Never too early to plan for college expenses








Look at your cute baby, and imagine the little tyke wearing a high school cap and gown about 17 years from now.


Picturing the child holding a diploma, when he or she can't even hold a rattle yet, is probably next to impossible. But that day will come. And if you are like most parents, as you watch junior walk across the stage to pick up a diploma, you will be vacillating between feelings of pride and utter fear. At that point, your child will be headed to college, and the price tag will be so shocking you'll be tossing and turning at night.


If college prices continue to climb as they have the past few years, by the time today's newborns go to college, the sticker price will be about $37,700 for one year of tuition, room and board at a state university and $98,200 at a private college, said Kalman Chany, a college financial aid consultant and author of "Paying for College Without Going Broke." For a four-year education, it will be about $161,500 at a university in your state or $426,400 at a private college, he estimates. To put that into perspective, many public colleges now run about $20,000 a year, and some private colleges are more than $55,000.






So maybe at this point you figure you will stick a bat or ball in the little tyke's hands the moment he or she can hold it in hopes they are on the road toward winning an athletic scholarship. But let's face it: That's a remote possibility. Should you despair? 


Remember, you don't need the entire sum saved for college the day junior moves into a dormitory room. And during the next 17 years, your salary probably will rise along with college costs, so the numbers won't look as shocking as they do today. In addition, low- and middle-income families don't have to pay the full sticker price if they are smart about college choices.


But if you want to make paying for college as painless as possible, you are going to have to start planning now. For the next 17 years, you will have to keep your eye on the calendar. Before children are old enough to get braces, some savvy parents start helping them build the type of resumes that will win scholarships.


Still, don't count on scholarships to do all the heavy lifting. No matter how polished your child turns out to be in high school, the chances are you will have to come up with a good sum of money yourself. So start now by saving as much as you can. Anything is better than nothing. If you start saving $100 a month for college and invest it in a balanced mutual fund that's roughly divided half and half in stocks and bonds, you should have about $40,000 by the time you pack up the car with junior's belongings and head to college.


But also make sure you have your priorities right. Too many parents — especially those laden with their own college loans — want to spare their children college debt. So they plop money into a college savings account for their children, while neglecting to save for their own retirement. This is upside-down planning.


I've heard from many parents who can't retire because they put their child's education ahead of their own savings, and their child ends up finished with college, enjoying a Wall Street or a law firm salary, and is debt-free.


The rule of thumb for saving enough money for retirement is: Start saving 10 percent of pay in a 401(k), IRA or both, beginning in your 20s. If you wait until your 30s, it's 12 to 15 percent. If you happen to have an employer that offers the typical 3 percent matching money for a 401(k), you can stash away 7 percent of your own pay and — with the free money from your employer — you will hit the 10 percent mark.


For college savings, you can make investing easy and the most profitable if you keep Uncle Sam away from taxing your savings. Plop either the $2,000 limit a year into a Coverdell college savings account, or if you can manage to save more, skip the Coverdell and use a 529 college savings plan offered by a state government. Anything you save in these accounts will be tax-free for you and your child if it goes to pay for college. Tell grandparents and other relatives about the child's 529 plan, so they can send birthday and other gifts into the college fund.


Elementary school


Maybe you've been saving diligently since you helped the little tyke blow out the candle on that first birthday cake. If you were making life easy on yourself, you evaluated 529 plans, chose one with low fees and solid performance, and you've been letting the investment experts at the plan invest your money in the manner that typically is appropriate for your child's age.


Are you satisfied with the 529 plan you chose, and the investments you've chosen within the plan? You are allowed to make changes once a year — selecting a plan in another state if you want, or different investments in the plan. Remember, you don't have to stick with the plan in your state, although many states give you an extra tax break if you do. And you can save money if you go to a state 529 plan directly rather than using a financial adviser. According to Morningstar, the average cost if you do this on your own is about 0.60 percent, but with an adviser it's 1.5 percent — a much higher amount that will detract from the amount you amass.


Say your child received $2,000 from grandma at birth. In the cheap 0.60 fund, the savings would become about $6,680 by college if the investments earned 8 percent. The same investments in the 1.50 fund would be $5,720. Try this calculator: tinyurl.com/seccalc.


