U.S. economy adds 157,000 jobs in January

U.S. employers added 157,000 jobs in January and hiring was stronger over the past two years than previously thought, providing reassurance that the job market held steady while economic growth sputtered.

The mostly upbeat Labor Department report Friday included one negative sign: the unemployment rate rose to 7.9 percent from 7.8 percent in December. The unemployment rate is calculated from a survey of households, while job gains come from a survey of employers.

The hiring picture over the past two years looked better after the department's annual revisions. Those showed employers added an average of roughly 180,000 jobs per month in 2012 and 2011, up from previous estimates of about 150,000. And hiring was stronger at the end of last year, averaging 200,000 new jobs in the final three months.

Stock futures rose after the report was released.

One notable change in the job market is the stronger contribution from construction firms. They added 28,000 jobs in January and nearly 100,000 in the past four months. The gains are consistent with a rebound in home construction and a broader recovery in housing.

Last month's hiring should cushion the impact of the higher Social Security taxes that most consumers are paying this year. And it would help the economy resume growing after it shrank at an annual rate of 0.1 percent in the October-December quarter.

Higher Social Security taxes are reducing take-home pay for most Americans. A person earning $50,000 a year will have about $1,000 less to spend in 2013. A household with two high-paid workers will have up to $4,500 less. Taxes rose after a 2 percent cut, in place for two years, expired Jan. 1.

Analysts expect the Social Security tax increase to shave about a half-point off economic growth in 2013, since consumers drive about 70 percent of economic activity.

The hit to consumers is coming at a precarious moment for the economy. It contracted in the fourth quarter for the first time in 3 1/2  years. The decline was driven largely by a steep cut in defense spending and a drop in exports. Analysts generally think those factors will prove temporary and that the economy will resume growing.

Still, the contraction last quarter points to what are likely to be key challenges for the economy this year: the prospect of sharp government spending cuts and uncertainty over whether Congress will agree to raise the federal borrowing cap.

Most analysts predict that the economy will grow again in the January-March quarter, though likely at a lackluster annual rate of around 1 percent. They expect the economy to expand about 2 percent for the full year.

Two key drivers of growth improved last quarter: Consumer spending increased at a faster pace. And businesses invested more in equipment and software.

In addition, homebuilders are stepping up construction to meet rising demand. That could generate even more construction jobs.

And home prices are rising steadily. That tends to make Americans feel wealthier and more likely to spend. Housing could add as much as 1 percentage point to economic growth this year, some economists estimate.

Auto sales reached their highest level in five years in 2012 and are expected to keep growing this year. That's boosting production and hiring at U.S. automakers and their suppliers.

Read More..

3 Things That Still Worry Me About BlackBerry

BlackBerry put on a pretty good show on Wednesday when it revealed the Z10 and the Q10, its first new smartphones in a year and a half. The demos were crisp, and the new BlackBerry 10 software looked clever. At the very least, it seems that BlackBerry has finally joined the modern smartphone era.

But despite my interest in BlackBerry’s new phones, I’m still worried about the future of the platform, and not merely because it’s been off the radar for a while. Looking at what BlackBerry did and didn’t announce, and what reviewers are saying about the product, gives me a few big reasons for concern:

Apps, Both Present and Future

BlackBerry deserves credit for having lots of apps out of the gate–more than 70,000, the company says–including some important ones like Twitter, Facebook, Angry Birds and The New York Times. Still, there are some big names missing from the list, including Netflix, YouTube, Spotify and Instagram. You can’t expect a new platform to have everything right away, though, so I don’t want to judge BlackBerry’s current app count too harshly.

It’s the future that I’m really worried about. What happens when the next Instagram comes out, and becomes a sensation on the iPhone and Android? Will BlackBerry be like Windows Phone–that is, just an afterthought in the minds of up-and-coming app developers? The good news is that Android apps are relatively easy to port to BlackBerry 10 (in fact, roughly 40 percent of those 70,000 launch apps are simple ports, ReadWrite notes), so RIM just has to convince developers to make a relatively small effort. We’ll see if they do.

Never Neglect Maps

The consensus among BlackBerry Z10 reviews is that its Maps app is subpar. The Verge complained about inaccurate data, and said the software couldn’t reliably find local businesses. CNet bemoaned a lack of features, such as walking directions, transit maps and street views. Apparently the software doesn’t even let you jump into the Maps app by tapping on an address or map in the web browser. That’s just basic stuff. At least the Maps app includes voice-guided turn-by-turn directions.

