health care

Walmart's New Clinics Are a Free Market Experiment in Health Care Reform

No one will ever head to Walmart for a kidney transplant, but retail companies and profit-based clinics certainly can offer high-quality, lower-level services—and impose market discipline in a sector that sorely needs it.

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When I needed new glasses, I went to an optometrist for an exam, picked out some dorky black frames, paid my portion and my insurance picked up the rest. Then, by chance, I walked into one of those ubiquitous Walmart optometry centers and realized I could have had the exam and the glasses for little more than the price of the copay. That speaks volumes about our current health system.

When a third party—insurance or government, for instance—pays for something, the prices escalate. What's the first thing an auto body shop asks when you take in your car to repair the fender? "Is this an insurance job?" If it is, the price will be higher than if you're paying for it yourself. I never asked the price of my appendix surgery last year, nor did I care. Blue Cross paid the tab.

It's far worse when government is the default payer, given there are no serious controls on costs. There only are two ways to divvy up resources: pricing or rationing. As economist Thomas Sowell explains, "What everyone wants adds up to more than there is. Market economies deal with this problem by confronting individuals with the costs of producing what they want, and letting those individuals make their own trade-offs."

Healthcare is tough because everyone needs access to life-saving surgeries and drugs. Unfortunately, our policymakers look at the problem through the wrong lens. Many seek to upend an insurance-based system that works remarkably well (despite the high prices) and replace it with government-run systems that will spend the nation into penury and lead to long waits for common services (rationing).

Instead of starting from scratch, policymakers ought to fill in the gaps—meet the needs of those people who are falling through the cracks of the current system. One idea goes back to that example in the first paragraph. No one will ever head to Walmart for a kidney transplant, but retail companies and profit-based clinics certainly can offer high-quality, lower-level services—and impose market discipline in a sector that sorely needs it.

Walmart announced last year that it intends to provide clinics that offer low-cost X-rays, lab work, checkups and dentistry, according to a recent CNBC article. "We're going to have a consumer revolution," former Apple CEO John Sculley told the news network. "Why? Because if the Walmart tests are successful, and I suspect they will be, people will be able to go in and get these kinds of health services at a lower cost than if they had health insurance."

One of the biggest flaws of Obamacare is that it imposed myriad healthcare mandates, requiring health policies to cover every manner of treatment and service that politicians deemed necessary. For instance, it's silly for an insurance company to be forced to provide my wife and me, who are in our late 50s, with birth-control coverage.

In other areas, we choose insurance based on our specific needs. I use insurance to protect against financially catastrophic events, not to cover minor services that I can pay for myself. Other people have different needs and priorities.

Scully explained that the big tech firms "realize that this is the largest remaining industry that has not been revolutionized by modern technologies that has transformed every other big industry in the United States." That's because health care, and health insurance, is dominated by government regulation and subsidy. Private companies can't revolutionize industries that are encrusted with Byzantine rules—and where price signals can't work their magic.

In particular, occupational licensing rules, which are enforced by entrenched industries that want to keep out the competition, make it difficult to innovate. That's true, especially in healthcare industries. One reason the gig economy has been so successful is these emergent companies have created newfangled ways to circumvent competition-stifling policies that lock inefficient systems into place. Thank goodness for clever work-arounds.

If you look at prices over time, you'll find that consumer buying power has improved dramatically in industries that have the fewest government regulations. I remember when my parents bought our first color television in 1973 for $470. I still recall the price because it was such a major purchase, the equivalent of around $2,700 in today's dollars. I recently bought a fancy smart TV for 300 bucks—and chose among dozens of options.

When products or services largely are immune to market pressure (because government provides, subsidizes or heavily regulates them), inflation levels are daunting. California public schools never have enough money even though per-pupil spending has soared. That's true for every public service. College tuition has soared. A day doesn't go by without some politician complaining about skyrocketing healthcare prices. Don't you think there's a connection?

Sculley predicts Walmart-style health clinics can lead to a "consumer revolution." That's no doubt true—provided government gets out of the way and allows it to happen.

This column was first published in the Orange County Register.

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  1. Let’s go Walmart!