To identify funds Morningstar thinks are best, go to tinyurl.com/bestfunds. Also check out savingforcollege.com.


As you evaluate the investments, keep in mind what "age-based" means. With that approach, the plan typically invests for you based on the child's age. Up to 4 years old, the money was probably invested about 80 percent in stocks and 20 percent in bonds. Between 5 and 10, it was probably 65 percent in stocks and 35 percent in bonds. The idea is to increase the money as much as possible when the child is young by using a significant amount of stocks. Then the closer the child gets to college, the more conservative the investing becomes so there's less chance of a loss when the first tuition bill rolls around.


You can lose money in 529 plan investments when the stock market goes down, but if investments turn more conservative along the way, you generally have time to recover by college. Many plans offer conservative investments if you can't stomach stocks. But remember the trade-offs. If you select a money market fund or CDs paying 2 percent interest, your $100 in savings a month would total less than $25,000 by the time a newborn makes it to college.


If you have been getting raises every year, consider increasing your contributions to the 529 plan — maybe setting up your account to move money automatically each payday. Also make sure you tell grandma and grandpa not to open any UGMA or UTMA account in the child's name. If your child is going to qualify for financial aid when he or she goes to college, a UGMA or UTMA will poison his chances.


Want to know if you are likely to get financial aid? For a ballpark idea, try the "estimated family contribution" calculator at the college you think your child might attend or: tinyurl.com/finaidest.






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Convicted killer back in custody

A convicted murderer from Indiana is on the loose because of some bad paperwork in Cook County. (WGN - Chicago)









Convicted murderer Steven Robbins was arrested late Friday in Kankakee, two days after he was mistakenly released from the Cook County Jail after being brought to Chicago to dispose of an old case against him, according to the Cook County sheriff's office.


Robbins, 44, who was serving a 60-year sentence for murder in Indiana, was apprehended "without incident" at about 10:55 p.m. in the 400 block of Frasier Avenue in Kankakee, according to Frank Bilecki, a spokesman for Cook County Sheriff Tom Dart. 


 Bilecki said Dart was on the scene and helped assist in the arrest. 








 Authorities tracked Robbins through interviews with family and friends who helped provide his location, according to the sheriff's office. 


Earlier, Cook County Sheriff Tom Dart took responsibility for mistakenly letting Robbins walk out of County Jail after a local charge against him was dismissed.


“We let people down, no mistake about it,” Dart said in an interview at sheriff’s offices in Maywood. “Our office did not operate the way it should have, clearly.”


The FBI, the U.S. Marshals Service and Cook County Crimestoppers raised $12,000 as a reward for information leading to Robbins’ capture, he said.


Dart said his office is still looking at where and how the system broke down to allow Robbins’ mistaken release from the jail,  but he said that officials at the  jail had no paperwork showing he was serving time in an Indiana prison for murder.


Like other indigent people, Robbins was outfitted with clothing from Goodwill – a long-sleeve brown shirt and brown pants – before being released out the front entrance, Dart said. He also likely was given bus fare.


Dart said the sheriff’s office uses an archaic system – entirely paper-driven – in handling the movement of an average of about 1,500 inmates every day. Some are entering the jail after their arrest and others are being bused to courthouses around the county for court appearances.


The sheriff said the warrant for Robbins’ arrest should have been quashed by prosecutors when armed violence charges were dismissed against him in 2007. In addition, he said prosecutors signed off on the sheriff’s office traveling to Indiana to pick up Robbins at the prison in Michigan City and bring him back on the outstanding warrant.


“We were able to get an extradition warrant on a case that didn’t exist,” Dart said. “That’s the first problem.”


Earlier, documents reviewed by the Tribune showed that paperwork filled out by Cook County sheriff’s officers this week made it clear that Robbins was serving a 60-year sentence for murder in Indiana and was to be returned to authorities there after being brought to Chicago to dispose of an old case against him.

“Please be advised that this subject is in our custody under the temporary custody provision of the interstate agreement on detainers,” a sheriff’s order accompanying Robbins’ paperwork read. The order noted Robbins’ murder conviction and 60-year sentence and then stated he “must be returned to the custody of Indiana DOC.”

