Millions of people with hearing loss are not using hearing aids, according to new research by Johns Hopkins scientists.

Nearly 6.7 million Americans age 50 and older have hearing loss, but only one in seven uses a hearing aid, according to the new research. The Hopkins researchers said it shows how under treated hearing loss is. It is the most expansive data analysis on the subject ever.

"Understanding current rates of hearing loss treatment is important, as evidence is beginning to surface that hearing loss is associated with poorer cognitive functioning and the risk of dementia," study senior investigator, otologist and epidemiologist Frank Lin said in a statement. "Previous studies that have attempted to estimate hearing aid use have relied on industry marketing data or focused on specific groups that don't represent a true sample of the United States population."

The study used data from the National Health and Nutrition Examination Survey, a research program that has periodically gathered health information from thousands of Americans since 1971. Participants answered questions about whether they used a hearing aid and had their hearing tested. The studied covered the period from 1999 to 2006.

The findings were published online in the Archives of Internal Medicine online.

They showed that only 14 percent of adults with hearing loss use hearing aids.

Lin said many with hearing loss don't using hearing aids because health insurance often does not cover the costs and because they aren't trained to use the devices. People also don't consider hearing loss a big deal.

"There's still a perception among the public and many medical professionals that hearing loss is an inconsequential part of the aging process and you can't do anything about it," Lin said. "We want to turn that idea around."

Some funding for the study was provided by the U.S. National Institutes of Health.

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By NOAKI SCHWARTZ and DAVID PITT

LOS ANGELES - China's soon-to-be-leader headed to California at the end of his four-day U.S. tour with plans to talk business with Gov. Jerry Brown, tour the Port of Los Angeles, hold a round table with a handful of other governors and maybe even go to a Lakers basketball game.

And, as with his previous travels, Vice President Xi Jinping's focus seems to be on forging relationships.

Xi arrived in Los Angeles on Thursday afternoon after spending the morning in Iowa, where officials from the U.S. and China signed a five-year deal to guide discussions on food security, food safety and sustainable agriculture. China became the top market for U.S. agricultural goods last year, purchasing $20 billion in U.S. agricultural exports, according to the U.S. Department of Agriculture.

Xi, expected to become president next year of the world's most populous nation, climbed into the cab of a John Deere tractor at a 4,000-acre farm near Des Moines and chatted with fifth-generation farmer Rick Kimberley. He asked detailed questions about farming techniques in Iowa, the nation's largest producer of corn and soybeans.

"He said the tractor really felt comfortable. He really enjoyed that," Kimberley said after the visit.

It was a reunion of sorts for Xi, who nearly three decades ago visited Iowa to study agricultural techniques and learn about corn production. He'd insisted on the stop in Iowa, and the farm visit capped the Midwest leg of his visit to the United States.

Xi was joined by U.S. Secretary of Agriculture Tom Vilsack and China Minister of Agriculture Han Changfu during the symposium. In his opening remarks, he said agriculture was an essential industry.

"Food security, energy security and financial security are three main areas of economic security in today's world," he said. "To promote international agricultural and for cooperation from a strategic perspective is of major and long-term significance."

For Los Angeles, Xi's visit will be a reminder of his country's big footprint at the busiest port in the United States - nearly 60 percent of the imports moving through the Port of Los Angeles come from China, $120 billion worth of computers, TVs, sneakers and other goods last year.

By Jonathan D. Epstein, The Buffalo News, N.Y.

Feb. 16--New York State insurance regulators have launched an industry-wide audit of health insurance premium rates, seeking to examine the accuracy of the data used by insurers and HMOs as the basis for their rate requests.

The state's "wide-ranging probe" will include on-site audits of health plans that are regulated by the state, including those sold to small businesses and directly to individuals in the "community-rated" market.

The audits will examine data about claims, insurer administrative costs, premiums and claims reserves. The state, which will hire a private accounting firm to help, will examine selected rate requests that have already been filed, but insurers will not know in advance if their proposal will be included in an audit.

