January 16, 2016

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Business January 16, 2016

Luxury And Self-Driving Cars Dominate Auto Show Talk

3:55

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NPR’s Sonari Glinton tells Michel Martin about week one of the North American International Auto Show in Detroit.

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MICHEL MARTIN, HOST:

The North American International Auto Show opened to the public today in Detroit. It’s one of the biggest auto shows in America.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED MAN: The 2016 North American Car of the Year is the Honda Civic.

(APPLAUSE)

UNIDENTIFIED MAN: The North American Truck Utility of the Year is the Volvo XC90.

MARTIN: Following a record year of auto sales, the big stories out of the show are luxury, trucks and car features that bring us closer to cars that drive themselves. NPR’s Sonari Glinton spent the week there, and he’s going to tell us more. Hi, Sonari.

SONARI GLINTON, BYLINE: Hey, how’s it going, Michel?

MARTIN: So the Honda Civic and the Volvo XC90 were the car and truck of the year, respectively. So let’s take them one by one – the Honda Civic, how come?

GLINTON: Well, it is actually a really amazing car. They have all the modern self-driving features that you can get in a really inexpensive vehicle. You can get Lane Assist, you can get a back-up camera, you can get all these sort of things for about $20,000, and that’s pretty amazing.

MARTIN: So are self-driving cars far away or not? We’ve heard so much about them, and it kind of make feel like they’re around the corner – yes or no?

GLINTON: Well, they’re around the corner and they’re far away. All the easy things – the driving down the road going 65 miles an hour, we can do that. What we can’t do is, you know, drive in an ice storm or figure out – is that a tumbleweed, is that a cat or is that a child? You know, there are these dynamic decisions that we have to make. And the car companies are spending billions of dollars right now on AI and robot technology. And that’s a part of the show, and that’s part of what everyone’s excited about because they’re actually putting the money in right now with the artificial intelligence. And you’re seeing it in the cars.

MARTIN: So now let’s talk trucks – the Volvo XC90 was the truck of the year. I’m not sure if that’s what people think of when they think of the truck. So tell me, first of all, why was it the truck of the year? What’s so great?

GLINTON: Well, you know, Volvo is a company that executes vehicles very well. It is an SUV. And SUVs are so important, as well as compact SUVs. This is where people are purchasing their cars. This is the playing ground. And the fact that a Chinese company, which owns Volvo, has spent about $11 billion restructuring the company is also a sign of a change in the structure of the auto industry, where a Chinese company has a seat on the floor of the North American International Auto Show. And that’s a sign of a change in the industry.

MARTIN: Finally, Sonari, your interview the head of Volkswagen has been getting a lot of play in the U.S. media. CEO Matthias Muller said, quote, “we didn’t lie.” And he was referring, of course, to VW’s emissions scandal. How are people receiving that?

GLINTON: Well, there’s a lot of shock, especially in Germany because there’s a sense and worry that he’s not the guy to handle this really big PR problem for Volkswagen. What we have to understand is that Volkswagen is much more central to the identity of Germany than, say, Chrysler is to ours. They employ hundreds of thousands of people. And this is really serious, and the German people and the German press and regulators are wondering if Matthias Muller can smooth this out. Now, he’s only been the CEO for three months, and there’s a worry that he’s not the person to get back the trust of the American people. And this is one of the most important markets for the company to win.

MARTIN: That NPR’s Sonari Glinton. He just got back from the Detroit Auto Show. Thanks, Sonari.

GLINTON: It’s a pleasure, as always.

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Sports January 16, 2016

Build It And Fans Will Come: Is There A Market For Two LA Football Teams?

3:14

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The new stadium planned for the Los Angeles Rams will be among the most sophisticated in the NFL. But what does the deal bring to a city that was without a team for more than 20 years?

Transcript

SCOTT SIMON, HOST:

This week, National Football League owners voted to send the St. Louis Rams back to Los Angeles, and they’re not the only team that’s looking to go west. The San Diego Chargers – well, they’re already west (laughter). The San Diego Chargers want to move to LA, too.

The Rams and the Oakland Raiders both left LA in 1995 after they struggled for years to attract fans.

From member station KPCC, Ben Bergman reports on the prospects of success this time ’round.

RANDY TROY: Welcome home, Los Angeles Rams

BEN BERGMAN, BYLINE: Just after the NFL’s announcement Tuesday, Randy Troy led a cheer for fellow Rams fans in exile on land where their new stadium will be built.

TROY: What’s that spell?

UNIDENTIFIED PEOPLE: Rams.

TROY: What’s that spell?

UNIDENTIFIED PEOPLE: Rams.

TROY: What’s that spell?

BERGMAN: If only fans were as excited about the team when it left. With a dismal record of 4-12, the Rams were dead last in NFL attendance. Sports Illustrated wrote fewer people went to the Rams last home game than went to a high school football game played in the same stadium 8 days before.

MARC GANIS: Los Angeles is a front-runner market. If you’re winning, you can’t charge enough for your tickets, and if you’re not, you can’t get people to come to the games.

BERGMAN: Marc Ganis should know. He’s a consultant to NFL teams who helped the Rams move to St. Louis. And he says yes, LA is a big market, second only to New York, but it’s also a fickle one, where there are lots of other things to do.

GANIS: There’s a strong argument that LA is really a one-team market rather than a two-team market.

BERGMAN: But two teams is what Los Angeles may very well get, which has more to do with NFL politics than whether two teams can be successful. The Rams, Chargers and Raiders all wanted to go to LA. Now the Chargers have a year to decide whether they want to move north. If they don’t, that option goes to the Raiders.

