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California's attorney general sued Sutter Health, accusing the hospital giant of illegally quashing competition and for years overcharging consumers and employers.The lawsuit marked a bold move by state Attorney General Xavier Becerra against the dominant health care system in Northern California as concerns mount nationally about consolidation among hospitals, insurers and other industry middlemen."It's time to hold health care corporations accountable," Becerra said at a news conference Friday. "We seek to stop Sutter from continuing this illegal conduct."The antitrust suit, filed in San Francisco County Superior Court, asks the court to prevent Sutter from engaging in anticompetitive practices and "overcharges."It said Sutter employs a variety of improper tactics, such as gag clauses on prices, "punitively high" out-of-network charges and "all-or-nothing" contract terms that require all of its facilities to be included in insurance networks.Taken together, Sutter's actions "improperly block any and all practical efforts to foster or encourage price competition between Sutter and any rival Healthcare Providers or Hospital Systems," according to the state's complaint. "Sutter's conduct injured the general economy of Northern California and thus of the state.Sutter, which owns 24 hospitals, reported net income of 3 million last year on .4 billion in revenue. Sutter's nonprofit health system also has 35 surgery centers, 32 urgent-care clinics and more than 5,000 physicians in its network.In a statement, Sutter it was reviewing the complaint and couldn't comment on specific claims.Overall, Sutter said, "healthy competition and choice exists across Northern California" for consumers seeking medical care. It also said its charges for an inpatient stay are lower than what other nearby hospitals charge."Sutter Health is proud to save patients, government payers and health plans hundreds of millions of dollars each year by providing more efficient and integrated care," the statement said.This high-profile legal fight caught the attention of employers and policymakers across the country amid growing alarm about the financial implications of industry consolidation. Large health systems are gaining market clout and the ability to raise prices by acquiring more hospitals, outpatient surgery centers and physicians' practices.Martin Gaynor, a health care economist at Carnegie Mellon University, said California's lawsuit may portend more litigation at the state level."There are a number of markets in the U.S. that are dominated by one very large, powerful health system," Gaynor said. "It could be that we're going to see a new level of activity by state antitrust enforcers looking at competition in their own backyards."Glenn Melnick, an economist and expert on hospital finances at the University of Southern California, said if the state prevails against Sutter it could put "a chill on anticompetitive practices that are being adopted across the U.S. and that could help slow down hospital price increases. That would be good news for consumers."The complaints about Sutter's high prices and market power have persisted for years.The state said its investigation started in 2012 under Kamala Harris, California's previous attorney general and now a U.S. senator. Six years ago, her office sent subpoenas to several health systems and insurers seeking information about market concentration and its effect on medical prices.A 2016 study found that hospital prices at Sutter and Dignity Health, the two biggest hospital chains in California, were 25% higher than at other hospitals around the state. Researchers at the University of Southern California said the giant health systems used their market power to drive up prices — making the average patient admission at both chains nearly ,000 more expensive.Last week, researchers at University of California, Berkeley issued a report that examined the consolidation of the hospital, physician and health insurance markets in California from 2010 to 2016. The authors said 44 of California's 58 counties had "highly concentrated" hospital markets.After the report was issued Monday, Becerra said his office would be reviewing those findings and pledged to apply more scrutiny to health care mergers and anti-competitive practices across the state.Sutter Health has gobbled up doctors' practices across the Bay Area, gaining market muscle that has pushed costs upward. Obstetricians employed by Sutter Health, for example, are reimbursed about three times more for the same service than independent doctors, according to a KHN review of OB-GYN charges on several insurers' online cost estimators. It's a key reason why Northern California is the most expensive place in the country to have a baby.At his news conference, Becerra said he's committed to scrutinizing other players besides Sutter in the health care industry who may be engaging in anticompetitive behavior and potentially harming consumers.Consumer advocates and state lawmakers applauded Becerra's aggressive action because of the toll high prices take on millions of Californians. Many residents struggle to pay rising insurance premiums and out-of-pocket expenses for emergency room visits or routine hospital tests."Consumers bear the burden of these monopolistic activities," said state Sen. Ed Hernandez (D-West Covina), chairman of the Senate health committee. "To ensure health care is affordable and accessible to all, we have to get a handle on predatory pricing."In many ways, Becerra's lawsuit mirrors a similar civil case filed in 2014 by a grocery workers' health plan.The attorney general's office filed a motion in court asking for its lawsuit and the class action to go to trial together before the same judge. The trial is scheduled for June 2019 in San Francisco."While we certainly would have preferred this happened earlier, we respect the attorney general's care in conducting a thorough investigation before filing charges," said Richard Grossman, the lead plaintiffs' lawyer representing the class of more than 1,500 employer-funded health plans.In its lawsuit, the attorney general's office blamed Sutter for much of the increase in health care costs