    1. If they started selling child porn youd never leave.


  2. When I needed new glasses, I went to an optometrist for an exam, picked out some dorky black frames, paid my portion and my insurance picked up the rest. Then, by chance, I walked into one of those ubiquitous Walmart optometry centers and realized I could have had the exam and the glasses for little more than the price of the copay. That speaks volumes about our current health system.

    Never mind, of course, that OD insurance is garbage virtually across the board.

    Also never mind that glasses you get from places like Wal-Mart are absolute garbage as well. If something breaks on that frame, congrats you need a new frame.

    I do like how there’s an attempt to draw a parallel between eye insurance and general health insurance though. It’s pretty dishonest. I know a few OD that have their own individual practices, and I also know they no longer take any insurance of any kind. Surprise!

    1. Oh, and we’ll see how ‘low cost’ Wal-Mart can be once they have to pay radiologists and buy expensive hardware like X-Ray machines.

      1. I’m glad you posted that they’ll have to invest in equipment and pay people’s salaries. I’ll bet Walmart never thought of that. They’re probably rethinking this whole thing as we speak.

        1. Yeah, after all it’s not like a Radiologist isn’t paid more than a Wal-Mart store manager after all…and the store manager is the most highly paid person at any individual location.

          $175,000 a year compared to $300,000+ a year. Gee-Wiz.

          The only reason their optical centers do well is because there’s an over abundance of OD grads and the market is over saturated. Can’t say the same about plenty of other provider types.

          One thing I fail to understand is how Wal-Mart is going to manage to evade all the expenses and regulations that go along with your average health clinic. After all, Wal-Mart will be fully as regulated as any other outlet offering health services.

          1. So as long as they can have one radiologist serving two or more stores they’ll cost less than they already pay a manager.

            They probably won’t even employ a radiologist directly and simply outsource to another company and pay a flat rate per image. They would then basically be negotiating pricing as if they were an insurer

            1. I agree that Wal-Mart probably won’t be hiring any actual doctors, and are instead angling to provide cheaper diagnostics. That said, they’re going to be seeing almost purely medicaid patients and I look forward to seeing how they manage to make that at all profitable since no one has really figured that one out yet.

              My guess is that they think that their retail sales will make up the difference, because no health system seems able to survive purely medicaid patients. I suppose even more government subsidy is always an option though.

              1. I’d think the thing they’d aim for is not accepting insurance period. Get things cheap enough most if their customers are paying the same out of pocket as what they’d be paying in copays anywhere else.

              2. I think most doctors after all is said and done would rather work for Walmart than the government. That is if the government is the only employer and Walmart is one supplier in a competitive market.

                The truth is you don’t want Walmart competing with the government because they would kick their ass.

            2. Of course. This is ‘Dr Welby’ from Bangalore looking at your X-rays

      2. It isn’t that expensive. You outsource the radiologist to India, and the techs don’t get paid all that much, relatively speaking.

        The cost taking a simple X-ray of an ankle sprain is not that high.

        I’ve seen a competitive, profit driven operation on this. I went to an orthopedic specialist with my son when every doctor in the state quit accepting any of the exchange plans. He was from eastern europe and ran his shop like he was trying to make a buck. He accepted all insurance – medicaid, cash.. whatever. Low prices. Fast service. The techs actually ran from room to room. Each tech running 4 X-ray rooms. They hustled. The doctor hustled.

        It was amazing to watch. It ran like a well-managed fast food restaurant. No wasted motion. Maximize throughput and productivity.

        He was making money on the lowest margin services – the ones that a traditional hospital would make up for by tacking on 20 other charges to medicaid.

        This is where they are aiming.

        1. I think you hit it on the nose that Wal-Mart is aiming for the technology portion, and indeed those techs don’t make anywhere near the same salary as the actual MD’s that do the evaluations of the ‘pictures’ they take. The fact remains that the actual equipment costs a pretty penny, and the odd’s that every Wal-Mart will have it’s own CT scanner or MRI is…extremely improbable unless they’re planning to buy up every after market system in the country.

          1. BYODB, can you stop talking?

            You have no clue what you’re talking about, are CLEARLY shilling for….what, exactly? High priced shitty insurance care status quo? Universal EXTREMELY shitty care?