In any case, having a good mapping service isn’t just about telling you where to go. It’s about using your location to deliver useful information. Google Now, for instance, can warn you about traffic before your commute home, and Apple‘s Passbook can call up a boarding pass when you get to the airport. These days, a really good standalone Maps app is only part of the equation, and BlackBerry doesn’t even have that yet.

Voice Commands and Virtual Assistants

BlackBerry has added voice commands in its new phones, but the list of supported actions is paltry compared to what Android and the iPhone offer. You can’t ask for movie times, the weather forecast, directions, or things to do. You can’t tell the phone to start playing music, answer a trivia question, calculate numbers or set reminders.

You may argue that it doesn’t matter, that most people don’t rely too heavily on voice commands to begin with. I think that will change as these virtual assistants become faster and support more types of queries. They’ll also become more useful in automobiles–in fact, some car makers are now starting to integrate Siri–and they may some day play a big role in wearable computing, allowing you to communicate by voice when your phone is just out of reach. It’s still early days for this kind of technology, but Apple and Google already have a huge head start. BlackBerry, by comparison, is just getting started.

I’m not saying the new BlackBerry phones are no good, or that no one should use them. Like I said before, the software has some clever ideas, such as the Hub that combines all communications into one area, and the Balance feature that acts as a separate login for business use. But the smartphone industry moves quickly, and BlackBerry’s period of rebuilding has taken its toll in a few key areas. As with before, it’s going to be hard for the company to catch up.

MORE: Check out a video about the new hardware and features

Wireless News Headlines – Yahoo! News

Title Post: 3 Things That Still Worry Me About BlackBerry
Url Post: http://www.news.fluser.com/3-things-that-still-worry-me-about-blackberry/
Link To Post : 3 Things That Still Worry Me About BlackBerry
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..

Appeals judges: Anti-paparazzi law appears legal

LOS ANGELES (AP) — An appeals panel says California's anti-paparazzi statute appears to be constitutional based on a brief filed by prosecutors.

A preliminary statement by three judges in Los Angeles requires a judge who dismissed charges aimed at a paparazzo who authorities say was driving recklessly to review his order. The judge may stick to his ruling, which would trigger a full appeal, or he could schedule further arguments on the case against freelance photographer Paul Raef.

Raef was the first person charged under the new law after a high-speed chase involving Justin Bieber last year.

Superior Court Judge Thomas Rubinson dismissed two charges in November, ruling the law is too broad and is unconstitutional.

Raef's attorney David S. Kestenbaum says he is asking Rubinson to stand by his ruling and allow a full appeal.

Read More..

The New Old Age Blog: Caregiving, Laced With Humor

“My grandmother, she’s not a normal person. She’s like a character when she speaks. Every day she’s playing like she’s an actress.”

These are words of love, and they come from Sacha Goldberger, a French photographer who has turned his grandmother, 93-year-old Frederika Goldberger, into a minor European celebrity.

In the photos, you can see the qualities grandson and grandmother have in common: a wicked sense of humor, an utter lack of pretension and a keen taste for theatricality and the absurd.

This isn’t an ordinary caregiving relationship, not by a long shot. But Sacha, 44 years old and unmarried, is deeply devoted to this spirited older relation who has played the role of Mamika (“my little grandmother,” translated from her native Hungarian) in two of his books and a photography exhibition currently underway in Paris.

As for Frederika, “I like everything that my grandson does,” she said in a recent Skype conversation from her apartment, which also serves as Sacha’s office. “I hate not to do anything. Here, with my grandson, I have the feeling I am doing something.”

Their unusual collaboration began after Frederika retired from her career as a textile consultant at age 80 and fell into a funk.

“I was very depressed because I lived for working,” she told me in our Skype conversation.

Sacha had long dreamed of creating what he calls a “Woody Allen-like Web site with a French Jewish humor” and he had an inspiration. What if he took one of the pillars of that type of humor, a French man’s relationship with his mother and grandmother, and asked Frederika to play along with some oddball ideas?

This Budapest-born baroness, whose family had owned the largest textile factory in Hungary before World War II, was a natural in front of the camera, assuming a straight-faced, imperturbable comic attitude whether donning a motorcycle helmet and goggles, polishing her fingernails with a gherkin, wearing giant flippers on the beach, lighting up a banana, or dressed up as a Christmas tree with a golden star on her head. (All these photos and more appear in “Mamika: My Mighty Little Grandmother,” published in the United States last year.)

