Medical Costs

A worrisome abdominal pain drove Jalal Afshar to seek treatment last year at healthcare giant Kaiser Permanente. The Pasadena resident and Kaiser member had lived for years with a rare condition known as Castleman's disease, which affects the lymph nodes and the body's immune system. But this was the first time he experienced such severe symptoms. Kaiser granted his request to see a specialist in Arkansas. But it ultimately declined to pay for his treatment there. By June, Afshar said, Kaiser was arranging for hospice care so that he could die at home.

UnitedHealth Group Inc., the nation's largest health insurer, said its first-quarter profit dropped 14% as medical costs climbed higher. The Minnetonka, Minn., company said its health plan membership increased 18% in the quarter to 42 million people, boosted by international growth. But UnitedHealth's biggest expense, medical costs, shot up 13% in the quarter to $22.6 billion. Analysts expressed some surprise at the increase in medical costs since some hospital chains and other medical providers have reported weaker patient volume.

Patients without health insurance, and those who are insured but fear the cost of medical care, are more likely to delay seeking life-saving treatment when having a heart attack. For the millions of American adults who don't have health insurance, and those who have it but worry that illness might ruin them financially, the signs of an impending heart attack do not set in motion the kind of rapid, lifesaving response that medical professionals urge, according to a study conducted at 24 urban hospitals across the nation.

An average day in a U.S. hospital cost $4,287 last year. It was less than $1,000 in New Zealand, France, South Africa and Spain. That's one of several cost comparisons reported Tuesday in an annual report by the International Federation of Health Plans, an industry trade group. The London organization surveyed its member companies in 12 different countries to gauge the variation in medical prices. "With the cost and availability of healthcare being an important topic around the world, it's essential that we not only examine the disparities that exist, but also why and how certain gaps do exist," said Tom Sackville, the group's chief executive.

A Long Beach hospital charged Jo Ann Snyder $6,707 for a CT scan of her abdomen and pelvis after colon surgery. But because she had health insurance with Blue Shield of California, her share was much less: $2,336. Then Snyder tripped across one of the little-known secrets of healthcare: If she hadn't used her insurance, her bill would have been even lower, just $1,054. "I couldn't believe it," said Snyder, a 57-year-old hair salon manager. "I was really upset that I got charged so much and Blue Shield allowed that.

The signs for Robert Martinez were not good when he arrived at the hospital four months ago. They rarely are when a body is stripped almost completely of the familiar insulating layer called skin. With more than 80% of his body burned in a refinery steam explosion and his lungs horribly damaged by contaminants from the blast, Martinez could breathe only with the aid of a ventilator as he lay comatose in his specially equipped bed at Torrance Memorial Medical Center.

A study comparing prices for hospital stays, physician office visits, drugs and other medical procedures in developed countries shows U.S. prices among the most expensive.  The International Federation of Health Plans, a London-based network of 100 insurance companies in 30 developed nations, annually looks at prices, and last week published its 2011 Comparative Price Report on medical and hospital fees by country. Among the results: Cost per day for hospital charges averaged $3,949 in the U.S., followed by Chile at $1,552.

In response to pressure from California regulators, Anthem Blue Cross agreed to a slightly lower rate increase for about 630,000 individual policyholders that will save consumers an estimated $54 million. Anthem, a unit of Indianapolis insurance giant WellPoint Inc., had sought to raise rates an average of 18% beginning Feb. 1. California Insurance Commissioner Dave Jones said Thursday that the company had agreed to reduce the average increase to 14% after regulators reviewed Anthem's rate filing.

For busy people, time is money. And when you've got more money than time, the cost of an executive physical examination is kind of like the price of a yacht. If you have to ask, you can't afford it. Tom Gilmore arrived at L.A.'s Good Samaritan Hospital on a bright Friday morning, sporting a dark blue Nike warmup suit the hospital had sent.

