Intel Teases Set-Top Box to Compete With Cable

Intel is developing a set-top box that delivers video on demand and live TV over the internet, a move that would place it in competition with the likes of Roku and your local cable company.

There’s no word on who’ll provide the all-important content we’d see on such a box or what we’d pay for it when it appears later this year, but Erik Huggers, Intel’s corporate vice president of media, promises a “superior experience” to what is already hooked up to your TV.

Huggers, speaking at the Dive Into Media event Tuesday, said the new device will launch under its own brand under Intel’s new media division. The service and set-top box are a huge departure for a company that has made its name supplying chipsets to just about everyone and has a less-than-stellar track record bringing products to the consumer market.

The device and web-TV service will compete directly with cable and satellite providers by delivering live TV via the internet. The box also will offer video on demand and a feature called Catch Up TV, which also is available in the BBC iPlayer. That means everything that is broadcast on network or cable TV would be available to play whenever you like, making it something like a cloud-based DVR that records everything on your TV. In that way, Intel isn’t just gunning for content providers, but also for the Apple TV and Roku box.

That’s because Intel thinks you have too many devices plugged into your TV, and it’s positioning its as yet unnamed box as “an all in one solution” to handle all your content. Huggers mentioned Netflix, suggesting we might see the streaming service as a partner.

The chipmaker had long been rumored to be working on its own streaming service and device. Tuesday’s announcement puts those rumors to rest but raises many new questions. The most pressing is how is this different than what’s already on the market. For example, how will this be different than subscribing to cable and will it save viewers money?

Current cable and satellite services package channels and sell them as bundles. These bundles have been a huge financial pain for viewers, because you’re often paying for channels you don’t watch. And while Huggers was quick to point out that bundles aren’t going away, he did say, “if bundles are done right, I think there is real value in that. An opportunity to create a more flexible environment.”  A la carte programming is still a long way off, but Huggers hinted at a bundling scenario somewhere between a la carte and the current cable and satellite offerings.

Even with a smarter bundle, don’t expect to save money on your bill. The unnamed Intel box that isn’t an Intel-branded-box is “not a value play but a quality play to create a superior experience,” Huggers said. That experience includes a redesigned electronic program guide and camera that determines who is watching TV and adjusts the environment and suggestions based on who is watching. If you’re concerned about privacy and you watch TV in your underwear, you can turn it off. Other superior features and pricing were not discussed, but Intel has its work cut out for it. Winning this game is all about providing solid content.

This is a huge leap for a company known more for the silicon powering computers than selling devices directly to consumers. Intel has produced reference designs for ultrabooks, smartphones and Windows 8 device hybrids for third parties, but its own consumer products and services have been largely ignored. Most would be surprised, for example, to learn that Intel has an app store called AppUp and a small Mac mini competitor called the NUC. Intel’s problem isn’t necessarily making good products, it’s marketing them.

And while the company has been recruiting employees from Apple, Jawbone, BBC and Microsoft to create this new device and new division, it’s going to have to make sure people actually know about it. Plus it really will have to deliver a substantially superior experience to cable and other set-top boxes to end up connected to the HDMI ports of viewer’s HDTVs.

Read More..

Director Panahi defies Iran ban to make another film

BERLIN (Reuters) – Iran‘s Jafar Panahi has defied a 20-year ban on filmmaking to secretly co-direct “Closed Curtain“, a multi-layered portrayal of how restrictions on his work and movement have brought on depression and even thoughts of suicide.

The movie, in competition at the Berlin film festival, has its premiere on Tuesday, but Panahi was not expected on the red carpet despite festival organizers saying the German government had requested he be allowed to travel.

His co-director and compatriot Kamboziya Partovi did attend a press conference along with actress Maryam Moghadam, but would not be drawn on what the consequences of making the movie could be for Panahi or others involved.

“Nothing has happened up until now,” he said, speaking through an interpreter. “We do not know what the future holds for us.”

Moghadam acknowledged she was taking a risk by acting in a project involving Panahi, a darling of the Western film festival circuit and best known for his 2000 movie “The Circle” and “Offside” released six years later.

