Patients

Amid anxiety over rising costs from the federal healthcare law, California received better-than-expected insurance rates for a new state-run marketplace, but many consumers still won't be spared from sharply higher premiums. Three years after President Obama's landmark law was passed, the state unveiled the first details Thursday on what many Californians can expect to pay for coverage from 13 health plans offering policies in the state's exchange, in which as many as 5 million people will shop for coverage next year.

Tabitha Smith had been sick for about a week last November with what she thought was just a cold. When she didn't get better, her mom pushed her to see a doctor. "I told her I can't afford the doctor," says Smith, a 31-year-old social media manager who has been uninsured for five years. "I've gone in the past," she says, "and it's just been so expensive without insurance. " Ultimately Smith decided that Mother knows best. She headed to an urgent care clinic near her home in La Puente.

When Susan had breast cancer, we heard a lot of lame remarks, but our favorite came from one of Susan's colleagues. She wanted, she needed, to visit Susan after the surgery, but Susan didn't feel like having visitors, and she said so. Her colleague's response? "This isn't just about you. " "It's not?" Susan wondered. "My breast cancer is not about me? It's about you?" The same theme came up again when our friend Katie had a brain aneurysm. She was in intensive care for a long time and finally got out and into a step-down unit.

More money was spent in the Los Angeles area on chronically ill patients in their final years than anywhere else in the United States, according to new data on Medicare patients released Wednesday. Spending in the last two years of life was about $112,000 per patient in Los Angeles as of 2010, about 60% higher than the national average, the report by the Dartmouth Atlas Project showed. From 2007 to 2010, Medicare spending on end-of-life care rose 15% nationwide. The jump occurred despite more patients enrolling in hospice care, fewer patients dying at the hospital and patients spending fewer days in the hospital in the last six months of life.

The Food and Drug Administration on Thursday cautioned consumers against using quinine for leg cramps, warning that the drug could cause severe side effects, including death. Quinine, sold in this country under the brand name Qualaquin, is approved for treatment of uncomplicated malaria, but has a long history of use as a remedy for leg cramps, especially at night. In many countries, it is sold over the counter. Studies have shown that it can reduce the incidence of cramps by one-third to one-half but that as many as one in every 25 users can suffer serious side effects.

Those searching for answers to the question " Is medical marijuana good medicine? " will find few in Dr. David Sack's Times Op-Ed article.   On the one hand, Sack concedes, "Marijuana can effectively treat neuropathic pain, and it has been shown to improve appetite and reduce nausea," an acknowledgment substantiating the plant's therapeutic utility. However, he later warns that cannabis' ability to provide relief for certain other conditions, such as lupus and anxiety, remains unproven.

Plantar fasciitis. If you haven't had to deal with it personally, just ask around. Chances are you know lots of people who can describe it in great detail: stabbing heel pain and agonizing steps followed by a frustratingly slow recovery. Plantar fasciitis - an inflammation of the plantar facsia, a thick band of tissue that runs along the arch from the heel to the toes - has become so ubiquitous that podiatrists can practically make the diagnosis before a patient even sets foot in their office.

Asthma sufferers have long relied on inhalers for relief from wheezing or coughing attacks. But as of Dec. 31, Primatene Mist -- the only available over-the-counter asthma inhaler -- was taken off shelves because of its adverse effect on the environment. Other inhalers are available, but these require a doctor's prescription. Some people with asthma aren't happy about the change, but lung doctors and asthma specialists agree that Primatene Mist wasn't the best option for patients anyway.

Until recently, very few people had ever heard of raspberry ketones, the aromatic compounds that give the berries their distinctive smell. Today, health food stores have trouble keeping the capsules or drops of the stuff on their shelves. Almost overnight, an obscure plant compound became the next big thing in weight loss - and all it took was a few words from Dr. Oz. In a February episode of "The Dr. Oz Show," Mehmet Oz told viewers that raspberry ketones were "the No. 1 miracle in a bottle to burn your fat. " Once Oz calls something a "miracle," it doesn't remain obscure for long.

What are the advantages and disadvantages of using the supplement nitric oxide? Richard Sunland Nitric oxide is a gas naturally found in the body; its function is conveying information between cells. One of its main jobs is increasing blood flow by dilating blood vessels, and that's why it's sometimes given in supplement form to heart patients, orally and intravenously. In at least one study it's been shown to be effective for lowering blood pressure.