"At a time when spiraling health insurance costs are an incredible burden for working people, it is essential that we ensure that rate requests are based on fair, accurate information that has not been manipulated," said Superintendent of Financial Services Benjamin Lawsky. "These in-depth audits will allow us to drill down underneath the numbers to make sure they are accurate."

Among other things, he said, regulators can look at whether insurers are accurately allocating administrative costs and broker commissions. They will also ensure that insurers have proper controls and oversight so that the data is reliable and accurate. "The audits may also help us identify areas where we can take measures to help control costs," Lawsky added.

But insurers and their trade group said the new audits would be redundant and would miss the bigger cause of rising health insurance premiums: the "soaring cost of medical care," not administrative costs. They cautioned that the added rules and burdens imposed by the state would contribute to rising premiums.

"The Department of Financial Services already has broad regulatory authority over plans, including the prior-approval process and regular audits it conducts of health plans," said Leslie Moran, spokeswoman for the New York Health Plan Association in Albany. "This new level of audits announced today seems duplicative, unnecessary and wasteful of taxpayer dollars."

By Prue Salasky, Daily Press, Newport News, Va.

Feb. 15--Virginians will now have clearer information on which to base their health care decisions. Virginia Health Information, an independent nonprofit financed by public and private funds, issued The Health Care Prices Report on Tuesday. Its intent is to give consumers sufficient information to negotiate the costs of their health-care services.

The fourth annual report shows the average allowed amount insurers pay for services, such as doctor visits, delivering babies, mammograms and CT scans. For example, it reports that an MRI of the back costs triple for a hospital outpatient ($3,400 average), as compared to one performed in a physician's office ($1,100). The same goes for arthroscopic knee surgery, which is four times as expensive for the hospital outpatient. By comparison, average cost for an ultrasound only varies by about $40 -- $592 versus $551 --depending on the setting.

"We're among a handful of states that publish this information. What's unique this year is that with the help of health insurance companies, consumers can see more detailed pricing information about specific health-care procedures," says Michael Lundberg, executive director of the reporting group.

The new information includes variations in price by where the procedure takes place and a breakdown of possible charges for the facility, surgeon, anesthesiologist, radiologist, physician and others. For example, Lundberg says, "A consumer can compare prices for a breast biopsy performed at a physician's office [$1,998], hospital [$2,476], or ambulatory surgical center [$3,391]." They can then discuss the best option with their doctor.

The information is particularly useful to those who pay out of pocket for health care: consumers without health care insurance; those with health savings accounts; those with high-deductible plans; and those who may be liable for upfront charges for medical tests or procedures.

Once a consumer has negotiated a price, Virginia Health Information recommends that they get the agreement in writing. It also cautions that the numbers have their limitations, particularly as they give statewide averages which do not account for local variations; it advises their use as a starting point for negotiations.

To read the full report, go to http://www.vhi.org/healthcareprices or call 1-877-VHI-INFO to get a print version.

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By Rob Dennis, The Argus, Fremont, Calif.

Feb. 14--When Dr. Dan Martin set up his practice in San Leandro more than six decades ago, it was a different town -- and a different kind of doctoring.

Martin charged $3 for an office visit and $5 for house calls, traveling all over the area to treat patients.

"I did house calls by the thousands, all the way from Union City to Lake Merritt," he said.

Over the next 50 years, he built a successful practice, helped launch two area hospitals and even graced the pages of Time magazine.

Today, at 91, he retains a vigor for life and a passion for medicine.

Until recently, he volunteered at the Davis Street Family Resource Center's free clinic in San Leandro. Last week found him checking seniors' blood pressure at the monthly Sons in Retirement luncheon at Francesco's restaurant in Oakland, and then addressing the group about advances in heart disease treatments.

"Doc Martin has been great about speaking," said John Hagebusch, the top officer or "Big Sir" of SIRS Branch 26, which has about 160 members. "He (checks) their blood pressure. He's here every month."

Martin, who has lived in Oakland since 1961, downplays his accomplishments, saying he's no high-flying surgeon or research doctor.

"I'm just an old general practitioner," he said.

Opening hospitals

Born in Portland, Ore., and raised in Eugene, Ore., Martin attended the University of Portland and then Oregon Health and

Science University, graduating in 1945.

