Athletes cash in on California's workers' comp

SACRAMENTO — In his seven-year career with the Denver Broncos, running back Terrell Davis, a former Super Bowl Most Valuable Player, dazzled fans with his speed and elusiveness.

At the end of his rookie year in 1995, he signed a $6.8-million, five-year contract. Off the field he endorsed Campbell's soup. And when he hung up his cleats, he reported for the National Football League Network and appeared in movies and TV shows.

So it may surprise Californians to find out that in 2011, Davis got a $199,000 injury settlement from a California workers' compensation court for injuries related to football. This came despite the fact Davis was employed by a Colorado team and played just nine times in California during an 88-game career, according to the NFL.

Davis was compensated for the lifelong effects of multiple injuries to the head, arms, trunk, legs and general body, according to California workers' compensation records.

He is not alone.

Over the last three decades, California's workers' compensation system has awarded millions of dollars in benefits for job-related injuries to thousands of professional athletes. The vast majority worked for out-of-state teams; some played as little as one game in the Golden State.

All states allow professional athletes to claim workers' compensation payments for specific job-related injuries — such as a busted knee, torn tendon or ruptured spinal disc — that happened within their borders. But California is one of the few that provides additional payments for the cumulative effect of injuries that occur over years of playing.

A growing roster of athletes are using this provision in California law to claim benefits. Since the early 1980s, an estimated $747 million has been paid out to about 4,500 players, according to an August study commissioned by major professional sports leagues. California taxpayers are not on the hook for these payments. Workers' compensation is an employer-funded program.

Now a major battle is brewing in Sacramento to make out-of-state players ineligible for these benefits, which are paid by the leagues and their insurers. They have hired consultants and lobbyists and expect to unveil legislation next week that would halt the practice.

"The system is completely out of whack right now," said Jeff Gewirtz, vice president of the Brooklyn Nets — formerly the New Jersey Nets — of the National Basketball Assn.

Major retired stars who scored six-figure California workers' compensation benefits include Moses Malone, a three-time NBA most valuable player with the Houston Rockets, Philadelphia 76ers and other teams. He was awarded $155,000. Pro Football Hall of Fame wide receiver Michael Irvin, formerly with the Dallas Cowboys, received $249,000. The benefits usually are calculated as lump-sum payments but sometimes are accompanied by open-ended agreements to provide lifetime medical services.

Players, their lawyers and their unions plan to mount a political offensive to protect these payouts.

Although the monster salaries of players such as Los Angeles Lakers guard Kobe Bryant and Denver Broncos quarterback Peyton Manning make headlines, few players bring in that kind of money. Most have very short careers. And some, particularly football players, end up with costly, debilitating injuries that haunt them for a lifetime but aren't sufficiently covered by league disability benefits.

Retired pros increasingly are turning to California, not only because of its cumulative benefits but also because there's a longer window to file a claim. The statute of limitations in some states expires in as little as a year or two.

"California is a last resort for a lot of these guys because they've already been cut off in the other states," said Mel Owens, a former Los Angeles Rams linebacker-turned-workers' compensation lawyer who has represented a number of ex-players.

To understand how it works, consider the career of Ernie Conwell. A former tight end for the St. Louis Rams and New Orleans Saints, he was paid $1.6 million for his last season in 2006.

Conwell said that during his 11-year career, he underwent about 18 surgeries, including 11 knee operations. Now 40, he works for the NFL players union and lives in Nashville.

Hobbled by injuries, he filed for workers' compensation in Louisiana and got $181,000 in benefits to cover his last, career-ending knee surgery in 2006, according to the Saints. The team said it also provided $195,000 in injury-related benefits as part of a collective-bargaining agreement with the players union.

But such workers' compensation benefits paid by Louisiana cover only specific injuries. So, to deal with what he expects to be the costs of ongoing health problems that he said affect his arms, legs, muscles, bones and head, Conwell filed for compensation in California and won.

Even though he played only about 20 times in the state over his professional career, he received a $160,000 award from a California workers' compensation judge plus future medical benefits, according to his lawyer. The Saints are appealing the judgment.

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Adele, 'Les Miserables' cast sing on Oscar stage

LOS ANGELES (AP) — It was an extra starry, musical day at the Dolby Theatre.

Adele took the stage first Friday, followed by the cast of "Les Miserables," singing together of the first time.

Oscar nominees Hugh Jackman and Anne Hathaway, along with co-stars Russell Crowe, Amanda Seyfried, Helena Bonham-Carter, Sasha Baron-Cohen, Eddie Redmayne, Aaron Tveit and Samantha Barks rehearsed their performances on the Oscar stage. They were backed by members of the musical's stage productions from London and Broadway.

"Les Miserables" director Tom Hooper sat in the front row of the theater as his cast sang.

Moments earlier, Adele dazzled the tiny audience of show workers with her performance of the James Bond theme "Skyfall."

"I need a lot more reverb on me," she said after her first run. "You might need to get a new reverb machine."

The 24-year-old multiple Grammy winner arrived wearing a black tunic, black leggings and flats, with no makeup and her hair in a ponytail.

"I'm going to have very high heels on the night, guys," she announced from the microphone, sipping tea between verses.

"Do you need the dresses?" she asked, and a team of stylists brought out the gowns Adele is considering for her Oscar performance.