His socially engaged films about issues such as women’s rights in Iran and support for the political opposition have made him a target of the Iranian authorities.

In 2010 he was banned from making films for 20 years and sentenced to six years in prison for “propaganda against the system”, although he is now under house arrest.

Moghadam, who has dual Swedish and Iranian nationality, told Reuters she would try to continue travelling to Iran, where she had family. “I am not the only one (taking risks),” she said.

“Closed Curtain” is the second picture Panahi has made in defiance of the ban, and it remains to be seen whether the 52-year-old faces further punishment for a movie that has drawn major attention in Berlin.

“This is Not a Film”, made in 2011, was reportedly smuggled out of the country on a USB stick hidden inside a cake.

EMPTY VILLA, FEAR, FRUSTRATION

“Closed Curtain” is set in an empty villa in Iran, presumably beside the Caspian Sea.

A man, played by Partovi, arrives with his dog, and proceeds to draw the curtains and black out the windows, sealing himself off from the world outside and preventing the authorities – real and imagined – from seeing what was happening.

When the dog accidentally switches on the television, we see footage of stray dogs being rounded up and killed, explaining why he had to be smuggled in inside a bag and kept indoors.

A young man and woman, on the run from the police, burst in and the woman stays, but her existence and that of the man becomes unclear as viewers must decide if they are fictional characters in Panahi’s script or actual people.

The layers of reality multiply as Panahi himself arrives, and posters advertising some of his past movies are revealed beneath sheets before being covered up again.

In the allegory of Panahi’s life under house arrest and inability to work freely, we see him walking into the sea at one point, a reference to taking his own life.

“He was not constantly thinking about suicide, no, because then he wouldn’t have been able to make the film,” Partovi said. “But if I imagine myself unable to work and just sitting at home, then I am sure I would start to think about suicide.”

According to Partovi, “Closed Curtain” was made out of a desire to express oneself, even though it was unlikely to be seen by people inside Iran.

“It’s difficult to work, but not being able to work is even more difficult, and especially when you are at the height of your career. You become depressed, and I believe this is shown in the film and it comes through.”

The mood is one of frustration, fear and anger, as young people are rounded up for having parties and drinking alcohol.

“She is a young woman like many other women in my country,” Moghadam said of her character Melika.

“She is a symbol of many other young women who struggle,” added the actress, who was wearing a hat to cover her hair.

She said her character represented “the dark side of his (Panahi’s) mind … that part that doesn’t hope any more and wants to give up.”

(Reporting by Mike Collett-White)

Movies News Headlines – Yahoo! News

Title Post: Director Panahi defies Iran ban to make another film
Url Post: http://www.news.fluser.com/director-panahi-defies-iran-ban-to-make-another-film/
Link To Post : Director Panahi defies Iran ban to make another film
Rating:
100%

based on 99998 ratings.
5 user reviews.
Author: Fluser SeoLink
Thanks for visiting the blog, If any criticism and suggestions please leave a comment

Read More..

Well: Straining to Hear and Fend Off Dementia

At a party the other night, a fund-raiser for a literary magazine, I found myself in conversation with a well-known author whose work I greatly admire. I use the term “conversation” loosely. I couldn’t hear a word he said. But worse, the effort I was making to hear was using up so much brain power that I completely forgot the titles of his books.

A senior moment? Maybe. (I’m 65.) But for me, it’s complicated by the fact that I have severe hearing loss, only somewhat eased by a hearing aid and cochlear implant.

Dr. Frank Lin, an otolaryngologist and epidemiologist at Johns Hopkins School of Medicine, describes this phenomenon as “cognitive load.” Cognitive overload is the way it feels. Essentially, the brain is so preoccupied with translating the sounds into words that it seems to have no processing power left to search through the storerooms of memory for a response.

---

Katherine Bouton speaks about her own experience with hearing loss.

A transcript of this interview can be found here.

---

Over the past few years, Dr. Lin has delivered unwelcome news to those of us with hearing loss. His work looks “at the interface of hearing loss, gerontology and public health,” as he writes on his Web site. The most significant issue is the relation between hearing loss and dementia.