He served for two years in the Army Medical Corps and then got a job paying $50 a month at Santa Clara Valley Medical Center.

In 1948, he settled in San Leandro, then a small but growing town of 25,000 people.

"I knew of him, because he was well-known." said Glen Barth, 90, of Castro Valley, who lived in San Leandro for 25 years after World War II. "It was a community then instead of a city."

The community needed its own hospital, though.

At the time, there were only two nearby options: a 35-bed Hayward hospital and an 85-bed facility in East Oakland.

So Martin backed efforts in the late 1940s and early 1950s to create the Eden Township Healthcare District and build Eden Medical Center in Castro Valley.

SAN JOSE, Calif. -- Fewer that one in four Californians have written instructions as to how and where they would like to die -- risking the immense emotional, physical and financial burden of end-of-life hospital care.

Yet an overwhelming majority of Californians would rather die at home, far from the tumult of a hospital, according to a poll released Tuesday.

"There is a huge gap between the place and way that people would like to spend their final days -- and the place and way that they do," said Dr. Mark D. Smith, president and CEO of the Oakland-based California HealthCare Foundation, which commissioned the survey.

Its findings echo the passionate voices of Bay Area News Group readers who, following a Cost of Dying article, said they want to spare their families the burden of end-of-life hospital care.

But many were uncertain how to ensure that their wishes were carried out.

The survey, called "Final Chapter: Californians' Attitudes and Experiences with Death and Dying," notes that California's elderly are a growing share of the state's population. The number of residents over 85 has quadrupled over the past 40 years.

It found that:

-- Nearly 8 in 10 Californians said that if they were seriously ill, they would want to speak with their doctor about end-of-life care. But fewer than 1 in 10 report having had a conversation, including just 13 percent of those 65 or older.

-- Eighty-two percent said that it is important to put their wishes in writing. Less than one quarter have actually done so. More than half say they have not talked with a loved one about the kind of care they want at the end of life.

-- Seventy percent said they would prefer to die at home. But only 32 percent pass away in their homes, according to the California Department of Public Health.

The family of Napa's Graeme Plant, who died Nov. 10, is deeply grateful that he took steps to ease their decision to let him die at home from pneunomia, rather than at the hospital.

Plant had watched his mother and sister slowly deteriorate with Alzheimer's disease and wanted to spare himself that fate.

By Gracie Shepherd, The Augusta Chronicle, Ga.

Feb. 14--Augusta-based inVentiV Medical Man­age­ment last week announced three new programs designed to better protect patients from inappropriate and ineffective care associated with cancer, cardiovascular and kidney treatments.

The company provides a watchdog service to those who are self-insured, including third-party administrators, employer groups and reinsurance carriers. Its specialty care physicians, nurses and billing experts lobby on behalf of customers to make sure appropriate care is given and that the patient is charged an appropriate price for that treatment.

"We have a constant vigilance going on," said Roxane Padgett, inVentiV's vice president of marketing and commercialization.

Ideally, inVentiV employees are in communication with the patient's physician from the moment a diagnosis is given. But even if inVentiV is brought into just the billing process, it closely inspects invoices and paperwork to make sure the customer's care was correctly recorded and priced competitively.

"We want to get involved before care is delivered, but the billing process is also extremely important," Padgett said.

The new programs focus on cardiovascular, kidney and cancer care, Padg­ett said. CEO Marc Palmer said his company's role in researching and lobbying for evidence-based medicine plays an important role in effective health-care reform.

"Cancer treatments align to evidence-based medicine as little as 30 percent of the time, 20 to 40 percent of the pacemakers doctors implant are medically inappropriate, and many patients living with the dangerous triad of uncontrolled diabetes, hypertension and high cholesterol will wind up with kidney failure and find themselves on dialysis," Palmer said. "Such inappropriate and ineffective

care is directly contributing to the rising cost of health care in the United States."

This expansion will result in new jobs, Padgett said, and perhaps even a second inVentiV location in Augusta. More information can be found at www.inventivmm.com.

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(c)2012 The Augusta Chronicle (Augusta, Ga.)

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By Greg Stiles, Mail Tribune, Medford, Ore.