            What?

            Walmart’s glasses are fine. The small retail clinics that have been popping up are great. Real medicine are real medicine prices–not inflated to feed the bureaucracy, politicians, and lobbyists.

            The quicker we get ALL medicine to the retail stage the better.

            If Walmart isn’t artificially hindered by the leftist idiocy that stifles most healthcare, I will bet money that they will soon be offering all manner of body scanning–and possibly funding innovation at rates never seen before.

            Profit makes things happen.

            1. You appear pretty capable of reading entire novels in between the lines.

              If you can’t tell who or what I’m shilling for, maybe don’t accuse me of being a shill in the first place.

              I am curious what makes Wal-Mart uniquely immune to market distortions that cause price inflation though.


              If Walmart isn’t artificially hindered by the leftist idiocy that stifles most healthcare, I will bet money that they will soon be offering all manner of body scanning–and possibly funding innovation at rates never seen before.

              Oh, I see. If the regulations didn’t exist Wal-Mart could do amazing things. Just like how if the regulations didn’t exist your corner clinic could do amazing things. Sadly, it applies to both of them now doesn’t it?

              1. After having read through all of your comments again, I have to say I have no idea why you came into this thread, both guns blazing to cut down even the idea of Walmart opening a further version of Kroger’s Little Clinic or CVS Minute Clinic.

                I will say that I think retail medicine is the way to go–and it needs someone with deep pockets that can pay for the fight against the entrenched healthcare industry.

                And that’s Walmart.

        2. It’s amazing how the profit motive drives competition to provide efficiency, almost as if it’s not from the benevolence of the doctor, the nurse, or the surgeon that we expect our healthcare, but from their regard to their own self-interest. Somebody could probably write a book about that, but nobody needs 23 different kinds of books when children are going to bed unhealthy every night in this country because they have no healthcare. Good healthcare, I mean. I suppose stupid people might stupidly buy affordable Yugo healthcare instead of the much better Rolls Royce healthcare if we let them, but those are the exact sort of stupid people who will stupidly go to Walmart and buy a cheap eight dollar shirt instead of going to Brooks Brothers and buying the much nicer forty dollar shirts. I swear, it’s like you practically have to force these sorts of stupid people to do what’s in their own self-interest.

      3. Dude… People get RAPED for this stuff everywhere they go.

        I go to an indie doctor with his own practice. He sends me straight to diagnostic companies, like LabCorp. When I had previously had lab work done through a big hospital the bill was 3x higher than when I went directly to LabCorp… And the hospital USED LabCorp for their testing! And TRIPLED the price because they can. Ditto when I’ve had xrays.

        Cutting out that kind of BS alone will make Walmart far cheaper than a typical hospital, and far more convenient… Even if they “only” end up being as efficient as intelligent operators like my GP guy and standalone labs/radiology companies.

    2. Eye insurance isn’t insurance in any meaningful term. You don’t buy it because you think you might need glasses sometime in the future. You buy it because you already need glasses and think it will save you money. It’s honestly just a payment plan for people who don’t know what insurance actually it’s with a lot of money skimmed off the top.

      1. Exactly this. Optical insurance is essentially a scam or, at best, a layaway plan where you waste some cash.

        It’s no coincidence that the same providers I know that don’t accept optical insurance also don’t take medicaid. Neither tend to cover the cost of actually seeing the patient. And even if they DO cover the cost, it’s not worth being paid six months after the fact.

      2. Precisely.

        Most people confuse insurance with a health care coverage plan. From an economic perspective, insurance is a very different thing.

        Go walmart, if you think you can disrupt such a moribund industry as health care. They potentially could bring services to areas that currently have none.

    3. Also, if a cheap pair of glasses last a third of the time a good pair would, but are a quarter of the cost and better match the deterioration of your eyes. The cheap pair of glasses are still a better deal.

      1. Zenni is incredible if you don’t care about brands, quality or appearance.

        1. You point out something I don’t understand. Why is it any less expensive to make ugly glasses? I get that the designer brands can charge a premium…. but the cheap brand should be able to copy a general look for almost nothing. Yet they make the clunkiest frames imaginable.