The dress producers favored? "It's very heavy — I mean I struggle to stand in it," Adele said. "Come and feel how heavy it is, so you don't think I'm a wimp!"

She performed her Oscar-nominated song five times before leaving the theater. "It's been good, yeah?" she asked producer Neil Meron, who nodded in approval.

Just after Adele wrapped, the star-studded "Les Miserables" cast took the stage. Hathaway chatted with Bonham-Carter as Jackman sang a capella. Then Hathaway checked her microphone with a quick verse.

"Ooh, that was flat," she said.

The entire cast assembled for a final run-through when Jackman spontaneously began singing "My Bonny Lies over the Ocean."

"My bonny lies over my daddy," the ensemble responded, breaking into laughter.

Other stars rehearsing Friday included Jennifer Hudson, who is set to perform a song from "Dreamgirls" at Sunday's ceremony.

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AP Entertainment Writer Sandy Cohen is on Twitter: www.twitter.com/APSandy .

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Drone Pilots Found to Get Stress Disorders Much as Those in Combat Do

U.S. Air Force/Master Sgt. Steve Horton

Capt. Richard Koll, left, and Airman First Class Mike Eulo monitored a drone aircraft after launching it in Iraq.

The study affirms a growing body of research finding health hazards even for those piloting machines from bases far from actual combat zones.

“Though it might be thousands of miles from the battlefield, this work still involves tough stressors and has tough consequences for those crews,” said Peter W. Singer, a scholar at the Brookings Institution who has written extensively about drones. He was not involved in the new research.

That study, by the Armed Forces Health Surveillance Center, which analyzes health trends among military personnel, did not try to explain the sources of mental health problems among drone pilots.

But Air Force officials and independent experts have suggested several potential causes, among them witnessing combat violence on live video feeds, working in isolation or under inflexible shift hours, juggling the simultaneous demands of home life with combat operations and dealing with intense stress because of crew shortages.

“Remotely piloted aircraft pilots may stare at the same piece of ground for days,” said Jean Lin Otto, an epidemiologist who was a co-author of the study. “They witness the carnage. Manned aircraft pilots don’t do that. They get out of there as soon as possible.”

Dr. Otto said she had begun the study expecting that drone pilots would actually have a higher rate of mental health problems because of the unique pressures of their job.

Since 2008, the number of pilots of remotely piloted aircraft — the Air Force’s preferred term for drones — has grown fourfold, to nearly 1,300. The Air Force is now training more pilots for its drones than for its fighter jets and bombers combined. And by 2015, it expects to have more drone pilots than bomber pilots, although fighter pilots will remain a larger group.

Those figures do not include drones operated by the C.I.A. in counterterrorism operations over Pakistan, Yemen and other countries.

The Pentagon has begun taking steps to keep pace with the rapid expansion of drone operations. It recently created a new medal to honor troops involved in both drone warfare and cyberwarfare. And the Air Force has expanded access to chaplains and therapists for drone operators, said Col. William M. Tart, who commanded remotely piloted aircraft crews at Creech Air Force Base in Nevada.

The Air Force has also conducted research into the health issues of drone crew members. In a 2011 survey of nearly 840 drone operators, it found that 46 percent of Reaper and Predator pilots, and 48 percent of Global Hawk sensor operators, reported “high operational stress.” Those crews cited long hours and frequent shift changes as major causes.

That study found the stress among drone operators to be much higher than that reported by Air Force members in logistics or support jobs. But it did not compare the stress levels of the drone operators with those of traditional pilots.

The new study looked at the electronic health records of 709 drone pilots and 5,256 manned aircraft pilots between October 2003 and December 2011. Those records included information about clinical diagnoses by medical professionals and not just self-reported symptoms.

After analyzing diagnosis and treatment records, the researchers initially found that the drone pilots had higher incidence rates for 12 conditions, including anxiety disorder, depressive disorder, post-traumatic stress disorder, substance abuse and suicidal ideation.

But after the data were adjusted for age, number of deployments, time in service and history of previous mental health problems, the rates were similar, said Dr. Otto, who was scheduled to present her findings in Arizona on Saturday at a conference of the American College of Preventive Medicine.

The study also found that the incidence rates of mental heath problems among drone pilots spiked in 2009. Dr. Otto speculated that the increase might have been the result of intense pressure on pilots during the Iraq surge in the preceding years.

The study found that pilots of both manned and unmanned aircraft had lower rates of mental health problems than other Air Force personnel. But Dr. Otto conceded that her study might underestimate problems among both manned and unmanned aircraft pilots, who may feel pressure not to report mental health symptoms to doctors out of fears that they will be grounded.

She said she planned to conduct two follow-up studies: one that tries to compensate for possible underreporting of mental health problems by pilots and another that analyzes mental health issues among sensor operators, who control drone cameras while sitting next to the pilots.

“The increasing use of remotely piloted aircraft for war fighting as well as humanitarian relief should prompt increased surveillance,” she said.

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Jason Bateman gives Ernest Borgnine's estate a new identity

Markus Canter and Cristie St. James, who share the title luxury properties director at Prudential in Beverly Hills, like Jason Bateman's real estate sense. The actor got privacy, potential and a knoll location for $3 million.

Actor Jason Bateman and his wife, actress Amanda Anka, are dropping anchor in the Beverly Crest area with the purchase of the estate of Ernest Borgnine for $3 million.