In addition, Judge Rickey Jones, assigned to the Leighton Criminal Court Building, ordered the Illinois case dismissed on Wednesday and wrote on paperwork that Robbins was to be released for “this case only,” the records show.
 
Yet Robbins was allowed to walk free out of the Cook County Jail Wednesday evening after his court appearance. Authorities today were reviewing the paperwork in Robbins’ file to see how the mistake was made and who was responsible, sources told the Tribune.


Also under investigation was why Robbins – whose 1992 charges of armed violence and drug possession had been dismissed by prosecutors nearly six years ago – was even brought to Chicago in the first place.

Robbins spent the night in the Cook County Jail on Tuesday to attend a court date Wednesday on a warrant issued when he skipped bail in his 1992 case, Frank Bilecki, a spokesman for the Cook County sheriff’s office, said on Thursday.


Cook County authorities picked up Robbins on Tuesday at a prison in Michigan City, Ind., explaining he needed to answer to pending charges in Chicago, said Doug Garrison, a spokesman for the Indiana Department of Corrections. The requisite paperwork spelled out the terms of his release and return, Garrison said.


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BlackBerry 10 installed base to reach 20 million in 2013, Windows Phone to reach 45 million






Despite showing clear promise and being a tremendous upgrade compared to earlier BlackBerry software, BlackBerry 10 didn’t receive the warmest welcome when it was unveiled earlier this week. At least one leading market research firm thinks BlackBerry (RIMM) has done enough to gain some good traction in 2013, however. ABI Research released new estimates this week projecting that the BlackBerry 10 installed base will reach 20 million by the end of 2013. The firm also says Microsoft’s (MSFT) Windows Phone platform, which struggled to garner interest in its early days, will see its installed base climb to 45 million by the end of the year.


[More from BGR: BlackBerry doesn’t need to catch up with Android and iOS overnight, it needs to live to fight another day]






“2013 should be seen as relative success for both Microsoft and BlackBerry,” ABI analyst Aapo Markkanen said. ”For the end of the year, we expect there to be 45 million Windows Phone handsets in use, with BlackBerry 10 holding an installed base of close to 20 million. Microsoft will also have 5.5 million Windows-powered tablets to show for it.”


[More from BGR: GS: Ignore the chatter, BlackBerry rebound is coming]


According to ABI, these figures will be “enough to keep developers interested” as the two companies battle for the No.3 spot in the smartphone war.


“The greatest fear for both Microsoft and BlackBerry is that the initial sales of their smartphones will disappoint and thereby kill off the developer interest, which then would effectively close the window of opportunity on further sales success. Our view is that the installed bases of this scale would be large enough to keep these two in the game,” Markkanen noted. ”It will definitely also help that both firms have actively kept the developers’ interest in mind while designing and rolling out their platforms.”


This article was originally published on BGR.com


Gadgets News Headlines – Yahoo! News




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Schwarzenegger: Simple Austrian upbringing made me green






VIENNA (Reuters) – Arnold Schwarzenegger credited his simple upbringing amid the lakes and hills of Austria for a recent conversion to fully fledged green activism, the latest stage in his varied career.


The former body-builder, star of the “Terminator” action films and governor of California grew up in Thal, a small village in the Austrian province of Styria, and emigrated to the United States at the age of 21.






“Growing up in my house, we knew about sustainability before it was hip. We called it ‘necessity’,” Schwarzenegger told an environmental conference he hosted in Vienna this week.


“We didn’t have video games, televisions or iPhones. We had the rolling hills, the castles, the ruins, and the beautiful lakes,” he said. “Even after I made it big and became governor of California, I held on to this love of nature.”


The “governator” – who left office and split with his wife of 25 years, Maria Shriver in 2011, has recently returned to making action movies – expressed surprise at the turn his life had taken, after he had thought all his ambitions fulfilled.


“When I was a little boy in Austria, all I could think about was moving to America, to become the greatest bodybuilder champion in the world and make millions of dollars and be an action hero,” said Schwarzenegger.


“My dream became reality. Who knew my greatest achievement would be in the real world fighting for a green energy future? Green energy wasn’t even in my vocabulary.”