          1. Zenni is good stuff.
            I get a lot of compliments on my $7 glasses.
            Only wish I’d sprung for the transition lenses

          2. Note that all glasses are made by the same company, then realize why they make the cheap glasses look like ass.

            1. this. This applies to sunglasses as well.

              1. Luxottica can set prices wherever they want, after all.

          3. Why are good looking neckties more expensive?

          4. “…Why is it any less expensive to make ugly glasses?…”

            It’s not, but cost isn’t the only driver of prices.

      2. Great.

        Now go and get yourself some cheap glasses….

        duh-duh duh. duh. duh-duh duhn duuuh…

        1. Deguello was an incredible album.

    4. “Also never mind that glasses you get from places like Wal-Mart are absolute garbage as well. If something breaks on that frame, congrats you need a new frame.”

      You can buy the same brands at Walmart or Target as they have at the optometrist’s office

      1. Obviously you can buy the same brands at Wal-Mart or Target given that they are literally all manufactured by Luxottica. The manufacturer has a monopoly, and no amount of rejiggering the OD market or insurance market is going to change that aspect of the business.

        That being said, you can’t always get the same thing. Wal-Mart and Target generally sell the cheapest stuff available, whereas your OD will try and sell the nicer things to try and make up for their medicaid and insurance patients.

        Frame cost is basically a scam by the manufacturer, but that doesn’t mean there isn’t a difference in quality between their sub-brands.

    5. “Also never mind that glasses you get from places like Wal-Mart are absolute garbage as well. If something breaks on that frame, congrats you need a new frame.”

      I buy cheap glasses. I could break several frames and still not spend as much money as it costs for “good” ones.

      1. Whereas I bought two nice frames for about $200 bucks ten years ago, and still have both of them and both are in perfect condition.

        *shrug*

        If you’re breaking your frames on the regular, it makes sense that you’d buy disposable glasses from Wal-Mart.

        1. I don’t break my frames on a regular basis- I said I could. I bought cheaper frames and still have them years later. Along with the other stuff I bought with the money I saved not buying “nice” frames.

          You want to buy expensive frames? Knock yourself out, it’s your money.

          *shrug*

          Not everybody needs what you think you do, you know.

          1. Not sure what you think I’m saying, beyond that cheap frames are cheap for a reason.

            Nowhere have I suggested that you should pay more. In fact, glasses should be cheaper virtually across the board but aren’t because of a monopoly on manufacture.

            Unless you’re buying some fancy titanium flex glasses, they are almost all lumps of identical cheap plastic.

            1. “Not sure what you think I’m saying, beyond that cheap frames are cheap for a reason.”

              Actually, you said cheap frames are essentially trash…

              “glasses you get from places like Wal-Mart are absolute garbage”

              I disagree.

              1. When I say cheap frames, I mean frames with plastic hinges and no nose pads. That kind of thing. And they are trash compared to a slightly more expensive frame that at least has metal hinges or internal wires.

                In reality, it probably depends more on your face and nose if those types of frames are tolerable for you. For me, it’s painful after a few hours and I tend to need a custom fit since my ears aren’t actually even. Might as well spring for a frame that can actually be bent instead of snapping off like a twig.

                1. Is there anybody who doesn’t think products with more/better features are (all else equal) preferable to ones without such? In the real world, however, all else is not equal. There are tradeoffs which must be considered and having the option of buying inexpensive “trash” glasses beats not being able to buy anything at all for people who don’t have the resources available to those who happen to be more fortunate.

                  Walmart sells cheap stuff. So what?

                  1. You’re right. There are trade-off’s. I enumerated some specific ones above. You seem to be really invested in proving that your cheap glasses are excellent, even when someone with fairly good knowledge of the industry is telling you they are the bottom of the proverbial barrel assuming they are really the cheapest available pair.

                    Their glasses will do one thing: help you see better. (Which, by the way, relies on the OD not the retail seller.)

                    Comfort, appearance, and durability be damned on a product you wear 12+ hours a day.

                    I will admit you are correct though: you can buy a Yugo and keep it running for decades. That doesn’t make it a quality product, it means you made due. Hell, I’d even admit that for some people the Yugo might be the ideal product. I’m glad that, for you anyway, your Yugo was the ideal product.

