line with South Korea by Friday so the sides could start discussing arrangements for the talks. The line is among several ties between the Koreas cut by the North in the last several months.

A likely partner for Ryoo in minister-level talks would be Kim Yang Gon, secretary of the Central Committee of the ruling Workers' Party. Kim visited Kaesong in early April before the North withdrew all its workers from the park.

The decade-old Kaesong complex, the product of an era of inter-Korean cooperation, shut down gradually this spring after Pyongyang cut border communications and access, then pulled the complex's 53,000 North Korean workers. The last of hundreds of South Korean managers at Kaesong left last month.

More than 120 South Korean companies had operations at Kaesong, which gave them access to cheap North Korean labor. It was also a rare source of hard currency for North Korea, though the economically depressed country chafed at suggestions that it needed the money Kaesong generated.

Smiling broadly, Han Jae-kwon, chief of the association of South Korean factories in Kaesong, told reporters that he welcomes the agreement. "We are having hope that the Kaesong factory park will be revived," he said.

The talks will be the first government-level negotiations between the two Koreas since President Park took office earlier this year with a North Korea policy dubbed "trustpolitik." She has outlined her intention to reach out to the foes to build trust while remaining firm on intolerance to provocations.

After relations dropped to their lowest level in decades under her predecessor, Lee Myung-bak, North Korea had been looking for a change under Park, who visited North Korea in 2002. But the first 100 days of her administration were trying times for "trustpolitik" as Pyongyang threatened to carry out nuclear attacks and to close Kaesong.

Both sides, however, have been looking for a face-saving way to restart relations. Pyongyang proposed a joint event on June 15, the anniversary of their 2000 agreement on reconciliation; Seoul has so far rejected the proposal.

The mood on the Korean Peninsula has been tense since North Korean leader Kim Jong Il died in December 2011. Pyongyang denounced Seoul for blocking most civilian visits to the North to pay respects.

The Koreas have technically been in a state of war for nearly 60 years because the Korean War ended in 1953 with a truce and not a peace treaty. The last reunions of Korean families pulled apart by that war were held in 2010.

Under Kim Jong Un, Kim Jong Il's son, North Korea has pursued both nuclear weapons and economic development as top priorities. In a Memorial Day speech earlier Thursday, President Park repeated her criticism of that stance, saying the two goals can't be achieved simultaneously. But she also called on North Korea to come to talks with Seoul to build trust.

The North has established economic development zones at Kaesong and near the Chinese border in Rason to pursue foreign investment. On Wednesday, the North's official Korean Central News Agency announced that the country had passed a law allowing for the creating of new economic development zones open to foreign investors. It wasn't clear where those zones would be set up.

The award committee commended McKibben for "building a global, social movement, fighting to preserve a sustainable planet."

McKibben, born in 1960, has written widely about the impact of global warming. In 2008, he founded 350.org, an international movement aimed at solving the climate crisis with representatives in some 190 countries.

The annual Sophie Prize was created in 1997 to reward efforts for a sustainable future. The winner is selected by a Norwegian cultural committee, which said Tuesday that the award ceremony will be held in October in Oslo.

The fourth seed Bruins closed out the series 4-1 against the sixth seeded Rangers to set up the showdown with the top-seeded Penguins for a place in the Stanley Cup Finals.

It is their first trip back to the Eastern Finals since the 2010-11 season where they went on to win the Stanley Cup.

Boston fell behind after Dan Girardi scored a power-play goal in the opening period but 22-year-old Torey Krug continued his strong post-season with a power-play goal of his own after three minutes of the second period.

It was Krug's fourth goal in his first five play-off games and sparked the Bruins into action.

Gregory Campbell snapped the tie with a goal 10 minutes later and he added a second goal in the dying seconds of the game when he managed to backhand the puck into an empty net despite being hooked right before the attempt.

"It was a tough series. They played hard and they are really similar to us," Campbell said.

"It was a physical series and most games could have gone either way but we fought hard."

Bruins goaltender Tuukka Rask saved 28 of 29 shots.

(Reporting by Ben Everill in Del Mar; Editing by Greg Stutchbury)

ASPEN, Colo. (AP) -- The image was chilling: Snowmobile rider Caleb Moore, launched over his handlebars on a backflip gone wrong, rolled down the landing hill with his 450-pound machine somersaulting behind him.

Run over by his sled, Moore lay on the snow for several minutes before being helped off the course. As of Wednesday, he was hospitalized in critical condition because of bleeding around his heart and a complication involving his brain.

Moore's was the worst accident at the Winter X Games, which wrapped up Sunday night after four days of competition, but it wasn't the only harrowing moment. The wipeouts included a runaway snowmobile that sent spectators scrambling.

Even the highlights were hardly tame. Snowboarding star Shaun White soared a competition record 24 feet into the air during the superpipe competition, and fellow boarder Elena Hight showed off a difficult trick called a"double alley-oop backside rodeo" that involved a couple of backflips and a 180-degree rotation. It had never been seen in a competition.

All that, plus Moore's crash, has some wondering whether dialing up the difficulty each year improves action sports or has simply made them too dangerous.

"Should we be asking these questions? We absolutely should be," said Dan Lebowitz, the executive director of Sport in Society at Northeastern University, which examines the role of sports to promote healthy development and social responsibility.

The people performing these superhuman feats "really are just human," he said. "How do we maintain safety in that progression when that progression sometimes pushes every envelope to some amazingly extreme point?"

Moore's injuries underscore the dangers at Winter X, which was filled with numerous cover-your-eyes crashes.