In a 2011 paper in The Archives of Neurology, Dr. Lin and colleagues found a strong association between the two. The researchers looked at 639 subjects, ranging in age at the beginning of the study from 36 to 90 (with the majority between 60 and 80). The subjects were part of the Baltimore Longitudinal Study of Aging. None had cognitive impairment at the beginning of the study, which followed subjects for 18 years; some had hearing loss.

“Compared to individuals with normal hearing, those individuals with a mild, moderate, and severe hearing loss, respectively, had a 2-, 3- and 5-fold increased risk of developing dementia over the course of the study,” Dr. Lin wrote in an e-mail summarizing the results. The worse the hearing loss, the greater the risk of developing dementia. The correlation remained true even when age, diabetes and hypertension — other conditions associated with dementia — were ruled out.

In an interview, Dr. Lin discussed some possible explanations for the association. The first is social isolation, which may come with hearing loss, a known risk factor for dementia. Another possibility is cognitive load, and a third is some pathological process that causes both hearing loss and dementia.

In a study last month, Dr. Lin and colleagues looked at 1,984 older adults beginning in 1997-8, again using a well-established database. Their findings reinforced those of the 2011 study, but also found that those with hearing loss had a “30 to 40 percent faster rate of loss of thinking and memory abilities” over a six-year period compared with people with normal hearing. Again, the worse the hearing loss, the worse the rate of cognitive decline.

Both studies also found, somewhat surprisingly, that hearing aids were “not significantly associated with lower risk” for cognitive impairment. But self-reporting of hearing-aid use is unreliable, and Dr. Lin’s next study will focus specifically on the way hearing aids are used: for how long, how frequently, how well they have been fitted, what kind of counseling the user received, what other technologies they used to supplement hearing-aid use.

What about the notion of a common pathological process? In a recent paper in the journal Neurology, John Gallacher and colleagues at Cardiff University suggested the possibility of a genetic or environmental factor that could be causing both hearing loss and dementia — and perhaps not in that order. In a phenomenon called reverse causation, a degenerative pathology that leads to early dementia might prove to be a cause of hearing loss.

The work of John T. Cacioppo, director of the Social Neuroscience Laboratory at the University of Chicago, also offers a clue to a pathological link. His multidisciplinary studies on isolation have shown that perceived isolation, or loneliness, is “a more important predictor of a variety of adverse health outcomes than is objective social isolation.” Those with hearing loss, who may sit through a dinner party and not hear a word, frequently experience perceived isolation.

Other research, including the Framingham Heart Study, has found an association between hearing loss and another unexpected condition: cardiovascular disease. Again, the evidence suggests a common pathological cause. Dr. David R. Friedland, a professor of otolaryngology at the Medical College of Wisconsin in Milwaukee, hypothesized in a 2009 paper delivered at a conference that low-frequency loss could be an early indication that a patient has vascular problems: the inner ear is “so sensitive to blood flow” that any vascular abnormalities “could be noted earlier here than in other parts of the body.”

A common pathological cause might help explain why hearing aids do not seem to reduce the risk of dementia. But those of us with hearing loss hope that is not the case; common sense suggests that if you don’t have to work so hard to hear, you have greater cognitive power to listen and understand — and remember. And the sense of perceived isolation, another risk for dementia, is reduced.

A critical factor may be the way hearing aids are used. A user must practice to maximize their effectiveness and they may need reprogramming by an audiologist. Additional assistive technologies like looping and FM systems may also be required. And people with progressive hearing loss may need new aids every few years.

Increasingly, people buy hearing aids online or from big-box stores like Costco, making it hard for the user to follow up. In the first year I had hearing aids, I saw my audiologist initially every two weeks for reprocessing and then every three months.

In one study, Dr. Lin and his colleague Wade Chien found that only one in seven adults who could benefit from hearing aids used them. One deterrent is cost ($2,000 to $6,000 per ear), seldom covered by insurance. Another is the stigma of old age.

Hearing loss is a natural part of aging. But for most people with hearing loss, according to the National Institute on Deafness and Other Communication Disorders, the condition begins long before they get old. Almost two-thirds of men with hearing loss began to lose their hearing before age 44. My hearing loss began when I was 30.

