Medical Care Industry

PacifiCare Health Systems Inc., which operates one of the nation's largest health-maintenance organizations, on Monday issued scorecards for its medical groups in California, a move company officials say is aimed at stoking competition and improving physician services to consumers. The firm's so-called quality index marks the first time an HMO has made rankings of its medical groups available to the public.

First-year medical student Hannah Segal sees the same patients and finds herself managing the same ailments during her frequent visits to a community health clinic on downtown Los Angeles' skid row. It's not the most glamorous or desired duty among her USC classmates, many of whom aspire to prestigious, high-paying medical specialties. But her work on the front lines of patient care has helped Segal find her passion. "I'm always really excited to come here," she said. "I get to really problem-solve over time.

Brentwood real estate broker Joan Gardner was suffering such excruciating pain with a swollen knee, months after a fall, that she was homebound, depressed and unable to work. Her doctor and orthopedic physical therapist encouraged her to have surgery, but Gardner declined because, "I'm stubborn and vain." Instead, she decided to try something different.

California's largest health insurer is teaming with hospitals and doctors throughout the state to better share ways to improve patient safety and cut costs, leaders of the initiative said Tuesday. Doctors, nurses and other health professionals at California hospitals will meet quarterly in person or over the Internet during the next three years to compare their practices and data for reducing medical problems such as hospital-borne infections. Woodland Hills-based Anthem Blue Cross is contributing $6 million toward the effort.

Business practices of a PacifiCare Health Systems unit in Nevada are being examined by that state's insurance division following complaints from physician groups that they're not being paid for services. Two auditors from the insurance division were at the company Thursday in Las Vegas, examining the health maintenance organization's billing and claims records.

First-year medical student Hannah Segal sees the same patients and finds herself managing the same ailments during her frequent visits to a community health clinic on downtown Los Angeles' skid row. It's not the most glamorous or desired duty among her USC classmates, many of whom aspire to prestigious, high-paying medical specialties. But her work on the front lines of patient care has helped Segal find her passion. "I'm always really excited to come here," she said. "I get to really problem-solve over time.

Want a health tip? Move to Canada. An impressive array of data shows that Canadians live longer, healthier lives than we do. What's more, they pay roughly half as much per capita as we do ($2,163 versus $4,887 in 2001) for the privilege. Exactly why Canadians fare better is the subject of considerable academic debate. Some policy experts say it's Canada's single-payer, universal health coverage system.

In the early evening of March 17, the man Erica McLean had hired to cure her husband of cancer arrived at their ranch in Sunland. David Chuah, a biochemist from Canada, carried a large brown bag brimming with pills, drops and powders, Erica recalls. Clive McLean, 60, was to take them in addition to the other therapies Chuah had prescribed during six months of treatment, she says.

Kaiser Permanente will be assessed a record fine today for its haphazard investigations of questionable care, physician performance and patient complaints at its California hospitals, according to state HMO regulators. The California Department of Managed Health Care said it will levy a $3-million fine against Kaiser, the largest HMO in the state, with 29 medical centers and more than 6 million members.

Dr. L. Stephen Coles, a physician and researcher at UCLA Medical School who for years has studied centenarians, made a radical statement to the audience that had gathered last month for the annual conference of the American Academy of Anti-Aging Medicine. There is no such thing as anti-aging medicine, he declared to the organization he has belonged to for a decade.

National healthcare legislation in Congress could slow the growth of medical costs, allowing employers to create 250,000 to 400,000 new jobs a year over the next decade, economists from Harvard University and USC are predicting. Wading into the hotly debated issue of whether the legislation is a job creator or a job killer, researchers from the two universities say that the reforms under consideration would slow the rate of cost increases and free up money for companies to raise wages and hire more workers.

David Nexon had a big problem. An early version of national healthcare legislation contained a $40-billion tax aimed squarely at members of the medical device trade association he represents. Nexon, a former advisor to the late Sen. Edward M. Kennedy (D-Mass.), went to work. He marshaled 14 people like himself -- lobbyists who were once congressional aides, many of them from staffs of congressional leaders or committees that had a hand in crafting the healthcare overhaul. When Senate Democrats unveiled their bill in mid-November, Nexon's handiwork was evident.

Kaiser Permanente unveiled plans Thursday for a $10-million medical office building that will offer primary care, some specialty care and other services to 80,000 South Los Angeles residents who are members of Kaiser's healthcare plan. Kaiser's 15,000-square-foot South Los Angeles medical offices are expected to open in 2011 on the southeast corner of West Manchester and South Denker avenues. A vacant building on the site will be torn down to make way for the new facility. Construction is scheduled to begin soon.

Healthcare reformers tell a wry joke about one of their number who, called to heaven, is given the opportunity to pose a single question to God. "Will we ever have universal health coverage in the United States?" the reformer asks. "Yes," comes the answer from on high, "but not in my lifetime." The simple truth implicit in this joke is underscored by the landmark healthcare bill passed this week by the Senate Finance Committee: America is walking up the driveway of universal coverage, but hasn't yet made it through the door.

President Obama's administration began holding private meetings with health industry executives and lobbyists at the White House a few weeks after he took office, a visitor list released Wednesday night by the White House shows. Richard Umbdenstock, president of the American Hospital Assn., was at the White House on Feb. 4 and has been back at least half a dozen times since, most recently May 22.

Invoking an argument used by President George W. Bush, the Obama administration has turned down a request from a watchdog group for a list of health industry executives who have visited the White House to discuss the massive healthcare overhaul. Citizens for Responsibility and Ethics in Washington sent a letter to the Secret Service asking about visits from 18 executives representing health insurers, drug makers, doctors and other players in the debate.

After nearly four decades in medicine, Dr. David Bearman seems the incarnation of a trusted old-school physician. His resume is long, his record unblemished. It's his choice of treatment that makes him conspicuous. For nearly every patient, Bearman recommends the same remedy: marijuana. There is the young lady with epileptic seizures, the middle-aged man with multiple sclerosis, the amputee bedeviled by phantom limb pain.

The 47-year-old man from Concord, Calif., an 82-year-old registered nurse from Walnut Creek and another man whose identity wasn't released never expected to die when they entered an outpatient clinic last May for a routine orthopedic procedure. They simply went in for a cortisone shot to treat pain and inflammation--a shot that, unknown to them or their doctors, was contaminated with a bacterium that causes meningitis.

Leading health industry groups have agreed to slow the explosive growth of healthcare spending, according to administration officials and others knowledgeable about the agreement. Hospitals, drug makers and doctors, among others, wrote a letter to President Obama outlining their plan, which estimates $2 trillion in savings over the next decade.

It started out as just another Thanksgiving Day stomachache, a nagging pain that sharpened until it reverberated from California halfway around the world. When the ache in her lower right abdomen became excruciating, the twentysomething woman was rushed to a surgery center, where the doctor diagnosed a ruptured appendix. The woman needed an operation -- fast. But before the surgeon could wheel her into the operating theater, he had to find out whether the patient's insurance company would pay.