(Reporting by Derek Brooks; Writing by Georgina Prodhan, editing by Paul Casciato)


Celebrity News Headlines – Yahoo! News





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Ferrol Sams, Doctor Turned Novelist, Dies at 90


Ferrol Sams, a country doctor who started writing fiction in his late 50s and went on to win critical praise and a devoted readership for his humorous and perceptive novels and stories that drew on his medical practice and his rural Southern roots, died on Tuesday at his home in Lafayette, Ga. He was 90.


The cause, said his son Ferrol Sams III, also a doctor, was that he was “slap wore out.”


“He lived a full life,” his son said. “He didn’t leave anything in the tank.”


Dr. Sams grew up on a farm in the rural Piedmont area of Georgia, seven mud-road miles from the nearest town. He was a boy during the Depression; books meant escape and discovery. He read “Robinson Crusoe,” then Mark Twain and Charles Dickens. One of his English professors at Mercer University, in Macon, suggested he consider a career in writing, but he chose another route to examining the human condition: medical school.


When he was 58 — after he had served in World War II, started a medical practice with his wife, raised his four children and stopped devoting so much of his mornings to preparing lessons for Sunday school at the Methodist church — he began writing “Run With the Horsemen,” a novel based on his youth. It was published in 1982.


“In the beginning was the land,” the book begins. “Shortly thereafter was the father.”


In The New York Times Book Review, the novelist Robert Miner wrote, “Mr. Sams’s approach to his hero’s experiences is nicely signaled in these two opening sentences.”


He added: “I couldn’t help associating the gentility, good-humored common sense and pace of this novel with my image of a country doctor spinning yarns. The writing is elegant, reflective and amused. Mr. Sams is a storyteller sure of his audience, in no particular hurry, and gifted with perfect timing.”


Dr. Sams modeled the lead character in “Run With the Horsemen,” Porter Osborne Jr., on himself, and featured him in two more novels, “The Whisper of the River” and “When All the World Was Young,” which followed him into World War II.


Dr. Sams also wrote thinly disguised stories about his life as a physician. In “Epiphany,” he captures the friendship that develops between a literary-minded doctor frustrated by bureaucracy and a patient angry over past racism and injustice.


Ferrol Sams Jr. was born Sept. 26, 1922, in Woolsey, Ga. He received a bachelor’s degree from Mercer in 1942 and his medical degree from Emory University in 1949. In his addition to his namesake, survivors include his wife, Dr. Helen Fletcher Sams; his sons Jim and Fletcher; a daughter, Ellen Nichol; eight grandchildren; and nine great-grandchildren.


Some critics tired of what they called the “folksiness” in Dr. Sams’s books. But he did not write for the critics, he said. In an interview with the Georgia Writers Hall of Fame, Dr. Sams was asked what audience he wrote for. Himself, he said.


“If you lose your sense of awe, or if you lose your sense of the ridiculous, you’ve fallen into a terrible pit,” he added. “The only thing that’s worse is never to have had either.”


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Chicago beer firm Crown Imports is caught in antitrust fight









An antitrust brouhaha in Washington has thrown the future of Crown Imports, a Chicago-based beer importer, into question.


The company, which ranks third in U.S. beer sales volume, is a joint venture between New York-based Constellation Brands Inc. and Mexico's Grupo Modelo, which makes Corona Extra, the leading imported beer in the U.S., and other brands. Crown sells Modelo brands as well as China's Tsingtao.


As part of its proposed sale to Anheuser-Busch InBev, Grupo Modelo agreed to sell its 50 percent stake in Crown to Constellation Brands for $1.85 billion. The separate transaction was meant to ease possible antitrust concerns that the merger would eliminate Crown Imports as a competitor.





But on Thursday the U.S. Department of Justice filed an antitrust suit against AB InBev to block its acquisition of Grupo Modelo. Antitrust officials said the merger would further increase the concentration of the U.S. beer market, leading to higher prices for American consumers.


The lawsuit said the sale of Modelo's interest in Crown Imports to its partner would only create "a facade of competition" between AB InBev and the importer.


"In reality, Defendants' proposed 'remedy' eliminates from the market Modelo — a particularly aggressive competitor — and replaces it with an entity wholly dependent on ABI," the Justice Department said in the lawsuit.