Forty-eight million Americans suffer from some degree of hearing loss. If it can be proved in a clinical trial that hearing aids help delay or offset dementia, the benefits would be immeasurable.

“Could we do something to reduce cognitive decline and delay the onset of dementia?” he asked. “It’s hugely important, because by 2050, 1 in 30 Americans will have dementia.

“If we could delay the onset by even one year, the prevalence of dementia drops by 15 percent down the road. You’re talking about billions of dollars in health care savings.”

Should studies establish definitively that correcting hearing loss decreases the potential for early-onset dementia, we might finally overcome the stigma of hearing loss. Get your hearing tested, get it corrected, and enjoy a longer cognitively active life. Establishing the dangers of uncorrected hearing might even convince private insurers and Medicare that covering the cost of hearing aids is a small price to pay to offset the cost of dementia.

---

---

Katherine Bouton is the author of the new book, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You,” from which this essay is adapted.

---

This post has been revised to reflect the following correction:

Correction: February 12, 2013

An earlier version of this article misstated the location of the Medical College of Wisconsin. It is in Milwaukee, not Madison.

Read More..

DealBook: Big Investors Strengthen Opposition to Dell's Sale

12:29 p.m. | Updated

One of the country’s biggest mutual fund managers signaled its opposition to Dell‘s proposed $24.4 billion sale on Tuesday, as another investor disclosed a major step in a campaign to fight the deal.

T. Rowe Price said in a statement that it was opposed to the $13.65-a-share takeover bid being offered by the company’s founder, Michael S. Dell, and the investment firm Silver Lake. With a stake of about 4.4 percent, T. Rowe Price is Dell’s third-biggest shareholder.

The second-biggest shareholder, Southeastern Asset Management, meanwhile disclosed in a regulatory filing that it had retained D.F. King, a big proxy solicitation firm, as an adviser. It also confirmed that it held about 8.44 percent of Dell’s shares, trailing only Mr. Dell.

Proxy solicitors like D.F. King play important roles in fights over shareholder votes. They canvass a company’s investor base, providing their clients with estimates of how shareholders are leaning and strategies for winning over allies.

Southeastern has also hired Dennis J. Block of Greenberg Traurig, an experienced mergers and acquisitions lawyer, according to a person briefed on the matter.

The emergence of T. Rowe Price as an opponent of the deal is the latest sign of discontent with the management buyout bid. While Mr. Dell controls about 16 percent of the company’s stock, his offer for the computer maker requires the approval of a majority of independent shareholders.

In a statement, T. Rowe Price’s chairman and chief investment officer, Brian C. Rogers, said, “We believe the proposed buyout does not reflect the value of Dell, and we do not intend to support the offer as put forward.”

A spokesman for Dell repeated a statement made on Friday, saying that a special committee of the board had considered a number of strategic alternatives. “Based on that work, the board concluded that the proposed all-cash transaction is in the best interests of stockholders,” according to the statement.

Silver Lake declined to comment. 

Shares of Dell closed on Monday above the buyout price for the first time since the offer was announced last week, signaling expectations that the bid might be increased.

In a company release on Friday, Southeastern said it planned to consider all of its options to fight the deal, including a proxy fight, a lawsuit and calling on a Delaware court to determine the fair value of Dell shares.

The high price the firm paid for its holding is probably driving its opposition. Analysts have estimated that Southeastern paid more than $20 a share on average, meaning it would lose over $800 million if the current deal were completed.

A person close to the firm disputed that estimate, suggesting that Southeastern’s cost basis was closer to $16.90 a share.

Southeastern and its chief executive, O. Mason Hawkins, have been unafraid to challenge companies when their stock prices fall. The firm was a major force for change at the oil and natural gas driller Chesapeake Energy last year, eventually winning representation on its board.

With Dell, there is a long road ahead. The vote for shareholders to approve the buyout offer is at least several months away.

Read More..

Report: U.S. recovered $4.2 billion from healthcare fraud in 2012

Federal officials say they recovered nearly $8 for every dollar spent on healthcare fraud investigations in 2012. (Scott Eells / Bloomberg)

By Chad Terhune

February 11, 2013, 9:59 a.m.