Feb. 14--Skipping a trip to the doctor because it's too expensive winds up raising the cost of treatment for everyone in the long run, a health insurance executive told a Chamber Forum audience Monday at the Rogue Valley Country Club.

Don Antonucci, president of Regence BlueCross BlueShield of Oregon, said the problem for many people begins when the cost of care increases. That in turn puts pressure on medical insurance costs, boosting the cost of coverage, leading people to drop insurance and not to seek care, which starts the cycle over.

"In the end, cost of care continues to increase, while we're now treating worsening conditions we could have treated earlier in the process," Antonucci said. "This is the cycle America finds itself in today."

The number of uninsured Americans will reach 60 million by 2015 and approach 70 million in 2020.

He cited industry research in 2010 showing 9 percent of employers intended to drop insurance coverage, while 21 percent probably will drop coverage.

There has been a growing shift of costs to private insurance ventures -- in 2010 private insurance companies reimbursed providers at 140 percent of Medicare reimbursements, a spread that is expected to rise to 155 percent in 2015 and 166 percent by the end of the decade.

"Unless the gap is closed in the private market place, we know the uninsured are not going to get the care they need," Antonucci said.

He said Americans can help reduce the costs by changing lifestyles to avoid diabetes and prediabetic conditions.

In fielding questions from the audience, he said the falling Medicare reimbursements will have a direct impact on local health care services.

"We're going to see this play out pretty dramatically here as it relates to Medicaid," Antonucci said. "In the state of Oregon, Medicaid is already reimbursing hospitals at a rate much lower than the cost of care. That's about to be cut in the state by another $239 million. When you take federal matches (into account), that equates to over $600 million that's coming out of the system."

By Susan Essoyan, The Honolulu Star-Advertiser

Feb. 12--A bill that would require health insurance companies to cover diagnosis and treatment for autism is poised for passage next week by two Senate committees, a move intended to help youngsters get vital early therapy.

"We think it's time to take action and make significant inroads on autism," Sen. Josh Green, Health Committee chairman, said Wednesday after conferring with Sen. Rosalyn Baker, chairwoman of the Consumer Protection Committee, at a joint hearing. "We do intend to move the bill forward."

A vote on Senate Bill 2631 is set for Tuesday during a joint meeting of the Health and Consumer Protection committees.

If the bill is ultimately passed and signed into law, Hawaii would join a growing number of states that are requiring private insurers to cover treatment for autism. At least 29 states have passed such legislation, most in the past five years, according to the National Conference of State Legislatures.

California, New York, Rhode Island, Virginia and West Virginia took action last year.

In its current wording, the bill would require coverage of screening, diagnosis and treatment of autism spectrum disorder for individuals through age 25 with a $50,000 annual cap on behavioral health treatment. It will be revised before the vote to include a lifetime cap as well and to clarify that only therapy by credentialed providers would be covered, said Green (D, Milolii-Waimea), a physician who introduced the measure.

Autism is a developmental brain disorder that hampers the ability to communicate and interact socially and can cause disruptive behavioral problems. The condition has no cure, but early intervention can help overcome its disabling aspects. The most common treatment involves intensive, individualized behavioral therapy, which has traditionally not been covered by medical insurance.

Hawaii legislators have considered mandating insurance coverage for autism in recent years but declined to act after the state auditor advised against the move in 2009. The auditor said educational and health services for children with autism were available through the Department of Education and the Department of Health. But the Health Department noted at the time that private insurance treatment is needed to supplement existing services, and advocates say treatment is limited in the public schools.

By ERICA WERNER

WASHINGTON - As President Barack Obama considered a decision on birth control policy, he heard it from inside and outside his White House: He risked a fierce backlash if he required religious employers to provide insurance coverage for contraception in violation of their beliefs.

Over the course of months, Catholic groups and officials spoke with White House aides, sent letters and wrote opinion columns. Vice President Joe Biden and other officials spoke of the need to aware of the consequences, given how Catholic groups would view the decision.

On the other side, women's health advocates and their allies inside the White House were adamant about the importance of making free contraception available to all women.

That's where Obama came down - before the furor that caused him to backtrack.

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