                    For other people, perhaps the Honda civic is a better fit. Still others might enjoy the bells of whistles of a Lexus. I don’t give a shit that you drive a Yugo, just don’t pretend it’s a Lexus.

            2. Unless you’re buying some fancy titanium flex glasses, they are almost all lumps of identical cheap plastic.

              Speak for yourself hipster. I wear wire frames like an adult.

        2. I have had new prescriptions put into old frames. The lens costs are pretty low compared to an expensive frame, but once my wife picks out the frames she wants to see me in, I try to make them last. Having 3 or 4 different sets of glasses is helpful too, allowing me to change looks at least a little bit.

    6. Walmart sells the same name brand frames as any other eyeglass store.

      Do they magically get shitty because they were paif for at a Walmart register?

      1. Jesus H. Christ, feel free to assume that I meant that every frame Wal-Mart sells are the cheapest frames available. They sell non-shitty frames too, but they aren’t the cheapest.

        If you wear cheap glasses that is your choice, and I’m not saying you shouldn’t wear cheap glasses. I will, however, point out that bargain basement glasses are little more than junk. I note that pewter rings being garbage doesn’t stop people from wearing them, either. I don’t see how that’s even remotely controversial.

        As always, you tend to get what you pay for.

        1. Ah, I see now. I did say that Wal-Mart frames are junk, and that’s on me. I say that because the vast majority of frames that people brought into places I’ve worked for repair were junk Wal-Mart frames that are, quite literally, irreparable.

  3. I wonder how they plan to deal with “certificate of need” regulations that stop people from opening competing healthcare services.

    1. The COD regulations already do a fine job of stopping people from opening competing healthcare services so I don’t see where they’d need a plan to deal with them at all.

      Oh, you meant how does Walmart plan on dealing with the COD regulations, I thought you meant how does the healthcare monopoly plan on dealing with Walmart. Yeah, no, Walmart’s fucked.

      1. Walmart has two things in abundance – lawyers and money.

        If they still sold guns, I’d throw a Warren Zevon joke in here.

    2. These are no different than a primary care physician or dentist hanging out his shingle. I am not aware of a single place where CONs control that.

      1. So if we just relabel a Wal-Mart health center as something other than a health center, they can escape certificate of need laws? Do tell.

        Because a Wal-Mart opening a health clinic that covers everything from diagnostics to dentistry is different from an already regulated market that does the exact same thing how?

        Note that this is specifically the market that CON laws already fuck up, and I’m not sure how Wal-Mart is going to side-step that just by selling gallon jugs of cheese poofs on the side.

        1. I just have to ask – how did you handle Amazon when you were running Walmart?

          See, me, I wouldn’t have known how to come up with a plan to handle Amazon or Walmart’s entry into the healthcare field, but then again, nobody was offering me the opportunity to make a shitload of money by developing such a plan so why would I bother? But you bet your ass if you offered me an opportunity to make billions of dollars off of developing such a plan, I’d do it.

          That’s how the free market works – offer somebody a shitload of money if they solve a particular problem and the problem tends to get solved. Walmart seems to think they can make a lot of money getting into the healthcare field, how much are you getting paid to tell them they’re full of shit?


          1. I just have to ask – how did you handle Amazon when you were running Walmart?

            Not sure what you mean, since I’ve never worked for either company. Instead I’ve worked for medical companies my entire adult life and recognize that Wal-Mart trying to penetrate that market is going to be interesting since they won’t escape any of the regulations that already intentionally stifle the market.

            Does Wal-Mart have the same lobbying force as the institutions that managed to get protectionist laws in place specifically to fuck over new comers to the market? I suppose it’s possible that the retail lobby might have more power than the medical lobby, but I suspect that’s not the case here in reality.

            If you think politicians are going to give more weight to retail companies that sell cheese poofs than they do to medical industry people that literally save lives, I have a bridge to sell you. And keep in mind that the medical industry loves them some protectionist legislation.

            Or…wait…are you assuming that there is a free market in healthcare? What world do you live in?

            1. They might go the uber route. Offer the services faster than the government can react. Then make the politicians take away the cheap access. Only politicians that can survive doing that are in New York and California, which still leaves a shit ton of paying customers.