The gated country English compound sits on a half-acre knoll. The 6,148-square-foot home features a formal entry hall, a grand staircase, a paneled library, an office, a den, six bedrooms and seven bathrooms. There is a guesthouse and a swimming pool.

Bateman, 44, stars in the comic film "Identity Thief," released this month. He is known to generations of TV viewers for his roles in "Arrested Development" (2003-present) and "Valerie," later retitled "The Hogan Family" (1986-91). Anka, 44, has appeared in "Bones" (2008), "Notes From the Underbelly" (2007) and "Beverly Hills, 90210" (1996).

Borgnine, who died last year at 95, is remembered for his Oscar-winning performance in "Marty" (1955) and his work in the title role as commander of a madcap crew in the sitcom "McHale's Navy" (1962-65). Until 2011 he was the voice of Mermaidman on "SpongeBob SquarePants."

The estate came on the market in October for the first time in 60 years priced at $3.395 million.

Billy Rose, Paul Lester and Aileen Comora of the Agency in Beverly Hills were the listing agents. Richard Ehrlich of Westside Estate Agency represented the buyers.

Where pair spent days of their lives

Soap star Peter Reckell and his wife, singer Kelly Moneymaker, have sold their custom-built, eco-friendly home in Brentwood for $3.35 million.

Before building the 3,345-square-foot house, the couple had the existing home on the site torn down, crated and shipped to Mexico for reuse by Habitat for Humanity. Then they designed and built a three-bedroom, four-bathroom contemporary that uses solar power.

Green elements include a photovoltaic system with battery backup, skylights, recycled glass terrazzo floors with radiant heating, recycled denim and organic cotton insulation, bamboo cabinets and doors, a roof garden and a water reclamation system.

A temperature-controlled wine cave and a recording studio are among other features.

Along with an indoor/outdoor koi pond, a meditation fountain and a solar infinity pool, outdoor amenities include a 16th century East Indian temple that was turned into a pavilion.

"This is my sanctuary," Reckell said. It frames views of the Santa Monica Mountains Conservancy.

Reckell, 57, played Bo Brady on "Days of Our Lives" from 1983 through last year. The show began in 1965. He also appeared in "Knots Landing" (1988-89). He is an avid environmentalist and bikes to work.

Moneymaker, 42, is a former member of the music group Exposé. She was inspired to build an environmentally friendly home because the carpet and other elements in the old house bothered her allergies and affected her voice.

Public records show they bought the property in 2003 for $1.14 million.

Daniel Banchik of Prudential's West Hollywood office was the listing agent. Scott Segall of John Aaroe Group represented the buyer.

Another rock owner for home

Hard Rock Cafe co-founder Peter Morton has made his mark on L.A.'s real estate scene of late, buying the old Elvis Presley estate in Beverly Hills at year-end for $9.8 million.

But flying under the radar was his bigger off-market purchase midyear for a property in Bel-Air at $25 million, public records show. Area real estate agents not involved in the transaction say Morton plans to take down the existing home and build another on the site. The estate had belonged to Joseph Farrell, who founded National Research Group Inc. in 1978 and brought market testing to Hollywood. Farrell died in December 2011.

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Gunfire and deadly crash rattle the Las Vegas Strip

LAS VEGAS — A spectacular predawn crash on the Strip — triggered when bullets fired from a black Range Rover peppered a Maserati — hit this resort city right between the eyes. In the end, three people were dead and a major intersection under lockdown during a three-state manhunt for the shooters, leaving even casino veterans used to the extraordinary scratching their heads.

The mayhem was sparked, witnesses told police, by a quarrel early Thursday at a hotel valet stand.

The two vehicles left the Aria resort hotel and were heading north on Las Vegas Boulevard at 4:20 a.m., an hour when the casino marquees shine brightly but the gambling thoroughfare is largely empty. At Harmon Avenue, occupants inside the Range Rover opened fire on the Maserati, police said.

The silver-gray sports car, which was struck several times, sped into the intersection at Flamingo Road, ramming a Yellow cab. The taxi exploded, killing the driver and a passenger. Four other vehicles in the intersection were also involved in the crash and explosion, but officers offered no details.

"Omg Omg Omg that car just blew up!" one witness tweeted shortly after the crash, posting a photo of the wreckage. "God Bless their Souls! Omg!"

The driver of the Maserati died later at a hospital, police said. A passenger in the vehicle received minor injuries and was being interviewed by investigators. At least three others were also injured.

Police in Nevada, California, Arizona and Utah were on alert for the distinctive black Range Rover SUV, described as having dark-tinted windows, black rims and out-of-state paper dealer plates.

"We are going to pursue these individuals and prosecute them," Clark County Sheriff Doug Gillespie said at an afternoon news conference. "This act was totally unacceptable. It's not just tragic but unnecessary — the level of violence we see here in Las Vegas and across America."

Authorities had not publicly identified the dead. But a Las Vegas television station late Thursday identified the taxi driver as Michael Boldon, 62, who the station said had recently moved here from Michigan to care for his 93-year-old mother.

The victim's son, who drives a limousine, told Fox News 5 that he last talked with his father after 3 a.m., and later called his cellphone shortly after the crash to warn him to avoid the Strip. But there was no answer.