“It was like a game for us, deciding what crazy thing we were going to do next, how we were going to keep people from being bored,” said Sacha, who traces his close relationship with his grandmother to age 14, when she taught him how to drive and often picked him up at school. “Making pictures was a very good excuse to spend time together.”

“He thought it was very funny to put a costume on me,” said Frederika. “And I liked it.”

People responded enthusiastically, and before long Sacha had cooked up what ended up becoming the most popular character role for Frederika: Super Mamika, outfitted in a body-hugging costume, tights, a motorcycle helmet and a flowing cape.

His grandmother was a super hero of sorts, because she had helped save 10 people from the Nazis during World War II, said Sacha. He also traced inspiration to Stan Lee, a Jewish artist who created the X-Men, The Hulk and the Fantastic Four for Marvel comics. “I wanted to ask what happens to these super heroes when they get old in these photographs with my grandmother.”

Lest this seem a bit trivial to readers of this blog, consider this passage from Sacha’s introduction to “Mamika: My Might Little Grandmother”:

In a society where youth is the supreme value; where wrinkles have to be camouflaged; where old people are hidden as soon as they become cumbersome, where, for lack of time or desire, it is easier to put our elders in hospices rather than take care of them, I wanted to show that happiness in aging was also possible.

In our Skype conversation, Sacha confessed to anxiety about losing his grandmother, and said, “I always was very worried about what would happen if my grandmother disappeared. Because she is exceptional.”

“I am not normal,” Frederika piped up at his side, her face deeply wrinkled, her short hair beautifully coiffed, seemingly very satisfied with herself.

“So, making these pictures to me is the best thing that could happen,” Sacha continued, “because now my grandma is immortal and it seems everyone knows her. I am giving to everybody in the world a bit of my grandma.”

This wonderful expression of caring and creativity has expanded my view of intergenerational relations in this new old age. What about you?

Read More..

U.S. economy adds 157,000 jobs in January

U.S. employers added 157,000 jobs in January and hiring was stronger over the past two years than previously thought, providing reassurance that the job market held steady while economic growth sputtered.

The mostly upbeat Labor Department report Friday included one negative sign: the unemployment rate rose to 7.9 percent from 7.8 percent in December. The unemployment rate is calculated from a survey of households, while job gains come from a survey of employers.

The hiring picture over the past two years looked better after the department's annual revisions. Those showed employers added an average of roughly 180,000 jobs per month in 2012 and 2011, up from previous estimates of about 150,000. And hiring was stronger at the end of last year, averaging 200,000 new jobs in the final three months.

Stock futures rose after the report was released.

One notable change in the job market is the stronger contribution from construction firms. They added 28,000 jobs in January and nearly 100,000 in the past four months. The gains are consistent with a rebound in home construction and a broader recovery in housing.

Last month's hiring should cushion the impact of the higher Social Security taxes that most consumers are paying this year. And it would help the economy resume growing after it shrank at an annual rate of 0.1 percent in the October-December quarter.

Higher Social Security taxes are reducing take-home pay for most Americans. A person earning $50,000 a year will have about $1,000 less to spend in 2013. A household with two high-paid workers will have up to $4,500 less. Taxes rose after a 2 percent cut, in place for two years, expired Jan. 1.

Analysts expect the Social Security tax increase to shave about a half-point off economic growth in 2013, since consumers drive about 70 percent of economic activity.

The hit to consumers is coming at a precarious moment for the economy. It contracted in the fourth quarter for the first time in 3 1/2  years. The decline was driven largely by a steep cut in defense spending and a drop in exports. Analysts generally think those factors will prove temporary and that the economy will resume growing.

Still, the contraction last quarter points to what are likely to be key challenges for the economy this year: the prospect of sharp government spending cuts and uncertainty over whether Congress will agree to raise the federal borrowing cap.

Most analysts predict that the economy will grow again in the January-March quarter, though likely at a lackluster annual rate of around 1 percent. They expect the economy to expand about 2 percent for the full year.

Two key drivers of growth improved last quarter: Consumer spending increased at a faster pace. And businesses invested more in equipment and software.

In addition, homebuilders are stepping up construction to meet rising demand. That could generate even more construction jobs.

