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Aetna's profits more than doubled in the fourth quarter of 2003, rising to $249.5 million, or $1.56 a share, from $98.2 million, or 63 cents a share a year earlier. The insurer attributes the results to its ability to hold the line on medical costs and cut operating costs.... U.S. health care spending increased to $1.7 trillion last year, more than $5,800 for every American, according to a study in Health Affairs. A staggering number, to be sure, yet some take heart in the fact that the rate of spending is actually slowing, to 7.8 percent in 2003, from 9.3 percent in 2002 — the first decrease in six years.... Online enrollment of workers for health care benefits has exploded to the point where now a sizeable majority of employees at large companies sign up this way, according to Hewitt Associates. Seventy-seven percent of workers at companies with an average of 5,000 employees will use the Internet to enroll this year, says the consulting company.

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