Federal officials said they recovered a record-high $4.2 billion related to healthcare fraud and abuse in fiscal year 2012.

U.S. Atty. Eric Holder and Health and Human Services Secretary Kathleen Sebelius said the federal government recovered $7.90 for every dollar spent on healthcare-related fraud and abuse investigations.

The total of $4.2 billion in taxpayer dollars recovered for fiscal year 2012 was up slightly from $4.1 billion a year earlier, officials said. It's estimated that Medicare loses about $60 billion annually to fraud and improper payments.

"We are gaining the upper hand in our fight against healthcare fraud," Sebelius said.

The Obama administration has tried to crack down on Medicare fraud by boosting investigations in certain "hot spots" such as Miami and Los Angeles and using technology to detect schemes sooner.

Last year, Medicare said it began screening all 1.5-million providers enrolled in the government healthcare program to identify ineligible and potentially fraudulent providers or suppliers. As a result, officials said nearly 150,000 ineligible providers were booted from Medicare.

Still, some members of Congress have complained that the Obama administration has been too slow to deploy technology widely used by the credit-card industry to weed out fraud and abuse.

ALSO:

Former L.A. clinic owner makes Medicare's most-wanted list

Cache of Kaiser patient details was kept in family's home

Small surgeries, huge markups

Follow Chad Terhune on Twitter

Comments are filtered for language and registration is required. The Times makes no guarantee of comments' factual accuracy. Readers may report inappropriate comments by clicking the Report Abuse link next to a comment. Here are the full legal terms you agree to by using this comment form.

';
shareDiv.innerHTML = templateHTML;

/* append the new div to the end of the document, which is hidden already with CSS */
document.body.appendChild(shareDiv);

/* Store the div in both a regular JavaScript variable and as a jQuery object so we can reference them faster later */
var shareTip = document.getElementById('shareTip'),
$shareTip = $('#shareTip');

/* This extends our settings object with any user-defined settings passed to the function and returns the jQuery object shareTip
was called on */
return this.each(function() {
if (options) {
$.extend(settings, options);
}

/* This is a hack to make sure the shareTip always fades back to 100% opacity */
var checkOpacity = function (){
if ( $shareTip.css('opacity') !== 1 ){
$shareTip.css({'opacity': 1});
}
};

/* Function that replaces the HTML in the shareTip with the template we defined at the top */
/* It will wipe/reset the links on the social media buttons each time the function is called */
var removeLinks = function (){
shareTip.innerHTML = templateHTML;
};

/* This is the function that makes the links for the Tweet / Share functionality */

var makeURLS = function (link, message){
/* Here we construct the Tweet URL using an array, with values passed to the function */
var tweetConstruct = [
'http://twitter.com/share?url=', link, '&text=', message, '&via=', settings.twitter_account
],
/* Then join the array into one chunk of HTML */
tweetURL = tweetConstruct.join(''),

/* Same story for Facebook */
fbConstruct = [
'http://www.facebook.com/sharer.php?u=', link, '&src=sp'
],

fbURL = fbConstruct.join(''),

newHTML = [
''
],
shareHTML = newHTML.join('');
/* Load in our new HTML */
shareTip.innerHTML = shareHTML;
};

/* Since the shareTip will automatically fade out when the user mouses out of an element */
/* we have to specifically tell the shareTip we want it to stay put when the user mouses over it */
/* This effectively gives the user a 500 ms (or whatever) window to mouse */
/* from the element to the shareTip to prevent it from popping out */
$shareTip.hover(function(){
$shareTip.stop(true, true);
$shareTip.show();
checkOpacity();
}, function(){
$(this).fadeOut(settings.speed);
});

/* This function handles the hover action */
$(this).hover(function(){
/* remove the old links, so someone doesn't accidentally click on them */
removeLinks();

/* If there's already an animation running on the shareTip, stop it */
$shareTip.stop(true, true);

var eso = $(this),
message,
/* Store the width and height of the shareTip and the offset of the element for our calculations */
height = eso.height(),
width = eso.width(),
offset = eso.offset(),
link;


link = eso.children('a').attr('href');
message = escape( eso.find('img').attr('alt') ) || eso.attr(settings.message_attr);

if (link.search('http://') === -1){
link = 'http://www.latimes.com' + link;
}
link = encodeURIComponent(link);

/* If it's at the top of the page, the shareTip will pop under the element */
if (offset.top

Read More..