And home prices are rising steadily. That tends to make Americans feel wealthier and more likely to spend. Housing could add as much as 1 percentage point to economic growth this year, some economists estimate.

Auto sales reached their highest level in five years in 2012 and are expected to keep growing this year. That's boosting production and hiring at U.S. automakers and their suppliers.

Read More..

Hagel to stress opposition to a nuclear Iran in Senate testimony

WASHINGTON -- President Obama’s nominee for secretary of Defense, former Sen. Chuck Hagel, will stress at his confirmation hearing Thursday that he opposes letting Iran acquire nuclear weapons and will focus on developing military options to set back Tehran’s program, according to a U.S. official familiar with his planned testimony.

It will be Hagel’s first chance to explain his views publicly since his selection last month ignited fierce opposition from several former Republican colleagues and pro-Israel groups. They contend Hagel was not tough enough on Iran during his two terms as a GOP senator from Nebraska, and warn he might not push for a U.S. attack on Iran if one is needed.

“He’s going to be very clear that he fully supports the president’s policy of preventing Iran from getting a nuclear weapon,” said the U.S. official, who spoke on condition of anonymity because Hagel had not yet testified. “His job as secretary of Defense is to ensure that the military is prepared for any contingency, and he believes all options should be on the table, including military options.”

Hagel’s willingness to back the use of force against Iran is likely to be the key area of questioning during what is expected to be a daylong hearing with the Senate Armed Services Committee.

After a shaky start, Hagel’s nomination has picked up increasing support from Democrats, and the first Republican, Sen. Thad Cochran of Mississippi, announced Monday that he would vote for Hagel.

White House officials say they expect more Republicans to back Hagel and predict that when the full Senate votes, he will win more than the 60 votes necessary to avoid the threat of a filibuster.

Some pro-Israel groups have greeted Hagel’s nomination with opposition or lukewarm support. Even Democrats who back Hagel are determined to press him for greater clarity on how long diplomatic pressure and sanctions on Iran should be given to work before a military strike becomes necessary.

Sen. Carl Levin (D-Mich.), chairman of the committee, said “most Democrats are leaning very strongly” for Hagel, including himself. “That doesn’t mean I don’t have questions,” he added.

Many Republicans have not forgiven Hagel for publicly criticizing the George W. Bush administration for its handling of the war in Iraq, and they are likely to be considerably harsher in tone.

Sen. John Cornyn (R-Texas), speaking on the Senate floor Wednesday afternoon, said Hagel’s nomination had “already done damage to the United States’ credibility” in dealing with Iran.

“I realize that Sen. Hagel is now repudiating many of his past actions and statements,” he added. “But we’ve seen this before.”

Like Obama, Hagel has long called for a mix of negotiations and international economic sanctions to pressure Iran, insisting that military action should be considered only as a last resort. As he has sought support for his nomination, Hagel has emphasized that unilateral U.S. sanctions and even military action could be required.

“If Iran continues to flout its international obligations, it should continue to face severe and growing consequences,” Hagel said in response to written questions from the committee. ‘‘While there is time and space for diplomacy, backed by pressure, the window is closing. Iran needs to demonstrate it is prepared to negotiate seriously.’’

Ironically, the pressure on Hagel to come out strongly for a possible military strike against Iran comes as some Israeli officials, who have long pressed the Obama administration to consider a preemptive attack, say Iran appears to have backed away, at least for now, from what the West believes is a program to develop a nuclear bomb.

Sen. James Inhofe (R-Okla.), the top Republican on the panel, said last week that he and Hagel were “too philosophically opposed on the issues" for Inhofe to support his nomination, citing Hagel’s support for defense budget cuts and for cutting nuclear stockpiles. Inhofe was one of three Republicans who voted Tuesday against confirming Sen. John F. Kerry (D-Mass.) as secretary of State.

Senate Minority Leader Mitch McConnell (R-Ky.) on Tuesday declined to rule out the possibility that Republicans would require a 60-vote threshold for confirming Hagel.

“Sen. Hagel hasn't had his hearing yet, and I think it's too early to predict the conditions under which his nomination will be considered,” McConnell said.