The station also identified the driver of the Maserati as Ken Cherry, a rap artist from Oakland who also is known as "Kenny Clutch." The station quoted family members identifying Cherry as the driver. An Internet video of a Cherry song called "Stay Schemin" shows two men in a vehicle on the Strip.

Police had more questions than answers.

"It began with a dispute at a nearby hotel and spilled onto the streets," said Capt. Chris Jones of the Las Vegas Police Robbery and Homicide Division.

The morning's events threw the Strip into disarray all day. The gambling boulevard's busiest and best-known intersection was cordoned off by yellow police tape until nightfall, keeping traffic and curious pedestrians away from the carnage. Even skywalks were blocked off.

While slot machines beeped and card games continued inside casinos around the accident scene — including the Bellagio, Caesars Palace and Paris Las Vegas — hotel bell captains were fielding questions from tourists who had awakened to news of the crash and the Strip shutdown. The alleys and side streets between nearby hotels were clogged with pedestrians who inched along on narrow sidewalks, past delivery doors, many making their own paths between the landscaped bushes and palm trees.

Even casino industry workers were thrown into turmoil. Hotel maids and dealers who finished their midnight shifts after dawn were left without bus service home. "I'm stranded," said Tiruselam Kefyalew, 25, a maid. "What a day to leave my cellphone at home."

Limousine drivers who normally prowl the city's gambling core improvised detours. Some said the police blockade would cost them $500 or more in lost business and tips.

"Most people understand, but you have your complainers," said Jim DeSanto, a limo driver who waited for fares outside Bally's casino. "Those people will complain, even when everything is perfect."

Well after noon, guests peered out nearby hotel windows and others leaned into the street to glimpse the crime scene.

"Hey, honey, it must have happened right here," one man told his wife as they left Caesars around noon. The tourist, who would only say that he had arrived from Tampa, Fla., the previous evening, had looked out his hotel window at 4:30 to see a vehicle in flames.

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Well: Depression May Stifle Shingles Vaccine Response

Depression may lower the effectiveness of the shingles vaccine, a new study found.

The research showed that adults with untreated depression who received the vaccine mounted a relatively weak immune response. But those who were taking antidepressants showed a normal response to the vaccine, even when symptoms of depression persist.

Shingles, an acute and painful rash, strikes a million Americans each year, mostly older adults. Health officials recommend that those over 60 get vaccinated against the condition, which is caused by reactivation of the same virus that causes chickenpox, varicella-zoster.

In the new study, published in the journal Clinical Infectious Diseases, researchers followed a group of 92 older men and women for two years. Forty of the subjects had a major depressive disorder; they were matched with 52 control subjects of similar age. The researchers measured their immune responses to the shingles vaccine and a placebo shot.

Compared with the control patients, those with depression were poorly protected by the vaccine. But the patients who were being treated for their depression showed a boost in immunity — what the researchers called a “normalization” of the immune response. It is unclear why that was the case.

The authors of the study speculated that treatment of older people with depression might increase the effectiveness of the flu shot and other vaccines as well.

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Stocks open higher following a two-day decline

Strong earnings results from big U.S. companies offered investors a whiff of hope Friday. Stocks rose after a two-day slump, but remained on track for their worst week this year.

Hewlett-Packard drove the Dow Jones industrial average higher a day posting fiscal first-quarter earnings that beat the forecasts of analysts and the company itself. The results came as relief after months of bad news for the computer maker. Its stock rose $1.36, or 8 percent, to $18.46.

American International Group Inc. helped boost the Standard & Poor's 500 index after saying its fourth-quarter operating results exceeded forecasts. The company's net loss was $4 billion, mainly because of claims related to Superstorm Sandy, in the first full quarter after it finished repaying its $182 billion government bailout. Its stock rose $1.39, or 4 percent, to $38.67.

The Dow Jones industrial average was up 42 points at 13,922 in the first 45 minutes of trading. The Standard & Poor's 500 index rose six to 1,508. The Nasdaq composite index rose 14 to 3,145.

All three indexes remain down for the week. The S&P 500 is on track for its first weekly loss of the year.

Stocks plunged Wednesday afternoon after minutes from the Federal Reserve's latest policy meeting spooked investors. The minutes revealed disagreement at the Fed about how long to keep buying bonds in an effort to boost the economy. The slide continued Thursday.

Many analysts believe that the Fed's bond-buying and resulting low interest rates have driven this year's stock rally, which has lifted indexes to their highest levels since the 2008 financial crisis.

Among the other corporate news moving markets:

— Abercrombie & Fitch sank after a key sales metric declined in the all-important holiday quarter. Its stock fell $2.27, or 5 percent, to $46.78.

— WebMD Health Corp. soared after the health website operator reported better-than-expected revenue and an optimistic outlook for 2013. The stock rose $3.85, or 24 percent, to $20.15.

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Bulgari shows off Liz Taylor's gems

It isn't easy sometimes to be an ordinary person in Los Angeles, so near to and yet so far from the city's glamorous events.

You hear about the grand Oscar parties, but you will never be invited. The award ceremony may be taking place minutes from where you live, but you watch it at home, on TV, in your sweat pants — and you might as well be in Dubuque.