Boeing Begins Flight Testing of 787 Dreamliner to Find Battery Faults

Boeing’s ill-fated 787 has once again taken to the skies for testing in an effort to find a solution to the battery issue that has left the fleet grounded for the better part of the past month. The Federal Aviation Administration granted the company a special airworthiness certificate on Feb. 7, giving Boeing the ability to perform flights related to research and testing to solve the battery issue.

In early January the first of a series of lithium-ion batteries caught fire onboard a 787 parked on the ground in Boston. The next week a second Dreamliner battery experienced a thermal runaway during a passenger flight in Japan. Nobody was hurt in either incident, but the FAA issued an emergency airworthiness directive (.pdf) stating, “this AD requires modification of the battery system, or other actions, in accordance with a method approved by the Manager, Seattle Aircraft Certification Office (ACO), FAA.” Other agencies around the world followed suit and  the global fleet of 787s was grounded.

Boeing was allowed to make a one-time ferry flight of a Dreamliner from its Texas paint shop to the factory north of Seattle last Thursday. On Saturday the company prepared its only remaining active flight test aircraft, ZA005, at Boeing Field in Seattle for a preliminary test flight. The airplane departed Boeing Field Saturday morning and, as dictated by the FAA, flew over the sparsely populated areas in the eastern half of Washington state before finishing the two-hour, 19-minute flight over the Olympic Peninsula northwest of Seattle.

In a statement, a Boeing spokesman said the 787 had a crew of 13 on board and it was – thankfully – an uneventful flight. The two pilots and flight test engineers monitored the performance of the two lithium-ion batteries using test equipment installed specifically for the battery testing. However, Boeing has yet to share any details from the flight.

Today ZA005 was again back in the skies above eastern Washington on the second flight test. The test pilots on today’s flight were Randy Neville and Mike Bryan, the same pilots we flew with last year during a 787 preview. The airplane was the first to fly with the General Electric engines (Rolls Royce engines power the other 787s), and was being used for flight test work related to the next Dreamliner model, the slightly longer 787-9.

As flight testing begins to find a solution to the battery problem, airlines are being warned that the 787s they’ve ordered may be delayed yet again. However, production of the Dreamliner continues at both the Everett factory north of Seattle as well as the new factory in South Carolina. But without the ability to perform production flight testing of each new airplane – or simply deliver Dreamliners – the 787s are again turning the airports next to the factories into parking lots to house the massive planes.

Airlines with grounded 787 fleets are beginning to talk with Boeing about compensation for the millions of dollars being lost as their airplanes collect dust on the ground.

The National Transportation Safety Board continues its investigation into the root cause of the battery problem. The agency announced it found evidence of electrical shorts within a single cell of the 63 pound lithium-ion battery in the Boston airplane. The NTSB said it expects to issue a preliminary report in the next month, but it is up to the FAA to allow the airplane to begin flying again. No timeline has been issued, but most in the industry agree it is more likely a matter of months rather than weeks before the 787 will be carrying passengers again.

Read More..

Average movie ticket price hits record high

LOS ANGELES (TheWrap.com) – Movie-going got more expensive last year with ticket prices hitting record highs in 2012, the National Association of Theatre Owners said Monday.

The average ticket price hit $ 7.96, a three-cent bump from last year, but still the biggest annual number when not adjusted for inflation.

For the fourth quarter of 2012, 3D releases, such as “The Hobbit: An Unexpected Journey” and “Rise of the Guardians,” pushed ticket prices to $ 8.05. That was a 3.4 percent bump from the $ 7.78 cents audiences shelled out on average over the three months ending in September.

It was not, however, a record. In the second quarter of 2012, ticket prices hit unprecedented levels, averaging $ 8.12.