Sen. Lindsey Graham (R-S.C.) has said he would block Hagel’s nomination from coming to a vote unless the current Pentagon chief, Leon E. Panetta, agrees to testify about the Sept. 11, 2012, attack on the U.S. compound in Benghazi, Libya. A White House official downplayed the possibility that Hagel’s nomination could be blocked, saying negotiations were underway to let Panetta testify.

david.cloud@latimes.com

michael.memoli@latimes.com

Read More..

Facebook slumps as mobile ad growth fails to impress

(Reuters) – Shares of Facebook Inc were set to open 7 percent lower on Thursday as a surge in fourth-quarter mobile advertising revenue failed to live up to Wall Street’s high expectations.

Three brokerages downgraded the stock of the No. 1 social network, which has struggled to develop a full-fledged mobile advertising business.

Facebook has long established itself as one of the most important websites, but investors have worried that until the company’s mobile advertising strategy takes off, revenue growth will remain shaky.

The company reported a better-than-expected fourth-quarter profit on Wednesday and said its mobile advertising revenue doubled to $ 306 million, suggesting it was making inroads into handheld devices such as smartphones and tablets.

Investors were looking for at least $ 350 million in mobile advertising revenue, Piper Jaffray analyst Gene Munster said in a note to clients.

“While the trajectory of mobile growth may not be as steep as some investors were hoping, the theme of mobile as the future of Facebook remains intact,” he said.

BMO Capital Markets analyst Daniel Salmon, who downgraded the stock to “market perform” from “outperform”, however said Facebook’s 2013 stock performance would not be dictated by its ability to generate mobile ad dollars.

He said new catalysts were necessary to drive Facebook’s stock price up.

Facebook’s stock, which has lost over a quarter of its value since its botched debut in May, were down at $ 29.08 in premarket trading. The shares closed at $ 31.24 on the Nasdaq on Wednesday.

(Reporting by Neha Alawadhi in Bangalore; Editing by Saumyadeb Chakrabarty)

Social Media News Headlines – Yahoo! News

Title Post: Facebook slumps as mobile ad growth fails to impress
Url Post: http://www.news.fluser.com/facebook-slumps-as-mobile-ad-growth-fails-to-impress/
Link To Post : Facebook slumps as mobile ad growth fails to impress
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..

Beyonce to finally face media in New Orleans

NEW ORLEANS (AP) — Beyonce is expected to face the media Thursday as she previews her halftime performance at the Super Bowl. But the focus will likely be on her performance at that other big event earlier this month.

The superstar hasn't spoken publicly since it was alleged that she lip-synched her rendition of "The Star-Spangled Banner" at President Barack Obama's inauguration last week. Her critically praised performance came under scrutiny less than a day later when a representative from the U.S. Marine Band said she wasn't singing live and the band's accompanying performance was taped. Shortly after, the group backed off its initial statement and said no one could tell if she was singing live or not.

It's expected that the halftime performance will be a main focus of her afternoon press conference, even though she'd likely rather concentrate on questions about her set list for Sunday and her upcoming HBO documentary, "Life Is but a Dream." The documentary is being shown for the media just before Beyonce speaks and takes questions, as expected.

There has been plenty of speculation about Beyonce's Super Bowl performance, including reports there would be a Destiny's Child reunion with Michelle Williams and Kelly Rowland (Williams has shot down such speculation). Some are also curious about whether her husband, Jay-Z, will join her onstage, as they often do for each other's shows.

Beyonce has teased photos and video of herself preparing for the show, which will perhaps be the biggest audience of her career. Last year, Madonna's halftime performance was the most-watched Super Bowl halftime performance ever, with an average of 114 million viewers. It garnered more viewers than the game itself, which was the most-watched U.S. TV event in history.

___

Follow Nekesa Mumbi Moody at http://www.twitter.com

Read More..

Well: Waiting for Alzheimer's to Begin

My gray matter might be waning. Then again, it might not be. But I swear that I can feel memories — as I’m making them — slide off a neuron and into a tangle of plaque. I steel myself for those moments to come when I won’t remember what just went into my head.

I’m not losing track of my car keys, which is pretty standard in aging minds. Nor have I ever forgotten to turn off the oven after use, common in menopausal women. I can always find my car in the parking lot, although lots of “normal” folk can’t.

Rather, I suddenly can’t remember the name of someone with whom I’ve worked for years. I cover by saying “sir” or “madam” like the Southerner I am, even though I live in Vermont and grown people here don’t use such terms. Better to think I’m quirky than losing my faculties. Sometimes I’ll send myself an e-mail to-do reminder and then, seconds later, find myself thrilled to see a new entry pop into my inbox. Oops, it’s from me. Worse yet, a massage therapist kicked me out of her practice for missing three appointments. I didn’t recall making any of them. There must another Nancy.