Rodeo Drive too can make you feel like a scrap on the cutting room floor. As you stroll the wide and immaculate sidewalks of Beverly Hills' iconic shopping street, you pass by boutiques you'd feel self-conscious walking into. In the windows are baubles and trinkets you could never in three lifetimes afford.

Which is why it is rather nice to be invited to make a private appointment at the house of Bulgari, the fine Italian jeweler that opened its doors in 1884.

Elizabeth Taylor loved Bulgari jewels. Richard Burton, whose torrid affair with her began during the filming of "Cleopatra" in Rome, accompanied her often to the flagship shop on the Via Condotti. He liked to joke that the name Bulgari was all the Italian she knew.

So it is fitting that starting Oscar week, the jeweler is celebrating the Oscar-winning star with an exhibit of eight of her most treasured Bulgari pieces.

They are heavy on diamonds and emeralds — of rare size, gleam and value.

And Bulgari knows their value well.

After Taylor's death, it reacquired some of the gems at a Christie's auction. One piece, an emerald-and-diamond brooch that also can be worn as a pendant, sold for $6,578,500 — breaking records both for sales price of an emerald and for emerald price per carat ($280,000).

That brooch, whose centerpiece is an octagonal step-cut emerald weighing 23.44 carats, was Burton's engagement present to Taylor. He followed it upon their marriage (his second, her fifth) with a matching necklace whose 16 Colombian emeralds weigh in at 60.5 carats. Bulgari bought the necklace back too, for $6,130,500.

They are in the exhibit, along with Burton's engagement ring to Taylor and a delicate brooch — given to her by husband No. 4, Eddie Fisher — whose emerald and diamond flowers were set en tremblant so that they gently fluttered as Taylor moved.

The jewels are not for sale.

On Tuesday night, actress Julianne Moore wore the Burton necklace, with pendant attached, at a gala for Bulgari's top clients. At the dinner hour, guests were escorted along a lavender-colored carpet to a nearby rooftop that had been transformed into a Roman terrace.

Those honored guests, of course, got private viewings of Taylor's jewels.

But so did Amanda Perry, a healer from West Hollywood who arrived the next morning for one of the first appointments available to the public.

Someone had emailed news of the collection to the 35-year-old Taylor fan. She walked in off the street Tuesday, when the exhibit was open only to press — and Sabina Pelli, Bulgari's glamorous executive vice president, fresh from Rome, was taking sips of San Pellegrino brought to her on a silver tray between back-to-back interviews that started at 5 a.m.

The camera crews were long gone when Perry came back Wednesday. She had the exhibit, and handsome sales associate Timothy Morzenti of Milan, entirely to herself.

In a black suit, still wearing on his left hand the black glove he dons to handle fine jewels, Morzenti whisked Perry off via a private elevator to the exhibit on the second floor. The jewels stood in vitrines mounted high off the ground. Behind them were photos and a slide show of Taylor, bejeweled.

"Which piece would you like to see first?" Morzenti asked her as a security guard stood by. "I personally love the emerald ring."

Then he proceeded at leisure to explain Bulgari-signature sugar-loaf cuts and trombino ring settings, while tossing in occasional Taylor stories.

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Well: Getting Patients to Think About Costs

A colleague and I recently got into a heated discussion over health care spending. It wasn’t that he disagreed with me about the need to rein in costs; but he said he was frustrated every time he tried to do so.

Earlier that week, for example, he had tried to avoid ordering a costly M.R.I. scan for a patient who had been suffering from headaches. After a thorough examination, my colleague was convinced the headaches were the result of stress.

But the patient was not.

“She wouldn’t leave until she got that M.R.I.,” my colleague said. Even after he had explained his conclusions several times, proposed a return visit in a month to reassess the situation and ran so far overtime that his office nurse knocked on the door to make sure nothing had gone awry, the patient continued to insist on getting the expensive study.

When my colleague finally evoked cost – telling the woman that while an M.R.I. might ferret out rare causes, it didn’t make sense to spend the enormous fee on something of such marginal benefit – the woman became belligerent. “She yelled that this was her head we were talking about,” he recalled. “And expensive tests like this were the reason she had health insurance.”

Face flushed, he paused to take a deep breath. “Yeah, I may be all for controlling costs,” he finally said. “But are our patients?”

According to a new study in the journal Health Affairs, his concern about patients may not be far off the mark.

A growing number of initiatives aimed at controlling spiraling health care costs have been championed in recent years, aiming to replace the current model in which doctors are reimbursed for every office visit, test or procedure performed. These programs range from pay-for-performance, where doctors can earn more money by meeting predetermined quality “goals” like controlling patients’ blood sugar or high blood pressure, to accountable care organizations, where clinicians and hospitals in partnership are paid a lump sum to cover all care.

Their uninspired monikers aside, all of these plans share one defining feature: doctors are to be the key agents of change. Whether linked with quality measures, bundled payments or satisfaction scores, it is the doctors’ behavior and choice of treatments that result in savings, goes the thinking.

But as the new study reveals, doctors need to take into account more than just symptoms and diseases when deciding what to prescribe and offer. They must also consider their patients’ opinions and willingness to be cost conscious when it comes to their own care.

The researchers conducted more than 20 patient focus groups and asked the participants to imagine themselves with various symptoms and a choice of diagnostic and treatment options that varied only slightly in effectiveness but significantly in cost. They were asked, for example, to choose between an M.R.I. or a CT scan for a severe long-standing headache, with the M.R.I. being much more expensive but also more likely to catch some extremely rare problems.