The suits cites as evidence part of an internal memo that Crown's chief executive, Bill Hackett, wrote to employees after the transactions were announced in June. According to the suit, Hackett wrote, "Our #1 competitor will now be our supplier ... it is not currently or will not, going forward, be 'business as usual.'"


Under the terms of the proposed merger with Modelo, AB InBev also had the option to terminate its agreement with Crown Imports after 10 years, giving it full control of Corona distribution.


Constellation Brands on Friday attacked the Justice Department, saying in a statement that the suit "demonstrates its incomplete understanding" of the proposed merger. Constellation and AB InBev have indicated that they plan to challenge the suit.


In a detailed defense, Constellation said its full control of Crown would improve competition, not harm it. According to the lawsuit, Modelo controls about 7 percent of U.S. beer sales, far behind AB InBev's market-leading 39 percent.


Constellation attempted to ease concerns that AB InBev's merger with Modelo would lead to higher prices. Hackett said in a statement: "Our Crown team independently develops, implements and refines pricing, promotional and sales strategies for each of our brands in the U.S."


The proposed beer merger had reduced uncertainty hanging over Crown Imports because the Modelo-Constellation joint venture was set to expire at the end of 2016. The Justice Department action creates a new level of uncertainty, said Benj Steinman, president of Beer Marketer's Insights, a beer industry trade publication.


"Crown's fate is hanging in the balance," Steinman said.


asachdev@tribune.com


Twitter@ameetsachdev





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Hadiya Pendleton's 'twin' describes death of best friend

The best friend of Hadiya Pendleton talks about the moments before her friend was shot in Chicago on January 31, 2013. (Heather Charles, Chicago Tribune)









As she and her high school classmates fled from the gunfire, Hadiya Pendleton screamed that she had been shot, fell to the ground, struggled to get up and fell again, according to her best friend.


The best friend and another girl scrambled to Pendleton's side, cradling her in their arms as others ran for help.


"I was holding her hand trying to talk her through it," her best friend told the Tribune on Thursday. "I was like, 'You're going to be fine, you're going to be OK.'"








But Hadiya, 15, died shortly after a bullet pierced her back Tuesday, igniting outrage over the senseless loss of another young victim of Chicago's out-of-control gun violence and leaving her friends staggered by the horrifying chain of events on what had been a carefree afternoon.


In the account that follows, the Tribune is not naming those who witnessed the shooting and its aftermath because the gunman is still at large.


On Tuesday afternoon, the mood outside King College Prep in North Kenwood was jubilant. The students at the elite high school had just finished final exams, classes had let out early and the winter weather was spectacular, tipping into the low 60s.


Hadiya and her best friend, both sophomores, headed toward a nearby Potbelly's, one of their favorite places to eat, the friend said. But on their way, at about 1:30 p.m., they ran into friends who invited them to Harsh Park, just a few blocks away from the school.


"We were like, 'OK, sure, who doesn't want to walk around outside when it's nice?'" Hadiya's best friend said.


As they walked, the group of about a dozen teens discussed which tests had been easy and which had been hard. Some were volleyball players from King and others went to another high school, Hadiya's friends said.


Once they reached the small, residential park, Hadiya and others headed to a playground where they swung in the warm air while chatting about their plans for the summer and their 16th birthdays. Hadiya's best friend said she and Hadiya had talked about a joint sweet 16 party and possibly wearing matching gold heels and colorful outfits to celebrate the occasion.


But then a sudden downpour drove the teens beneath a metal awning where Hadiya played "Misery Business" by the band Paramore on her cellphone and others tweeted and texted as they waited out the rain.


Minutes later, however, Hadiya's best friend said she saw a gun-wielding male scale the park fence and approach the group. She yelled a warning to her friends, but the gunman opened fire, spraying the teens with bullets as they ran.


Hadiya was struck in the back about 2:20 p.m. One teen suffered a graze wound to an ankle. And a 17-year-old junior at King was hit in the left leg below the calf, according to his mother, who said he was trying to protect his girlfriend.


The teen's mother said that her son, an Eagle Scout, didn't realize he had been shot. He felt a little sting in his leg before he looked down and saw blood.


A nurse who lived in the area and was leaving her home at the time of the shooting ran to the group, applied a makeshift tourniquet to the teen shot in the leg and called 911. The nurse instructed the others on how to take care of Hadiya.