An average day in a U.S. hospital cost $4,287 last year. It was less than $1,000 in New Zealand, France, South Africa and Spain. That's one of several cost comparisons reported Tuesday in an annual report by the International Federation of Health Plans, an industry trade group. The London organization surveyed its member companies in 12 different countries to gauge the variation in medical prices. "With the cost and availability of healthcare being an important topic around the world, it's essential that we not only examine the disparities that exist, but also why and how certain gaps do exist," said Tom Sackville, the group's chief executive.

Re "Gun tax bills miss the mark," Editorial, March 12 It is rather this editorial that misses the mark. Guns and gun-related injuries and deaths in the United States account for Vietnam-level casualties every year. Costs necessarily accrue to society as a result of these casualties. Society must pay for police to investigate them, paramedics to try to save the lives of the victims, security guards in stores and banks, and now, after the massacre in Connecticut, armed guards in schools.

For seniors and their families, Alzheimer's disease and its hefty price tag are an increasingly scary prospect. About 5.4 million Americans are affected by Alzheimer's disease, making it the sixth leading cause of death in the United States. Because of growing life expectancies and aging baby boomers, that number is expected to triple by 2050. Alayna Tillman's mother and aunt both have Alzheimer's disease and live with Tillman, her husband and two sons in Lake View Terrace. Tillman says Medicare pays for many of the medical costs her mom and aunt incur.

In the span of 15 years, the number of bariatric surgeries performed in the United States has grown more than 16-fold to roughly 220,000 per year, gaining cachet as a near-panacea for obesity. Despite the daunting price tag, mounting research has boosted hopes that the stomach-stapling operations could reduce the nation's healthcare bill by weaning patients off the costly drugs and frequent doctor visits that come with chronic obesity-related diseases like diabetes and arthritis.

Although Republicans are eager to repeal the entire 2010 healthcare reform law, they started the new session of Congress last week by taking aim at one provision in particular: the Independent Payment Advisory Board, a yet-to-be-named group of 15 presidential appointees from various healthcare disciplines that could play a key role in limiting the growth of Medicare spending. Critics argue that it's a bad idea and even un-American to put so much power in the hands of unelected bureaucrats.

After pushing to cut Medi-Cal spending in each of his first two years in office, Gov. Jerry Brown now has to decide whether to seek to expand it by billions of dollars -- largely, but not entirely, on Washington's dime. A new report from researchers at UCLA and UC Berkeley suggests that the expansion might actually pay for itself through higher tax revenue and lower spending in other state programs. The researchers' cost estimates are just that, estimates, so there's no guarantee that things would work out as well for the state as their model suggests.

California's insurance commissioner said an 11% rate increase for small businesses by Anthem Blue Cross is "unreasonable" because the company overstated its costs and improperly added fees related to the federal healthcare law. Insurance Commissioner Dave Jones also said Anthem, a unit of industry giant WellPoint Inc., was reaping excessive profits in California. But under state law the commissioner has no authority to block the rate increase from taking effect this month. "This is a huge loophole in California law and in the federal Affordable Care Act," Jones said.

Re "Drug Benefit's Cost Estimates Soar, Surprise," Feb. 10: Medicare drug costs $724 billion instead of $400 billion? Must have been faulty intelligence. Surely the faultiest intelligence is that of President Bush. Or could it be that of gullible voters who fall for so much of his deceit? Stan Horn Long Beach

Re "The beloved budget buster," Editorial, Dec. 9 Your editorial on Medicare correctly identified novel procedures as one of the drivers of rising medical costs. It prescribed better comparisons of the cost-effectiveness of treatments as an essential part of the cure. The Tufts Cost Effectiveness Analysis Registry, the premier compiler of cost-effectiveness research, gives a further reason for optimism. Its data reveal that one-fifth of novel treatments result in better health and lower costs.

Re "Anthem plans average rate hike of 18%," Business, Nov. 28 Anthem Blue Cross' spokesman may blame his company's rising costs on the economic downturn, which he says causes people to avoid buying insurance. But as a longtime Anthem policyholder, that's not the reason I've thought about dropping coverage. Plain and simple, it's Anthem's double-digit rate increases. Nothing else I purchase increases in cost this much. Not too long ago, I received a tiny refund check because Anthem failed to meet the minimum requirement that 80% of premiums go toward medical costs.