Movies News Headlines – Yahoo! News

Title Post: Average movie ticket price hits record high
Url Post: http://www.news.fluser.com/average-movie-ticket-price-hits-record-high/
Link To Post : Average movie ticket price hits record high
Rating:
100%

based on 99998 ratings.
5 user reviews.
Author: Fluser SeoLink
Thanks for visiting the blog, If any criticism and suggestions please leave a comment

Read More..

Well: Price for a New Hip? Good Luck Getting a Reliable Estimate

Jaime Rosenthal, a senior at Washington University in St. Louis, called more than 100 hospitals in every state last summer, seeking prices for a hip replacement for a 62-year-old grandmother who was uninsured but had the means to pay herself.

The quotes she received might surprise even hardened health care economists: only about half of the hospitals, including top-ranked orthopedic centers and community hospitals, could provide any sort of price estimate, despite repeated calls. Those that could gave quotes that varied by a factor of more than 10, from $11,100 to $125,798.

Ms. Rosenthal’s grandmother was fictitious, created for a summer research project on health care costs. But the findings, which form the basis of a paper released on Monday by JAMA Internal Medicine, are likely to fan the debate on the unsustainable growth of American health care costs and an opaque medical system in which prices are often hidden from consumers.

“Transparency is all the rage these days in government and business, but there has been little push for pricing transparency in health care, and there’s virtually no information,” said Dr. Peter Cram, an associate professor of internal medicine at the University of Iowa, who wrote the paper with Ms. Rosenthal. He added: “I can get the price for a car, for a can of oil, for a gallon of milk. But health care? That’s not so easy.”

President Obama’s Affordable Care Act focused primarily on providing insurance to Americans who did not have it. But the high price of care remains an elephant in the room. Although many experts have said that Americans must become more discerning consumers to help rein in costs, the study illustrates how hard that can be.

“We’ve been trying to help patients get good value, but it is really hard to get price commitments from hospitals — we see this all the time,” said Jeff Rice, the chief executive of Healthcare Blue Book, a company that collects data on medical procedures, doctors visits and tests. “And even if they say $20,000, it often turns out $40,000 or 60,000.”

There are many caveats to the study. Most patients — or insurers — never pay the full sticker price of surgery, because insurance companies bargain with hospitals and doctors for discounted rates. When Ms. Rosenthal balked at initial high estimates, some hospitals produced lower rates for a person without insurance.

But in other ways the telephone quotations underestimated prices, because they did not include the fees for outpatient rehabilitation, for example.

In an accompanying commentary, Andrew Steinmetz and Ezekiel J. Emanuel of the University of Pennsylvania acknowledged that there was “no justification” for the inability to provide estimates or for the wide range of prices. But they said that more rigorous data on quality — like infection rates and unexpected deaths — were required to know when high prices were worth it.

“Without quality data to accompany price data, physicians, consumers and other health care decision makers have no idea if a lower price represents shoddy quality of if it constitutes good value,” they wrote.

But, broadly, researchers emphasized that studies had found little consistent correlation between higher prices and better quality in American health care. Dr. Cram said there was no data that “Mercedes” hip implants were better than cheaper options, for example.

Jamie Court, the president of the California-based Consumer Watchdog, said: “If one hospital can put in a hip for $12,000, then every hospital should be able to do it. When there’s 100 percent variation in sticker price, then there is no real price. It’s about profit.”

Dr. Cram said the study did contain some good news: some of the country’s top-ranked hospitals came up with “bargain basement prices” in response to repeated calls. “If you’re a good consumer and shop around, you can get a good price — you don’t have to pay $120,000 for a Honda,” he said.

But that shopping can be arduous in a market not set up to respond to consumers. To get a total price, Ms. Rosenthal often had to call the hospital to get its estimate for on-site care, and a separate quote from doctors. And many were simply perplexed when she asked for a price upfront, Ms. Rosenthal said, adding, “The people who answered didn’t know what to do with the question.”

Read More..

Ambitious makeover planned for old housing project

Denise Penegar puts a little extra effort into the teenage girls, the ones who've dropped out of high school to care for their firstborns.

Don't be afraid, the outreach worker tells them. Come down to the housing project's community center, get your GED and some job skills. Change your life.

"I was one of those girls," said Penegar, now 51 and still living in Jordan Downs, the Watts housing project where she was born.