When it came to their own treatment, “patients for the most part did not want cost to play any role in decision-making,” said Dr. Susan Dorr Goold, one of the study authors and a professor of internal medicine and health management and policy at the University of Michigan in Ann Arbor. Most did not want their doctors to take expenditures into account, and many made it clear that they would ask for the significantly more expensive medications, procedures or diagnostic studies, even if those options were only slightly better than the cheaper alternatives. “That puts doctors, whose primary responsibility is to their individual patients, in a very difficult position.”

A majority of the participants refused to consider the expenses borne by insurers or by society as a whole when making their choices. Some doubted that one individual’s efforts would have any real overall impact and so gave up considering cost-savings altogether. Others said they would go out of their way to choose the more expensive options, viewing such decisions as acts of defiance and a kind of well-deserved “payback” after years of paying insurance premiums.

Underlying all of these comments was the belief that cost was synonymous with quality. Even when the focus group leaders reminded participants that the differences between proposed options were nearly negligible, participants continued to choose the more expensive options as if it were beyond question that they must be more efficacious or foolproof.

The study’s findings are disheartening. But Dr. Goold and her co-investigators believe that public beliefs and attitudes about cost and quality can be changed. They cite the dramatic transformation in attitudes about end-of-life care as an example of how initiatives to improve understanding can lead people to make higher quality and more cost-effective decisions, like choosing hospices over hospitals.

“We need to begin to talk about these issues in a way that doesn’t turn it into a discussion pitting money against life, and we need to find ways of getting people to think about not spending money on things that offer marginal benefit” Dr. Goold said. “Because it’s going to be tough otherwise trying to implement any cost-saving measures, if patients don’t accept them.”

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Freddie Mac: 30-year mortgage rate rises slightly to 3.56%

The average interest rate for a 30-year fixed home loan was 3.56% early this week, according to the giant mortgage finance company Freddie Mac. The low rates are helping to spur more construction of new homes. (Katie Falkenberg / For The Times)

By E. Scott Reckard

February 21, 2013, 8:01 a.m.

Lenders were offering 30-year fixed mortgages at an average 3.56% this week, up slightly from last week, while the 15-year fixed loan held steady at 2.77%, according to Freddie Mac’s weekly survey.

Start rates on adjustable mortgages were flat to slightly higher, Freddie Mac said in the survey, released Thursday.

The 30-year rate, pegged at 3.53% for the three previous weeks, is now up about a quarter of a percentage point from its record lows late last year.  

QUIZ: How much do you know about mortgages?

The favorable rates have helped to drive housing demand, pushing prices higher. The online real-estate site Zillow Inc. said Thursday that nearly 2 million U.S. homeowners were freed from negative equity in 2012, meaning their mortgages were no longer larger than the value of their homes.

The low rates also are encouraging new-home construction, although new-home starts slipped slightly in January compared to December.

Freddie Mac asks lenders each week what terms they are offering borrowers on popular types of loans. In the latest survey, the borrowers would have paid an average 0.8% of the loan amount in upfront fees and discount points to the lenders.

US Total Construction Spending data by YCharts

ALSO:

Refinances surge thanks to help for underwater borrowers

Gary Winnick asking $225 million for 8.4-acre Bel-Air estate

Banks have provided $45.8 billion in aid under mortgage settlement

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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,
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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..

Grapevine on Interstate 5 closed due to ice

By Hailey Branson-Potts

February 20, 2013, 7:19 a.m.

The California Highway Patrol shut down a stretch of Interstate 5 through the Grapevine early Wednesday because of ice.

The freeway was closed about 6:35 a.m. between Castaic and Grapevine Road, said CHP Officer Ed Jacobs. No motorists were stranded, he said.

“Until further notice, it’s Mother Nature’s call” on when to reopen the highway, Jacobs said.

Lingering rain, snow showers and gusty winds were expected to affect mountain regions until midday, according to the National Weather Service. Up to three inches of snow could fall Wednesday at elevations as low as 2,000 feet.

The additional precipitation could create hazardous icy roadways, the National Weather Service said. Snowfall, coupled with heavy winds, could reduce visibility to zero.

A stretch of California 58 in Kern County, which was shut down Tuesday night because of snow, remained closed, according to the California Highway Patrol.

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Autopsy confirms Mindy McCready's death as suicide

HEBER SPRINGS, Ark. (AP) — Authorities in Arkansas say preliminary autopsy results confirm country music singer Mindy McCready's death was a suicide.

The Cleburne County sheriff said in a statement Wednesday that preliminary autopsy results from Arkansas' state crime lab show McCready's death was a suicide from a single gunshot wound to the head.

Investigators have said McCready apparently shot and killed her late boyfriend's dog before she turned the gun on herself Sunday at her home in Heber Springs, Ark. Authorities found McCready's body and the dog on the front porch where her longtime boyfriend, musician David Wilson, died last month of a gunshot wound to the head.

Authorities are investigating Wilson's death as a suicide but haven't determined an official cause of death yet.