In the meantime, another friend of Hadiya's ran to a nearby Subway restaurant, burst through the door and asked to borrow a man's phone to call 911.


But by then wailing police cars whizzed by toward the park, so she called her mom.


"I told her to stay put," her mother told the Tribune. "I can't even tell you, as a mother, what it's like to get that phone call. My goal was to get to my child."


The friend said that she and Hadiya met freshman year at a high school dance camp. The friend joined poms, while Hadiya became a majorette, traveling to Washington last month to perform in a competition with her squad during President Barack Obama's inauguration weekend.


The girls were nicknamed "twins" by classmates and teachers because of their similar appearance, the friend said. From haircut to smile to skin tone to personalities, the two were hard to tell apart, she said.





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Sony ignites talk of PS4 unveil with Playstation meeting






TOKYO (Reuters) – Sony Corp will this month host its first major Playstation meeting in two years, sparking a flare-up in online speculation the Japanese consumer electronics giant is preparing to unveil the successor to its 70 million-selling PS3 games console.


Sony declined to say whether it would release a new product at the meeting in New York on February 20. “We will be talking about the Playstation business,” spokesman Masaki Tsukakoshi said on Friday. A Google search for “Sony Feb 20 Playstation” returned more than 7 million hits.






The last time Sony held a Playstation event, in January 2011, it presented a protoype of its handheld Vita console. Before that, it convened a gathering in 2005 two months after it first demonstrated the PS3 concept. A meeting in 1999 revealed designs for the PS2.


It has been more than six years since Sony launched the PS3 home console, a longer gap than between it and its PS2 predecessor, adding to the anticipation that it will soon disclose its next gaming concept.


Since Sony’s last home console launch, the games market has been transformed by the boom in smartphones and tablet computers that have wooed players with free or cheap games.


Sony and other console makers Nintendo Co Ltd and Microsoft Corp now have to contend with competition from hand-held devices made by Apple Inc, Samsung Electronics and others.


Analysts expect that tablets and other mobile devices will match the power and graphics of today’s games consoles within a few years.


Struggling under competitive pressure, Nintendo on Wednesday cut its sales target for the Wii U, successor to its 100 million-selling Wii, to 4 million machines by the end of March from its launch in November, compared with an earlier forecast for 5.5 million.


(Reporting by Tim Kelly; Editing by Daniel Magnowski)


Gaming News Headlines – Yahoo! News





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Whitney Houston anniversary to be marked with TV Grammy special






LOS ANGELES (Reuters) – Grammy organizers plan to mark the first anniversary of the sudden death of Whitney Houston with a behind-the-scenes TV show on how they scrambled to honor the singer just 24 hours after she died.


The Recording Academy said on Thursday that the hour-long special entitled “The Grammys Will Go On: A Death in the Family” will air on February 9, the day before the 2013 Grammy Awards ceremony in Los Angeles.






Houston, who sold hundreds of millions of records and scored the mega hits “I Will Always Love You” and “I Wanna Dance with Somebody,” drowned in a bathtub at a Beverly Hills hotel room on February 11 2012 – the eve of last year’s Grammy Awards show.


Houston’s unexpected death at age 48 cast a shadow over the event, which quickly changed its program to pay homage to the soaring voice that had dominated the Grammys in decades past.


Singer and actress Jennifer Hudson performed a medley of Houston’s hits at last year’s Grammys, and rapper and host LL Cool J opened the show with a prayer.


The TV special on broadcaster CBS features rehearsals and interviews with artists – including Hudson, Bruce Springsteen and Taylor Swift – and the show’s producers in the hours before and after Houston’s death.


The Recording Academy produces the annual Grammy awards.


(Reporting by Eric Kelsey, editing by Jill Serjeant and David Brunnstrom)


Music News Headlines – Yahoo! News





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Insurance Industry Report Faults High Fees for Out-of-Network Care


Michael Nagle for The New York Times


Angel Gonzalez, 36, faced huge bills after emergency gallbladder surgery, despite having good insurance coverage. “I was on the hook for more than I made in a year.”







Just over a year ago, Angel Gonzalez, 36, awoke with searing chest pain at 2 a.m. A friend drove him to the closest emergency room.