In California's new state-run health insurance market, Kaiser Permanente will cost you. The healthcare giant has the highest rates in Southern California and some other areas of the state, surpassing rivals such as Anthem Blue Cross and other smaller competitors. The relatively high premiums from such a strong supporter of the federal healthcare law surprised industry analysts, and it has sparked considerable debate about the company's motives. Some experts say Kaiser intentionally bid high to avoid drawing too many customers next year who are sick or who have been uninsured for years and may be costlier to treat.

Years after facing patient dumping allegations and hefty legal settlements, Southern California hospital executives have begun working with advocates for the homeless to improve the health of homeless patients and to reduce their use of area hospitals. Hospital administrators are driven by the national healthcare law, which offers incentives to provide better care at lower cost and imposes penalties when patients are unnecessarily readmitted to hospitals. Homeless patients are among the most frequent users of the region's medical centers, often because they lack regular medical care.

Many days, the sheer weight of Iszurette Hunter's clinical depression becomes more than she can lift. She clings to her bed in her South Los Angeles home. Important obligations slide away, including keeping appointments with doctors who are trying to control her asthma and high blood pressure. "I don't have no desire," she explains. As the nation seeks to extend healthcare coverage to millions of new and in many cases chronically ill patients, one of the great parallel challenges to controlling costs and improving delivery of care will be managing the mental health problems of people like Hunter.

If a doctor is going to tell a patient he's obese and needs to lose weight, that patient seems more likely to trust the advice if the doctor is overweight too, scientists say. It might seem that patients want role models in their primary care doctors, but in matters of weight, that doesn't seem to be the case. Researchers from John Hopkins Bloomberg School of Public Health set out to see what effect a doctor's weight might have on patients; they published their findings in the June issue of Preventive Medicine.

After finding a lump in her breast, Laura Wells had to wait nearly six months before getting a confirmed diagnosis of cancer. The 46-year-old Costa Mesa woman was uninsured and working part-time when she discovered the lump in 2007. She worked for months to scrape together enough cash, first to pay for an exam, then a mammogram, and finally to see a doctor who diagnosed her disease. She frantically searched for programs to help pay for the surgery and chemotherapy she needed, initially without much success.

Half of physician Mimi Choi's pediatric patients are overweight or obese. She instructs them to eat more fruits and vegetables. Now she can go one step further - refer them to a discounted produce stand steps away from the South Los Angeles health center where she works. Choi said she can talk about better nutrition until she is "blue in the face," but her patients will eat more fresh food only if it's available and affordable. "One of the biggest issues is access," she said.

Many days, the sheer weight of Iszurette Hunter's clinical depression becomes more than she can lift. She clings to her bed in her South Los Angeles home. Important obligations slide away, including keeping appointments with doctors who are trying to control her asthma and high blood pressure. "I don't have no desire," she explains. As the nation seeks to extend healthcare coverage to millions of new and in many cases chronically ill patients, one of the great parallel challenges to controlling costs and improving delivery of care will be managing the mental health problems of people like Hunter.

You've heard about the "Wheat Belly" diet, right? Well, technically, it doesn't exist. Dr. William Davis points out that the word "diet" does not appear on either the cover of his bestselling "Wheat Belly" book published in 2011 or on the follow-up, "Wheat Belly Cookbook," which was published last month and already tops bestseller lists. And that omission is intentional, Davis said. "Wheat Belly" is about stripping your plate of a substance that contributes to heart disease, causes joint pain, inflammation, foggy thinking, bloating and much more, Davis said.

Consumers have been told by insurers again and again that if they want cheaper prices for prescription drugs, they need to order them in bulk from mail-order pharmacies. And typically, it works out that way. Sometimes, however, the prices reveal how screwy our healthcare system is - and what a challenge it can be to get a straight answer about medical costs. Jeff Zoldos, 61, had such an experience after his employer switched his coverage to Aetna at the beginning of the year.

As University of California patient care workers returned to the picket lines Wednesday, hospital administrators said they were gratified that so many others chose to come to work. More than three-quarters of union members who had been scheduled to work Tuesday did so, said Dianne Klein, spokeswoman for the UC office of the president. Hospital officials said they expected a similar turnout Wednesday. "The [union] leadership is engaged in this game of brinkmanship," Klein said.