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Ask an Expert: Questions About Hearing Loss? A Help Desk

This week’s Ask the Expert features Neil J. DiSarno, who will answer questions about hearing loss. Dr. DiSarno is the chief staff officer for audiology at the American Speech-Language-Hearing Association. From 1998 to 2012 he was chairman of the department of communication sciences and disorders at Missouri State University. Following are the types of questions that Dr. DiSarno is prepared to answer.

Neil J. DiSarno of the American Speech-Language-Hearing Association.

¶My wife has told me she believes I’m not hearing as well as I used to. What sort of specialist should I see and what can I expect?

¶I’ve been told that I should consider using hearing aids. If I decide to, how much better am I likely to hear?

¶I’ve noticed that my 2-year-old granddaughter’s speech is not developing properly. Neither her mother or the pediatrician seem to be concerned, but I suspect there is a problem. What do you suggest?

¶I use hearing aids, but still have great difficulty hearing conversation in restaurants and in large group settings. Is this common and is there something more that I can do to improve my ability to function in those settings?

Please leave your questions in the comments section. Answers will be posted on Wednesday, Feb. 27. (Unfortunately, not all questions may be answered.)

Booming: Living Through the Middle Ages offers news and commentary about baby boomers, anchored by Michael Winerip. You can connect with Michael Winerip on Facebook here. You can follow Booming via RSS here or visit nytimes.com/booming and reach us by e-mail at booming@nytimes.com.

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Stocks slip following homebuilding slowdown

Associated Press

February 20, 2013, 8:54 a.m.

Stock indexes are slipping in midday trading after the government reported that housing construction slowed down during the first month of the year.

The Dow Jones industrial average fell 33 points to 14,001 as of noon Eastern Wednesday.

The Standard & Poor's 500 index dropped seven points to 1,523. The Nasdaq composite fell 20 points to 3,193.

The Dow closed at its highest level of the year Tuesday, bringing it within one percent of 14,164, the record high reached more than five years ago.

GPS device maker Garmin plunged 9 percent after the company's results missed analysts' forecasts.

Boeing rose 1 percent. An investigation into the overheating of a battery that caused a Boeing 787 to make an emergency landing in Japan last month found that it was incorrectly wired.

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..

Four dead, including suspect, in series of Orange County shootings

Orange County sheriff's officials said they don't know what prompted a series of shootings across multiple cities early Tuesday morning that left at least four people dead and others wounded.

Authorities believe the violence began in Ladera Ranch, south of Mission Viejo.

The first call came at 4:45 a.m. reporting a shooting on Red Leaf Lane, where deputies discovered a woman shot dead at the scene.

The suspect, described as a man in his 20s, fled the area in an SUV.

Sheriff's Department spokesman Jim Amormino said “multiple incidents” then occurred in Tustin and another at the Santa Ana border before the suspect apparently shot and killed himself in Orange.

“There’s a lot to sort out,” he said.

Tustin Police Lt. Paul Garaven said the suspect attempted to carjack multiple vehicles in Tustin, with  each shooting occurring a few minutes apart.

Police received a report about 5:30 a.m. of a carjacking near Red Hill Avenue and Nisson Road near the 5 Freeway in Tustin, Garaven said.

The carjacking suspect opened fire and wounded a bystander, he said.

Soon after that, another carjacking was reported near the 55 Freeway, Garaven said. The victim of that carjacking was killed, Garaven said. A body lay covered by a yellow tarp on Village Way near the McFadden Avenue freeway entrance.

Another shooting was reported on Edinger Avenue near the Micro Center in Tustin, Garaven said. Officers confirmed that another carjacking had taken place, he said.

One person was killed and another was taken to a hospital. Officers spotted the suspect in a stolen vehicle, followed him into the city of Orange and initiated a traffic stop near the intersection of East Katella Avenue and North Wanda Road, Garaven said.

The suspect then shot and killed himself, Garaven said. Garaven said there is “no threat to the community” because the suspect is deceased.

Bill Myers, who works at Allied Refrigeration at Edinger Avenue in Tustin, said he passed numerous police vehicles on his way to work early Tuesday.

The Micro Center, across the street from Allied Refrigeration, was roped off, and police were at the scene, Myers said.

Myers arrived at work at about 6:20 a.m. and said there was "a bunch of activity going on. It was pretty crazy."

Read More..

Clive Davis reveals in memoir that he's bisexual

NEW YORK (AP) — Record executive Clive Davis says he's bisexual.

In his new memoir, out Tuesday, the 80-year-old, who is twice divorced, reveals that he had sex with a man in the 1970s. Davis writes in "The Soundtrack of My Life" that he hadn't been repressed or confused during his marriages and that sex with a man "provided welcome relief."

He also writes that he started dating a man from 1990 to 2004, which he says was a "tough adjustment" for his son Mitchell. He says after "one trying year," he and his son worked things out. Davis is the father of three children.

Davis is the chief creative officer of Sony Music Entertainment. He writes that he's been in a "strong monogamous relationship" with a man for the last seven years.

Read More..

Well: Susan Love's Illness Gives New Focus to Her Cause

During a talk last spring in San Francisco, Dr. Susan Love, the well-known breast cancer book author and patient advocate, chided the research establishment for ignoring the needs of people with cancer. “The only difference between a researcher and a patient is a diagnosis,” she told the crowd. “We’re all patients.”

