How hard can it be to measure the health of a population? Oregon is finding out it's difficult to decide even what to track. But the state received almost $2 billion in federal funds to improve the health of its residents and to cut costs. The state faces substantial fines if it can't prove it has done the job.

Health insurers are obligated to cover pumps to help moms breast-feed. But there is a variety of equipment. Some nursing mothers prefer faster, electric models that cost more. Insurers may say a less expensive manual pump would do just fine.