Am I losing track of me?

Equally worrisome are the memories increasingly coming to the fore. Magically, these random recollections manage to circumnavigate my imagined build-up of beta-amyloid en route to delivering vivid images of my father’s first steps down his path of forgetting. He was the same age I am now, which is 46.

“How old are you?” I recall him asking me back then. Some years later, he began calling me every Dec. 28 to say, “Happy birthday,” instead of on the correct date, Dec. 27. The 28th had been his grandmother’s birthday.

The chasms were small at first. Explainable. Dismissible. When he crossed the street without looking both ways, we chalked it up to his well-cultivated, absent-minded professor persona. But the chasms grew into sinkholes, and eventually quicksand. When we took him to get new pants one day, he kept trying on the same ones he wore to the store.

“I like these slacks,” he’d say, over and over again, as he repeatedly pulled his pair up and down.

My dad died of Alzheimer’s last April at age 73 — the same age at which his father succumbed to the same disease. My dad ended up choosing neurology as his profession after witnessing the very beginning of his own dad’s forgetting.

Decades later, grandfather’s atrophied brain found its way into a jar on my father’s office desk. Was it meant to be an ever-present reminder of Alzheimer’s effect? Or was it a crystal ball sent to warn of genetic fate? My father the doctor never said, nor did he ever mention, that it was his father’s gray matter floating in that pool of formaldehyde.

Using the jarred brain as a teaching tool, my dad showed my 8-year-old self the difference between frontal and temporal lobes. He also pointed out how brains with Alzheimer’s disease become smaller, and how wide grooves develop in the cerebral cortex. But only after his death — and my mother’s confession about whose brain occupied that jar — did I figure out that my father was quite literally demonstrating how this disease runs through our heads.

Has my forgetting begun?

I called my dad’s neurologist. To find out if I was in the earliest stages of Alzheimer’s, he would have to look for proteins in my blood or spinal fluid and employ expensive neuroimaging tests. If he found any indication of onset, the only option would be experimental trials.

But documented confirmation of a diseased brain would break my still hopeful heart. I’d walk around with the scarlet letter “A” etched on the inside of my forehead — obstructing how I view every situation instead of the intermittent clouding I currently experience.

“You’re still grieving your father,” the doctor said at the end of our call. “Sadness and depression affect the memory, too. Let’s wait and see.”

It certainly didn’t help matters that two people at my father’s funeral made some insensitive remarks.

“Nancy, you must be scared to death.”

“Is it hard knowing the same thing probably will happen to you?”

Maybe the real question is what to do when the forgetting begins. My dad started taking 70 supplements a day in hopes of saving his mind. He begged me to kill him if he wound up like his father. He retired from his practice and spent all day in a chair doing puzzles. He stopped making new memories in an all-out effort to preserve the ones he already had.

Maybe his approach wasn’t the answer.

Just before his death — his brain a fraction of its former self — my father managed to offer up a final lesson. I was visiting him in the memory-care center when he got a strange look on his face. I figured it was gas. But then his eyes lit up and a big grin overtook him, and he looked right at me and said, “Funny how things turn out.”

An unforgettable moment?

I can only hope.

---

Nancy Stearns Bercaw is a writer in Vermont. Her book, “Brain in a Jar: A Daughter’s Journey Through Her Father’s Memory,” will be published in April 2013 by Broadstone.

Read More..

Small surgeries, huge markups

A Southern California surgery center charged teacher Lynne Nielsen $87,500 for a routine, 20-minute knee operation that normally costs about $3,000.

Despite the huge markup, the Long Beach Unified School District and its insurer, Blue Shield of California, paid virtually all of the bill from Advanced Surgical Partners in Costa Mesa. Blue Shield mailed the $84,800 check to the high school Spanish teacher last month and told her to sign it over to the surgery center.

Nielsen said she was outraged and refused to send the check. Instead, she asked the California attorney general's office to investigate the matter. "This is insane," she said.

The 61-year-old is the latest patient caught up in a growing battle nationwide over billing by outpatient surgery centers. Industry experts say some of these surgery centers seek out well-insured patients such as Nielsen, sometimes by waiving their copays and deductibles, and then bill their insurers exorbitant amounts for out-of-network care.