across Northern California because "Sutter embarked on an intentional, and successful, strategy of securing market power in certain local markets." State lawyers also pointed out that Sutter's conduct triggered an "umbrella effect" by encouraging other providers to raise their own prices.The state's lawsuit said Sutter used its windfall from excessive prices to acquire more hospitals and medical groups. It also enabled Sutter to "bestow extremely high salaries for its officers and upper management," according to the state complaint.Patrick Fry, Sutter's chief executive from 2005 to 2016, had .4 million in total compensation during his last year there, according to Sutter's 990 tax filing for 2016, the most recent year available.Overall, 18 executives at Sutter had million or more in total compensation during 2016, the federal tax filing shows.Karen Garner, a Sutter spokeswoman, said Fry's compensation in 2016 reflects retirement benefits he accrued over many years. She added that "industry comparisons show our salaries are reasonable and competitive, given the size, scope and complexity of our organization." 7370

CAMP PENDLETON, Calif. (KGTV) — A brush fire on Camp Pendleton sent heavy smoke into the air above Oceanside Tuesday.Residents reported seeing heavy smoke in the North County from the base. Camp Pendleton officials say the fire closed Stewart Mesa Rd., between Donald Cook and the 41 Area, at about 1:30 p.m.The blaze reached 18 acres before fire crews stopped its forward progress just before 2 p.m. No personnel or structures were threatened, according to the base.The brush fire ignited as the region endures elevated fire danger, with gusty offshore winds in the mountains and foothills and humidity hovering between 15 and 25 percent. 647

CAPE CANAVERAL, Fla. (AP) — Mars is about to get its first U.S. visitor in years: a three-legged, one-armed geologist to dig deep and listen for quakes.NASA's InSight makes its grand entrance through the rose-tinted Martian skies on Monday, after a six-month, 300 million-mile (480 million-kilometer) journey. It will be the first American spacecraft to land since the Curiosity rover in 2012 and the first dedicated to exploring underground.NASA is going with a tried-and-true method to get this mechanical miner to the surface of the red planet. Engine firings will slow its final descent and the spacecraft will plop down on its rigid legs, mimicking the landings of earlier successful missions.That's where old school ends on this billion U.S.-European effort .Once flight controllers in California determine the coast is clear at the landing site — fairly flat and rock free — InSight's 6-foot (1.8-meter) arm will remove the two main science experiments from the lander's deck and place them directly on the Martian surface.No spacecraft has attempted anything like that before.The firsts don't stop there.One experiment will attempt to penetrate 16 feet (5 meters) into Mars, using a self-hammering nail with heat sensors to gauge the planet's internal temperature. That would shatter the out-of-this-world depth record of 8 feet (2 ? meters) drilled by the Apollo moonwalkers nearly a half-century ago for lunar heat measurements.The astronauts also left behind instruments to measure moonquakes. InSight carries the first seismometers to monitor for marsquakes — if they exist. Yet another experiment will calculate Mars' wobble, providing clues about the planet's core.It won't be looking for signs of life, past or present. No life detectors are on board.The spacecraft is like a self-sufficient robot, said lead scientist Bruce Banerdt of NASA's Jet Propulsion Laboratory."It's got its own brain. It's got an arm that can manipulate things around. It can listen with its seismometer. It can feel things with the pressure sensors and the temperature sensors. It pulls its own power out of the sun," he said.By scoping out the insides of Mars, scientists could learn how our neighbor — and other rocky worlds, including the Earth and moon — formed and transformed over billions of years. Mars is much less geologically active than Earth, and so its interior is closer to being in its original state — a tantalizing time capsule.InSight stands to "revolutionize the way we think about the inside of the planet," said NASA's science mission chief, Thomas Zurbuchen.But first, the 800-pound (360-kilogram) vehicle needs to get safely to the Martian surface. This time, there won't be a ball bouncing down with the spacecraft tucked inside, like there were for the Spirit and Opportunity rovers in 2004. And there won't be a sky crane to lower the lander like there was for the six-wheeled Curiosity during its dramatic "seven minutes of terror.""That was crazy," acknowledged InSight's project manager, Tom Hoffman. But he noted, "Any time you're trying to land on Mars, it's crazy, frankly. I don't think there's a sane way to do it."No matter how it's done, getting to Mars and landing there is hard — and unforgiving.Earth's success rate at Mars is a mere 40 percent. That includes planetary flybys dating back to the early 1960s, as well as orbiters and landers.While it's had its share of flops, the U.S. has by far the best track record. No one else has managed to land and operate a spacecraft on Mars. Two years ago, a European lander came in so fast, its descent system askew, that it carved out a crater on impact.This time, NASA is borrowing a page from the 1976 twin Vikings and the 2008 Phoenix, which also were stationary and three-legged."But you never know what Mars is going to do," Hoffman said. "Just because we've done it before doesn't mean we're not nervous and excited about doing it again."Wind gusts could send the spacecraft into a dangerous tumble during descent, or the parachute could get tangled. A dust storm like the one that enveloped Mars this past summer could hamper InSight's ability to generate solar power. A leg could buckle. The arm could jam.The tensest time for flight controllers in Pasadena, California: the six minutes from the time the spacecraft hits Mars' atmosphere and touchdown. They'll have jars of peanuts on hand — a good-luck tradition dating back to 1964's successful Ranger 7 moon mission.InSight will enter Mars' atmosphere at a