Though he was living on $18,000 a year as a graduate student, Mr. Gonzalez had good insurance and the hospital, St. Charles in Port Jefferson, N.Y., was in his network. But the surgeon who came in to remove Mr. Gonzalez’s gallbladder that Sunday night was not.


He billed Mr. Gonzalez $30,000, and an assistant billed an additional $30,000. Mr. Gonzalez’s policy covered out-of-network providers, but at a rate it considered appropriate: $2,000. “I was on the hook for more than I made in a year,” Mr. Gonzalez said.


A health insurance industry report to be released on Friday highlights the exorbitant fees charged by some doctors to out-of-network patients like Mr. Gonzalez. The report, by America’s Health Insurance Plans, or AHIP, contrasts some of the highest bills charged by non-network providers in 30 states with Medicare rates for the same services. Some of the charges, the insurers assert, are 30, 40 or nearly 100 times greater than Medicare rates.


Insurers hope to spotlight a vexing problem that they say the Affordable Care Act does little to address. “When you’re out of network, it’s a blank check,” said Karen Ignagni, president and chief executive of AHIP. “The consumer is vulnerable to ‘anything goes.’ ”


“Unless we deal with cost, we won’t have affordability,” she added. “And unless we have affordability, we won’t have people participating” under the Affordable Care Act.


Among the fees on the report’s list are a $6,205 outpatient office visit to a doctor in Massachusetts for which Medicare would have paid $152; a $12,000 bill for examining a tissue specimen in New York for which Medicare would have paid $128; and a $48,983 surgeon’s fee for a total hip replacement in New Jersey that Medicare would have reimbursed at $1,543. Many of the highest billers were in New York, Texas, Florida and New Jersey.


Elisabeth R. Benjamin, co-founder of the Health Care for All New York coalition, who is often at odds with the insurance industry, said that “is one area we totally agree on.” She continued, “Out-of-network billing is just out of control.”


Even when out-of-network fees are compared with average commercial insurance reimbursements, which are usually greater than Medicare, she said, “It’s pretty outrageous.”


Doctors say the report is skewed because it focuses on a few dozen cases of overcharging that are not representative of their billing. In response to the insurers’ report, the American Medical Association noted on Thursday that a recent analysis found that doctors’ services account for just 16 percent of health care costs.


“There are outliers in every profession, in every business,” said Dr. Andrew Y. Kleinman, a plastic surgeon who is vice president of the Medical Society of the State of New York.


Dr. Kleinman also noted that insurers had effectively shifted the costs of out-of-network care onto patients by changing reimbursement formulas. Instead of the rates commercial insurers usually pay doctors, insurers increasingly are basing their out-of-network payments on Medicare rates, usually far lower.


A growing number of high-end, flexible health plans offer policies that cover outside providers at, for example, 140 percent of Medicare. “They’re selling you an insurance product you can’t use,” Dr. Kleinman said. “You’re buying an insurance policy where the out-of-network benefit is worthless.”


The industry’s own report suggests that using Medicare rates as a benchmark will lead to patients’ picking up much more of the cost for out-of-network care, whether they carefully select a specialist or, as in the case of Mr. Gonzalez and many others, have no choice in the matter.


Had Mr. Gonzalez been 65 or older, Medicare would have paid only $958 for the surgery. The average commercial price is $12,292, according to FAIR Health, an independent nonprofit group that tracks information on health care costs.


But Mr. Gonzalez’s health plan, United Healthcare, determined the fee should be $1,273, of which the company paid $838. Mr. Gonzalez filed appeals, which were rejected. He then contacted Community Health Advocates at the Community Service Society of New York for help, and the group’s caseworkers negotiated with the surgeon on his behalf.


After months of wrangling, the surgeon agreed to accept a significantly reduced payment: $340.


Consumer advocates and health insurance executives are calling for greater transparency in health care pricing, including upfront disclosure of prices of medical procedures and services.


“The health care industry can give you an estimate, just like any other industry,” said Carrie H. Colla, an assistant professor at the Dartmouth Institute for Health Policy and Clinical Practice, noting that the Dartmouth-Hitchcock Medical Center has a patient price estimator online.  


“It’s just not current practice right now,” Dr. Colla said. “Sometimes a doctor won’t even know. The patient really has to push for it.”


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