Anthem Teams Up With Google Maps

With hospital emergency departments luring patients by advertising short wait times, the state's largest health insurer is asking its members to consider cheaper care at urgent-care centers and in-store clinics when appropriate.

Anthem Blue Cross Blue Shield in Virginia yesterday launched a Google Maps tool on its website that lets consumers search for options such as MinuteClinic, Patient First and doctor's offices that take unscheduled walk-ins.

"From our perspective, if you have a true emergency, the best place to be is the emergency room," said Dr. Jay Schukman, Anthem's regional vice president and medical director.

"But for those conditions where it could be treated in an urgent-care center or a physician's office, that's the most appropriate place to go," Schukman said.

Anthem officials say a review of the plan's fully insured members' ER use for 2008 found that more than 60 percent of visits were "avoidable visits" or visits for problems that could have been treated in an urgent-care or other setting.

Anthem is advising plan members that some conditions, including sore throat, sprains and strains, minor headaches, ear or sinus pain, minor animal bites, stitches and minor allergic reactions, generally can be treated in less expensive settings.

HCA Virginia and Bon Secours Richmond health systems promote short ER waits.

Bon Secours promotes "no wait" emergency care at St. Mary's, St. Francis, Memorial Regional and Richmond Community.

In May, HCA Virginia's Chippenham, Johnston-Willis, Henrico Doctors' and John Randolph hospitals began posting the estimated ER wait times on the hospitals' websites. The estimated times also are displayed on electronic billboards around the metro area.

The Anthem review found the average cost of an ER visit was $441, compared with $98 for urgent-care centers and $52 for clinics inside stores. These costs include what the patient and health plan paid.

"There are times when I am sure [the patient] will get charged the full fare," Schukman said. "There are some hospitals that will transition you over to their urgent-care area as opposed to their emergency area, but generally speaking the charges there are still higher than going to an urgent-care center . . . or a physician's office or a retail health clinic."

Schukman said people may go to emergency rooms out of habit or convenience.

Hospitals get a significant share of their inpatients from people who get admitted from emergency department visits.

"We encourage [patients] to learn when to go to primary care, when to go to emergency care and when to go to urgent care," said Dr. James Dudley, an emergency physician at Riverside Tappahannock Hospital.

"It's important to remember that the [emergency room] is the only place that's always there," said Dudley, a former president of the Virginia chapter of the American College of Emergency Physicians.

In the new Anthem initiative, patients can go to an Anthem website, plug in an address and find nearby retail clinics and urgent-care centers. The website also advises consumers that they can call Anthem's 24-hour nurse information line for guidance.

Anthem also is reaching out to doctor's offices, spokesman Scott Golden said.

"A lot of times they may get a call after hours, and I think the standard response was 'Well, if you feel it's an emergency, go to the emergency room,' which by all means everybody should," Golden said.

The outreach to doctors will focus on medical situations where urgent care and retail clinics are options.

Richmond Times-Dispatch

Atlas Shrugged's Timeless Moral: Profit-Making Is Virtue, Not Vice

In the years leading up to 2008—09's financial meltdown, government control over mortgages, interest rates and America's banking system was at an all-time high.

And yet when crisis struck, free enterprise took the blame.

_________________________

I work for nothing but my own profit — which
I make by selling a product they need to men
who are willing and able to buy it. ...
I do not sacrifice my interests to them
nor do they sacrifice theirs to me;
we deal as equals by mutual consent
to mutual advantage.

_________________________

The cure, therefore, was to give government even wider powers. Washington can now bail out any company, fire CEOs, override contracts and print billions of dollars to "stimulate" the economy — all in the name of the public interest. The result? Our deficits and debt continue to mount, and there's a real possibility of a future like Greece's.

This is the state of our world today. It's remarkably similar to the state of the world in Ayn Rand's "Atlas Shrugged," a mystery story about a future America whose economy is disintegrating and whose government is accumulating power faster than anyone thought possible. This parallel is a big reason a record 500,000 people bought "Atlas Shrugged" last year.

Read the rest of the editorial by Yaron Brooks on Investor.com.

Worse Than A Zero Sum Game

"When it comes to higher unemployment benefits or any other stimulus spending, the resources given to the unemployed have to be taken from someone else. There isn't a "tooth fairy.” The government doesn't create resources, it redistributes them. For everyone who is given something there is someone who has that something taken away.

While the unemployed may spend more as a result of higher unemployment benefits, those people from whom the resources are taken will spend less. In an economy, the income effects from a transfer payment always sum to zero. Quite simply, there is no stimulus from higher unemployment benefits.

To see this, imagine an economy that produces 100 apples. If 10 of those apples are given to the unemployed, then people who otherwise would have had those 10 apples now won't. The stimulus of 10 apples for the unemployed is exactly offset by the destimulus of 10 apples for those people from whom the 10 apples were taken.

Given the massive inefficiencies the government creates in securing resources from the private sector, there may also be a large negative income effect over wide ranges of stimulus spending. This is the proverbial "toll for the troll." These massive inefficiencies could lead to lower output.

To see these effects clearly, imagine a two person economy in which one of the two people is paid for being unemployed. From whom do you think the unemployment benefits are taken? The other person obviously. While the one person who is unemployed may "buy" more as a result of unemployment benefits, the other person from whom the unemployment sums are taken will "buy" less. There is no stimulus for the economy.

But it doesn't stop there. While the income effects sum to zero, the substitution effects aggregate. The person from whom the unemployment funds are taken will find work less rewarding and will work less. The person who is given the unemployment benefits will also find work relatively less rewarding and will therefore work less. Both people in this two-person economy will be incentivized to work less. There will be less work and more unemployment.

Not only will increased unemployment benefits not stimulate the economy, they will at the same time lower the incentives for people to work by reducing the amount people are paid for working and increasing the amount people are paid for not working. It's pretty basic economics."

Art Lafer in today's WSJ