Sometimes, she imagines how different her life might have been if someone had knocked on her door when she was 17, caring for her first baby. What would it have meant just to have "someone who is here who can help pick me up"?

Penegar is on the front lines of a bold social experiment underway at Jordan Downs, a project notorious to outsiders for its poverty, blight and violence but seen by many longtime residents, for all its problems, as a close-knit community worth preserving.

In the last year, the Housing Authority of the City of Los Angeles has begun an effort to transform Jordan that could cost more than $600 million. The plan is to turn the complex of 700 aging units into a mixed-income community of up to 1,400 apartments and condominiums, with shops and restaurants and fancy touches such as native plant gardens. The city hopes to draw in hundreds of more-affluent residents willing to pay market rate to live side by side with the city's poorest.

Spurred by changes in federal funding and policy, such "mixed use" developments have sprung up in place of infamous housing projects all over the country. But experts say Jordan is taking an approach that has not been tried on this scale.

Typically, public housing residents are moved out ahead of the bulldozers, scattered to search for new shelter. In Los Angeles, the housing authority has promised that any of the 2,300 Jordan residents "in good standing" can stay in their old units until the day they move into new ones. The project is to be built in phases, beginning with units on 21 acres of adjacent land purchased by the authority in 2008 for $31 million.

To ease the transition, the city has dispatched "community coaches" like Penegar, along with teachers, social workers, therapists — even police officers whose charge is not to make arrests but to coach youth football and triathlon teams.

In essence, officials intend to raze the buildings, not the community — and radically change its character.

It will be an enormous challenge, with success likely to be measured in tiny increments.

Only 47% of adults at Jordan reported any wages to the housing authority last year. As in many urban projects, poverty and social ills have multiplied through the generations, leaving some residents unfamiliar with opportunities and expectations beyond the neighborhood. Some rarely leave the area.

Before inviting in new neighbors with expectations of safety and comfort, the housing authority has begun flooding Jordan Downs with social services. Many of the programs are focused on women, because more than 60% of Jordan Downs' tenants live in households headed by single mothers. But men are targeted too — for job training and lessons in parenting, for instance.

By December, 10 months into the effort, more than 450 families had been surveyed by intake workers and 280 signed up for intensive services.

"Most people would say it's ambitious, but I think it's essential," said Kathryn Icenhower, executive director of Shields for Families, the South Los Angeles nonprofit that is running many of the new programs under a more than $1-million annual contract with the housing authority.

It is unknown, however, how effective the social services will be, how easy it will be to draw in wealthier residents and how many millions of dollars the federal government — a major source of funding — will provide.

Already, the housing authority has picked a development team — the for-profit Michaels Organization and the nonprofit Bridge Housing, both with respectable track records in other cities. But with financing still uncertain, it is unclear exactly how many units will be built or how much various occupants would pay.

Ultimately, a working family could pay hundreds of dollars more in rent than unemployed tenants next door for a nearly identical unit. Officials say they do not expect Watts to draw the same kind of high-income residents as the former Cabrini Green project in Chicago, which sat on prime real estate near downtown. But Jordan is in a convenient location, near the intersection of the 105 and 110 Freeways; and in a high-rent city like Los Angeles, even the steepest rates at Jordan are likely to seem a bargain.

Despite the onslaught of social services and some palpable changes — including a 53% plunge in the violent crime rate at Jordan last year — financial risks abound.

Later this spring, the authority plans to put in an application for $30 million from the federal government's Choice Neighborhoods Program as seed money. Without it, the project could be delayed.

Read More..

Wired Science Space Photo of the Day: Wings of the Seagull Nebula

This image shows the intricate structure of part of the Seagull Nebula, known more formally as IC 2177. These wisps of gas and dust are known as Sharpless 2-296 (officially Sh 2-296) and form part of the “wings” of the celestial bird. This region of the sky is a fascinating muddle of intriguing astronomical objects — a mix of dark and glowing red clouds, weaving amongst bright stars. This new view was captured by the Wide Field Imager on the MPG/ESO 2.2-metre telescope at ESO’s La Silla Observatory in Chile.

Image: ESO [high-resolution]

Caption: ESO

Read More..