The cost of managed healthcare in California has passed the national average for the first time, according to a report released by the California HealthCare Foundation. Health insurance premiums in California increased 8.7 percent in 2006, a sharp rise compared to the state’s inflation rate of 4.2 percent and well over the national increase of 7.7 percent, according to the Oakland-based foundation. The average California HMO enrollee paid $342 in premiums each month versus $337 paid by the average American, the report found. Additionally, more than 60 percent of HMO members paid at least $15 for a doctors visit this year, a 15 percent increase since 2003. Premiums have experienced increases nationally as members look for more options in doctors and medical facilities. Historically, HMO premiums in California were significantly below the national average, although the report does not detail what has caused the sudden shift.