All too often, critics say, insurers pay these large sums and then cite high medical bills for why insurance premiums keep rising for businesses and consumers.

"This bill is so outrageous it almost takes my breath away," said Gerald Kominski, director of the UCLA Center for Health Policy Research. "This is an example of what's wrong with our healthcare system, and employees and taxpayers of the school district are paying the price here."

In response to questions from The Times, Blue Shield defended its $84,800 payment as proper. Advanced Surgical Partners, through its lawyer, said the bill was excessive. Amid the scrutiny, the two sides agreed to a lower amount this week.

Nationwide, some insurers have begun to challenge these bills from outpatient centers. Last year, a unit of insurance giant Aetna Inc. sued several surgery centers in Northern California and accused them of overbilling the insurer more than $20 million. It has pursued similar actions against providers in New Jersey and Texas. Other insurers such as UnitedHealth Group Inc. have filed similar suits in California.

In one instance, Aetna said, a California surgery center charged $73,536 for a kidney stone procedure when the average in-network charge was $7,612. Aetna said it paid some of these bills before disputing them in court.

Doctors and surgery centers say the criticism is unjustified. Surgery centers say they have helped reduce healthcare costs by offering convenient care at a fraction of what hospitals charge for colonoscopies, cataract surgeries and other outpatient procedures. These facilities now handle up to 40% of all outpatient surgeries, according to the Ambulatory Surgery Center Assn.

Nielsen went to Advanced Surgical Partners in November at the recommendation of her surgeon even though it was out of her insurance network. She checked beforehand with the facility and it assured her they would accept whatever Blue Shield offered to pay.

The surgery center's $87,500 bill was just for use of its facility and supplies. Nielsen's orthopedic surgeon and anesthesiologist billed separately and were paid about $1,200 combined.

Henry Fenton, an attorney for the surgery center, said this bill "was excessive and not correct. I'm sure they will be more careful in the future."

Blue Shield said its typical rate for this arthroscopic knee procedure in Southern California is about $3,000 among in-network providers.

"This surgery center is charging 30 times the average by remaining out of network to advance this outrageous and anti-consumer practice," said Blue Shield spokesman Steve Shivinsky. "This is a national problem."

Yet the company said it was obligated to pay nearly all of Advanced Surgical's bill because it is bound by the health plan rules set by the teacher's employer, the Long Beach school district. The school system is self-insured, meaning it pays its own medical bills and uses Blue Shield to administer its benefits and process claims.

In other situations involving out-of-network care, it's common for insurers to pay only about 60% of what's deemed to be "usual and customary" charges or some percentage of Medicare rates. Insurers and out-of-network medical providers routinely spar over what constitutes a reasonable amount.

Kominski, the UCLA professor, said he faulted both Blue Shield and the school district for "dropping the ball on this. There were lots of opportunities for red flags to go off on such an outlandish bill."

After defending its handling of the claim, Blue Shield reversed course this week and stopped payment on its $84,800 check. It told Nielsen that the surgery center had agreed to accept $15,000 instead.

"We are very pleased that Advanced Surgical Partners agreed to accept a more competitive rate," Shivinsky said.

Overall, Blue Shield said, it expects to have new measures in place by next month to better address these out-of-network billing issues for certain employer health plans. It also said employers should do more to encourage workers to use in-network facilities that are paid negotiated rates.

The Long Beach school district expressed frustration at the teacher's bill, but it echoed Blue Shield's explanation that it will incur additional costs at times because it has promised employees out-of-network benefits.

"This out-of-network issue regarding surgery centers is one that we want to explore with our employee groups in the next bargaining cycle," said Chris Eftychiou, a district spokesman.

Joe Boyd, executive director of the Teachers Assn. of Long Beach, said there is nothing in the employee contract to prevent the school district and Blue Shield from rejecting inflated medical bills.

"That's absurd. It isn't a requirement of the contract to pay fees that are five or 10 times what's customary," Boyd said. "We don't want the school district or our members ripped off."

Nielsen said she remains angry that Blue Shield declined to do anything when she first complained about the situation in December. She plans to continue pursuing the matter with the attorney general's office, which records show has begun an inquiry.

"Our insurance premiums wouldn't keep increasing," she said, "if they paid a fair amount for these procedures."

chad.terhune@latimes.com

Read More..