supersonic 12,300 mph (19,800 kph), relying on its white nylon parachute and a series of engine firings to slow down enough for a soft upright landing on Mars' Elysium Planitia, a sizable equatorial plain.Hoffman hopes it's "like a Walmart parking lot in Kansas."The flatter the better so the lander doesn't tip over, ending the mission, and so the robotic arm can set the science instruments down.InSight — short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport — will rest close to the ground, its top deck barely a yard, or meter, above the surface. Once its twin circular solar panels open, the lander will occupy the space of a large car.If NASA gets lucky, a pair of briefcase-size satellites trailing InSight since their joint May liftoff could provide near-live updates during the lander's descent. There's an eight-minute lag in communications between Earth and Mars.The experimental CubeSats, dubbed WALL-E and EVE from the 2008 animated movie, will zoom past Mars and remain in perpetual orbit around the sun, their technology demonstration complete.If WALL-E and EVE are mute, landing news will come from NASA orbiters at Mars, just not as quickly.The first pictures of the landing site should start flowing shortly after touchdown. It will be at least 10 weeks before the science instruments are deployed. Add another several weeks for the heat probe to bury into Mars.The mission is designed to last one full Martian year, the equivalent of two Earth years.With landing day so close to Thanksgiving, many of the flight controllers will be eating turkey at their desks on the holiday.Hoffman expects his team will wait until Monday to give full and proper thanks.___The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content. 6433

CDC Director Robert Redfield stated on Thursday during the first White House coronavirus task force briefing held since July that schools should remain open during the pandemic, despite a number of major school districts going virtual only in recent weeks.This week, New York City became the latest major school district to close building amid a surge in cases across the country.“Today, there is extensive data that we have gathered over the last two to three months to confirm that k-12 schools can operate with face-to-face learning and they can do it safely and they can do it responsibly," Redfield said. "The infections we have identified in the schools, when they have been evaluating, were not acquired in schools. They were acquired in the community and the household.”CDC data released in October indicated that children can spread the virus within schools, but children under the age of 10 were less likely to do so. The CDC’s data did not find a link between a rise in cases and schools reopening in the fall.Earlier this week, the American Association of Pediatrics noted that over 1 million American children have been infected with the coronavirus."We urgently need a new, nation-wide strategy to control the pandemic, and that should include implementing proven public health measures like mask wearing and physical distancing,” said AAP President Sally Goza. “This pandemic is taking a heavy toll on children, families and communities, as well as on physicians and other front-line medical teams. We must work now to restore confidence in our public health and scientific agencies, create fiscal relief for families and pediatricians alike, and support the systems that support children and families such as our schools, mental health care, and nutrition assistance.”Redfield and Vice President Mike Pence both incorrectly stated during Thursday’s White House coronavirus task force update that the CDC never recommended school shutdowns.Earlier guidance called for schools in areas with substantial community transmission (the CDC did not distinguish between uncontrolled or controlled) to, "Implement extended school dismissals (e.g., dismissals for longer than two weeks). This longer-term, and likely broader-reaching, dismissal strategy is intended to slow transmission rates of COVID-19 in the community. During extended school dismissals, also cancel extracurricular group activities, school-based afterschool programs, and large events."Dr. Elinore F. McCance-Katz, the assistant secretary for Mental Health and Substance Abuse, said there needs to be a focus on students’ mental health.“We must find a way to alleviate that stress without ignoring the fact that our nation faces the very real and deadly virus,” McCance-Katz said. “The work of schools and the school personnel do daily is valuable beyond any words I can deliver. In addition to education, schools provide their children a profound sense of security and stability for the structure and safety of schools are an integral role of health.”McCance-Katz added that teachers and staff need to feel safe when going to schools, and that communities must do what is needed to minimize community spread.“We must use masks and we must enforce social distancing, we must employ creative and innovative ways to limit the number of children in a building at any given time. There are tools we have and we must think through help us to use them to keep our schools open,” she said. 3466

CARLSBAD (CNS) - A 47-year-old man suffered severe injuries when he lost control of his speeding car and struck a tree on a Carlsbad street, police said Tuesday.Dispatchers received a report of a solo vehicle crash shortly before 6:10 p.m. Monday in the 7100 block of Corintia Street, off Alga Road, Carlsbad police Lt. Christie Calderwood said.Officers responded and found the man -- a Carlsbad resident -- unconscious inside a Mercedes-Benz CLS 55 sedan, Calderwood said.A preliminary investigation found that the victim was speeding when he struck a curb, lost control of the sedan and crashed into the tree, the lieutenant said.Paramedics took the injured motorist to the hospital for treatment of "severe injuries," Calderwood said. An update on the man's condition was not immediately available and it was not immediately known if drugs or alcohol were factors in the crash.Anyone with information about the crash was asked to contact Cpl. Travis Anderson, a Carlsbad police accident investigator, at 760-931-2208 or travis.anderson@carlsbadca.gov. 1062