It was an eerily prescient lecture. Less than two months later, Dr. Love was given a diagnosis of acute myelogenous leukemia. She had no obvious symptoms and learned of her disease only after a checkup and routine blood work.

“Little did I know I was talking about myself,” she said in an interview. “It was really out of the blue. I was feeling fine. I ran five miles the day before.”

Dr. Love, a surgeon, is best known as the author of the top-selling “Dr. Susan Love’s Breast Book” (Da Capo Press, 2010) now in its fifth edition. She is also president of the Dr. Susan Love Research Foundation, which focuses on breast cancer prevention and research into eradicating the disease. But after decades of tireless advocacy on behalf of women with breast cancer, Dr. Love found herself in an unfamiliar role with an unfamiliar disease.

“There is a sense of shock when it happens to you,” she said. “In some ways I would have been less shocked if I got breast cancer because it’s so common, but getting leukemia was a world I didn’t know. Even when you’re a physician, when you get shocking news like this you sort of forget everything you know and are scared the same as everybody else.”

Because Dr. Love’s disease was caught early, she had a little time to seek second opinions and choose her medical team. She chose City of Hope in Duarte, Calif., because of its extensive experience in bone marrow transplants. At 65, Dr. Love was startled to learn she was considered among the “elderly” patients for this type of leukemia.

She was admitted to the hospital and underwent chemotherapy. Because her blood counts did not rebound after the treatment, her stay lasted a grueling seven weeks.

She went home for just two weeks, and then returned to the hospital for a bone-marrow transplant, with marrow donated by her younger sister, Elizabeth Love De Garcia, 53, who lives in Mexico City.

Although the transplant itself was uneventful, the next four weeks were an ordeal. Dr. Love developed pain and neuropathy from the chemotherapy drugs. Dr. Love’s wife, Dr. Helen Cooksey; daughter, Katie Love-Cooksey, 24; and siblings offered round-the-clock support. Ms. Love-Cooksey slept in the hospital every night. “I wasn’t very articulate during that time, but I always had my family there,” Dr. Love said. “They were great advocates for me.”

The transplant “is quite an amazing thing,” Dr. Love said. Her blood type changed from O positive to B positive, the same type as her sister. She also has inherited her sister’s immune system, and a lifelong allergy to nickel has disappeared. “I can wear cheap jewelry now,” she said. She returned to work last month.

Dr. Love has been told her disease is in remission, though her immune system remains compromised and she is more susceptible to infection. So she avoids crowds, air travel and other potential sources of cold and flu viruses.

While Dr. Love has always been a strong advocate for women undergoing cancer treatment, she says her disease and treatment has strengthened her understanding of what women with breast cancer and other types of cancer go through during treatments.

“There are little things like having numb toes or having less stamina to building muscles back up after a month of bed rest,” she said. “There is significant collateral damage from the treatment that is underestimated by the medical profession. There’s a sense of ‘You’re lucky to be alive, so why are you complaining?’ ”

Dr. Love says her experience has emboldened her in her quest to focus on the causes of disease rather than new drugs to treat it.

“I think I’m more impatient now and in more of a hurry,” she said. “I’ve been reminded that you don’t know how long you have. There are women being diagnosed every day. We don’t have the luxury to sit around and come up with a new marketing scheme. We have to get rid of this disease, and there is no reason we can’t do it.”

People who remain skeptical about the ability to eradicate breast cancer should look to the history of cervical cancer, she said. Decades ago, a woman with an abnormal Pap smear would be advised to undergo hysterectomy. Now a vaccine exists that can protect women from the infection that causes most cervical cancers.

“We need to focus more on the cause of breast cancer,” she said. “I’m still very impressed with the fact that cancer of the cervix went from being a disease that robbed women of their fertility, if not their lives, to having a vaccine to prevent it.”

Dr. Love, who wrote a book called “Live a Little!,” said illness has also made her grateful that she didn’t put off her “bucket list” and that she has traveled the world and focused on work she finds challenging and satisfying.

“It just reminds you that none of us are going to get out of here alive, and we don’t know how much time we have,” she said. “I say this to my daughter, whether it’s changing the world or having a good time, that we should do what we want to do. I drink the expensive wine now.”

Read More..

12 non-U.S. billionaires pledge half their fortune to charity

Britain's Richard Branson is among 12 billionaires from outside the U.S. who have signed on to the Giving Pledge. (Adrian Dennis / AFP/Getty Images)

By Alejandro Lazo

February 19, 2013, 8:33 a.m.

Virgin Group founder Richard Branson is among the first group of billionaires from outside the U.S. who have signed up to donate at least half of their wealth to charitable causes as part of the Giving Pledge initiative started by Warren Buffett and Bill and Melinda Gates.

The 12 foreign billionaires who have signed on to the pledge bring the total of signatures to 105 families, according to Bloomberg News. The initiative asking billionaires to pledge at least half of their fortune to philanthropy has largely been focused on the wealthy in the U.S.

“As a young man, I never set out to make money,” Branson wrote in his pledge letter. “We set out to create things that we could be proud of and try to make a difference.”

Other international billionaires pledging include mining magnet Andrew Forrest, Ukrainian businessman Victor Pinchuk and German entrepreneur Hasso Plattner.

ALSO:

Financial planning for the average investor

Daring investors are betting on 'frontier markets'

Anxious investors are day-trading with retirement accounts

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..