Halldor Helgason of Iceland over-rotated on a flip in the snowboard big air competition and had to be taken off on a sled with a concussion. Rose Battersby of New Zealand sustained a lumbar spine fracture in a wipeout during practice before the skiing slopestyle competition, which will be an Olympic sport next winter at the Sochi Games.

Then there was this: Summer X Games motocross champion turned snowmobile newcomer Jackson Strong tumbled off his machine during the best trick competition, the throttle sticking and the sled swerving toward fans as they scurried away. The machine came to a rest when it got tangled in some netting and no one was seriously hurt.

Such a scenario had already crossed the mind of Levi LaVallee, a snowmobiler who captured two gold medals only to be sidelined for the final two competitions after tearing a muscle in his back.

"I've always thought about, 'What happens if the thing tips over and the throttle sticks?'" LaVallee said. "It was good, though, because it showed that X Games has a good setup with the fencing."

Whether action sports are too dangerous is an issue that's been raised before.

When freestyle skier Sarah Burke died in a training accident a little more than a year ago in Park City, Utah, there were questions about the halfpipe. Before that, the sport was examined when snowboarder Kevin Pearce suffered a severe brain injury in a fall in the same pipe as Burke two years earlier. Pearce has recovered and served as an analyst at Winter X.

But in general, the athletes accept the risks and defend their disciplines.

"To lose Sarah was such a blow to this entire industry," said snowboarder Gretchen Bleiler, who didn't compete this year as she recovers from a serious eye injury she suffered in training. "This sport brings so much joy, happiness and balance to my life and that far outweighs what could happen. You can't ever live your life with what could happen."

In a statement, X Games officials said they've paid close attention to safety issues over the event's 18-year history: "We've worked closely with athletes, risk management specialists, sport organizers and event managers to present the best possible experience for athletes and spectators. Further measures are constantly being evaluated."

Athletes say they prepare as best they can by trying out new tricks into foam pits and air bags set up at the bottom of courses. But even all the caution in the world can't prevent the fact that sometimes well-practiced maneuvers can go wrong in the air.

"You don't want to live your life in fear because of a situation," LaVallee said. "Look, I'm driving down the road right now and the worst-case scenario is a car could swerve over into my lane and run over me there it is, end of the road.

"That's kind of the same thing we think when we're competing. Hopefully, the preparation and countless hours of training and practicing will prevent the worst-case scenario from happening."

Tucker Hibbert the Shaun White of snowmobiling after winning his sixth straight SnoCross title just hopes casual fans understand that what they see on television is not true snowmobiling.

"You're seeing the most extreme side of what we do," Hibbert said. "That's a lot different than what the average person does on a snowmobile."

Hibbert doesn't participate in events such as best trick because, "I just wasn't born with those skills. I sit back and watch those guys, enjoy what they do."

He paused.

"You just hate to see anyone crash, anyone get hurt," Hibbert said.

Moore was in the middle of an impressive run in the freestyle event when he caught the top of the hill that was serving as a landing area. He initially walked away with help and went to a hospital with a concussion.

Moore later developed bleeding around his heart and had surgery. His family said that Moore, of Krum, Texas, also had a complication involving his brain.

Colten Moore, Caleb's younger brother and defending champion in the event, separated his pelvis in a crash later that same night.

LaVallee is no stranger to horrific wipeouts.

While training for the "Red Bull: New Year. No Limits" daredevil series two years ago in Southern California, LaVallee lost control of his snowmobile high in the air and landed violently on his side, bouncing down the landing ramp. He broke ribs, cracked his pelvis, collapsed one lung and punctured the other.

But he returned the next year and jumped a record 412 feet, 6 inches.

"We're passionate about the sport that we're in," LaVallee said.

"Anyone who competes has that drive to succeed, to go bigger than the next person or be the first one to do it."

The mentality is similar throughout action sports, even if the bar keeps getting raised.

"There are going to be benchmarks set and people trying to exceed that benchmark," Lebowitz said. "That's just the essence of our society and our social culture."

National Transportation Safety Board spokesman Eric Weiss said equipment and salvage personnel were in place to pull the fuselage out of a pond in Ephratah, an hour west of Albany in rural Fulton County.

Frank and Evelyn Amerosa of Utica, N.Y., were aboard the Angel Flight on Friday night when the twin-engine aircraft went down, according to police and family members.

Rescue workers have been scouring woods and a big, murky pond where the bulk of the aircraft was submerged. Wreckage from the crash was dispersed over a large area, with pieces of the plane and documents found as far as five miles away.

John Campbell, 70, of Stamford, Conn., was flying the couple back from the Boston area, where Frank Amerosa was being treated for brain cancer, officials and family said.

The bodies of both Campbell and Evelyn Amerosa were recovered from the crash site. Searchers continued to look for the body of 64-year-old Frank Amerosa on Tuesday, authorities said. The retired trucker had been diagnosed with brain cancer more than a year ago.

Campbell was a volunteer pilot for Angel Flight, a nonprofit group that arranges free air transportation for the sick. Angel Flight Northeast said it has set up free air transportation and medical care for more than 65,000 children and adults on about 60,000 flights covering more than 12 million miles. It was founded in 1996.

Weiss said salvage workers hoped to have the wreckage out of the pond by the end of the day. He said the fuselage as well as debris collected from surrounding woods and fields will be transported to a secure facility in Delaware to be examined by crash investigators.

The Piper PA 34 departed from Hanscom Field in Bedford, Mass., and was headed to Rome, N.Y., before it crashed just after 5 p.m. Friday, Federal Aviation Administration spokeswoman Kathleen Bergen said. The plane did not issue a distress call before losing radar and radio contact, the NTSB said.

Weiss said a preliminary NTSB report on the accident will be issued in about two weeks, with a final report on the probable cause in about 18 months.