GANIS: That’s just part of the compromise that had to be achieved.

BERGMAN: Yesterday, Stan Kroenke said he’s currently in talks with the Chargers. He’s the owner of the Rams, the 63rd richest man in the world and one of the country’s biggest landowners. But I asked him if two teams can really thrive in LA playing in the same stadium.

STAN KROENKE: The National Football League – they have done those studies, and they think they can.

BERGMAN: But you do?

KROENKE: You want to get into the rational economics of it? It’s always better for me to have another team. Just remember – that’s 10 more dates every year. That’s more people coming to the facility, so it’s always better for me.

BERGMAN: That depends partly whether a second team would be a tenant or a partner. Either way, Kroenke will control most of the massive 300-acre entertainment and retail center.

KROENKE: For me as a developer and a sports owner, it’s a once-in-a-lifetime opportunity.

BERGMAN: Kroenke has likely looked at MetLife Stadium in New Jersey as a model. Sports economist Andrew Zimbalist points out everything there is shared equally by the Giants and the Jets.

ANDREW ZIMBALIST: Those are two ownership groups that never got along in the past. They’re doing quite well.

BERGMAN: A lot of their success comes from a strong market for luxury suites. It turns out many New York companies buy suites for both teams. That’s important because in the NFL, most revenue is shared among teams. Luxury suites are the big exception. Kroenke says that’s crucial for his project.

KROENKE: It allows you certain streams of income to, for example, support the building of an iconic stadium in the second biggest media market in the country, so that’s an attractive proposition.

BERGMAN: The Los Angeles Rams announced a waiting list for tickets will open Monday.

For NPR News, I’m Ben Bergman in Los Angeles.

Copyright © 2016 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by a contractor for NPR, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of NPR’s programming is the audio.

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Health January 16, 2016

Why Doctors Need To Have Answers For Patients' Questions About Costs

How much does that test cost and how much is it worth?

How much does that test cost and how much is it worth? Fanatic Studio/Getty Images hide caption

toggle caption Fanatic Studio/Getty Images

For years, Mrs. Sutton came to see me in the office every three months. Visiting the doctor quarterly was “the right thing to do,” she told me, given the fact that she had both diabetes and high blood pressure.

She always set the agenda at our visits. She brought lists of questions and requests that followed the recommendations of her fellow churchgoers and the health materials she had read.

It came as no surprise to me when she asked to undergo a colonoscopy at age 68, in order to be screened for colon cancer. She had read that colon cancer was treatable if caught early, and several friends had told her that undergoing “the scope” was the most comprehensive means of screening.

I agreed that it was a good idea and dutifully made the referral to the gastroenterologist. When the report came back a few weeks later, I was pleased to learn there were no polyps found.

When I mentioned the test to Mrs. Sutton at our next visit, I assumed she’d be as happy with the results as I had been. Instead, her reaction shocked me.

“How on earth could this cost so much?” she demanded of me. “This is an outrageous bill!” she said, referring to both the colonoscopy charges and the facility fee, which totaled more than $5,000.

“Yes, the prices of medical tests can be hard to believe, but you have Medicare” I told her. Because Mrs. Sutton had ‘Medigap coverage,’ she owed nothing.

The fact that her out-of-pocket costs were zero failed to sway her. It was the principle of the thing. She felt gouged by the price of a procedure which she valued at a few hundred dollars at most.

Unfortunately, there was no turning back. The damage had been done. Mrs. Sutton made very clear to me that she’d never undergo a test that pricey again, even if insurance paid for it.

Furthermore, she told me that she expected me to provide better information about what something might cost beforehand.

Without realizing it, I had fallen into the abyss of medical prices— a topic that still puzzles and enrages millions of Americans.

Like many doctors, what little I know about medical pricing comes from a combination of what my patients tell me and what my family and I experience personally. There was no formal training in medical school about health care spending or the cost-effectiveness of various tests and treatments.

Instead, we were taught to ignore costs and focus on the best care and treatment we could provide. This was health care, American-style. No stone should go unturned in the pursuit of a diagnosis. Any and all resources should be brought to bear in treatment. Payment was almost never discussed in polite company.

Fortunately, I think, doctors are warming to the idea that we must be better stewards of the resources we command.

Pharmaceuticals were long an exception to the cost-is-no-concern rule. Orthodox medical teaching has always emphasized the principle that a well-established, low-priced generic drug is as good as a more expensive name-brand alternative. Yet evidence shows that in spite of mutual doctor-patient desire to discuss drug costs, we docs usually shirk the duty.

Diagnostic tests are an entirely different kettle of fish. Despite patient demand to know the cost of a test or procedure, it’s been very hard to get reliable price quotes. New entities have formed to try to solve this perennial puzzle: One company provides an app that links with insurers’ databases to accurately list contracted prices. Another provides incentives to patients to get tests in-network by offering discounts and sending patients a check for a small portion of the accrued savings.

Which brings me back to Mrs. Sutton, who died before smartphones changed the way we live. Back when she confronted me about the cost of her colonoscopy, there was no app to help her shop around. Nor was there any resource for me to guide her to the most cost-effective alternative.

All of my experience to that point had taught me that patients with insurance simply didn’t care about prices. Mrs. Sutton begged to differ. Her reaction taught me never to make that assumption again.

John Henning Schumann is a writer and doctor in Tulsa, Okla. He serves as president of the University of Oklahoma, Tulsa. He also hosts Public Radio Tulsa’s Medical Matters. He’s on Twitter: @GlassHospital

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