              1. I feel like this is a non-sequitur. Uber has nothing to do with medical at all. Are you saying Doctors will be contract labor for a digital platform in the near future? That is possible, we already see some emerging trends in that vein. Remote surgery, digital consults, that kind of thing. That’s more thanks to ubiquitous Doctor shortages than it has anything to do with access though, and shortages don’t usually lead to reduced prices in reality.

        2. BYODB, if you could point me to one place where CON laws restrict the ability of primary care practitioners to open an office or group practice I sure would like to know. Because from a regulatory standpoint that’s what these are.

          1. Do any search for CON laws restricting the opening of new clinics or hospitals and I think you’ll find it happens all the damn time.

            I’m not sure how Wal-Mart will be considered a private or group practice when they don’t have any doctors actually working for them, though. Last I saw, CON laws are perfectly able to stifle new construction of diagnostic centers which would seem to be more akin to what we’re talking about.

            Obviously, that said, not everywhere is retarded enough to have CON laws on the books.

            1. No, it does not happen all the time for primary care providers. While the practitioners need a license their place of practice (unlike a pharmacist or even massage therapist) does not. That is what I’m trying to tell you. There are no CON restrictions on opening a walk in primary care clinic. You made the assertion there are, you are the one who needs to back it up.

              Diagnostic centers are, by definition, not primary care, nor are they what Wal-Mart is proposing to do.

              1. Wasn’t trying to say that primary care providers fall under CON laws, but rather Wal-mart isn’t getting into the primary care business as far as I can tell. I had to find my own source outside of the article to get any actual details about their plan.


                By partnering with local providers, the new Walmart Health center will deliver services including primary care, labs, X-ray and EKG, counseling, dental, optical, hearing, community health (nutritional services, fitness) and health insurance education and enrollment all in one facility, conveniently located outside the store with a separate entrance for customers. The clinic will provide low, transparent pricing for key health services for local families, regardless of insurance status.

                So it seems to be that Wal-Mart is becoming a different kind of middle man by including baseline pricing of local providers in one place (which most hospitals don’t even have available, last I saw, so I’d be amazed if a local hospital could cite the price of anything accurately to Wal-Mart when they can’t even do so internally.)

                In essence, they’d be getting around CON laws by pairing up with providers who already got through the CON process independently of working with Wal-Mart. I imagine that’s one way they can keep their own costs lower, but I’m still unclear on exactly what is so revolutionary here.

                They sound like a referral service that signs people up for medicaid or insurance then shunts them off to providers that take those services to me.

  4. CVS has been doing something similar for a few years with their Minute Clinics, but they are only in major markets. If Wal-Mart rolls this out to the majority of their stores it will really change the healthcare landscape nationally.

    1. I went to one of these. They had a PA on staff who didn’t know anything beyond the common cold. Still, if you needed Amoxycillin for an ear infection for your kid… it was golden.

      In my case… I had a minor ailment that was not in the sweet spot. So they were less helpful than an urgent care doc-in-the-box. I ended up self-diagnosing and self-treating.

      1. Amusingly I worked for a University health clinic for a time, and in that case our PA knew way more than our MD but still had to have an MD on site to oversee them. That’s sort of the thing about a physicians assistant, they still require a physician.

        I wonder where the physician was at your CVS clinic, because as far as I’m aware there still needs to be a physician for them to assist. I’m guessing one MD for the region that has PA’s at each clinic, perhaps? Honestly, I don’t know the particulars on how ‘present’ the MD has to be to be considered overseeing a PA.

        1. That was my impression. They also have “nurse practitioner” as the medical person on site at a lot of these places.

          She called in for a consult and didn’t get anywhere.

          I will say this… she put me in the right direction to look into my condition. I had a rash on my hand that looked a lot like shingles, but didn’t fit the full criteria. It looked a bit like it had a raised edge… so maybe ringworm, I thought. She said it didn’t really look like ringworm. So that was helpful.

          I ended up going with “some form of immune reaction that is now self perpetuating” and put some hydrocortisone on it. It made an immediate difference. I wouldn’t have done it if she hadn’t said “not ringworm”.

          So props to the PA.

          1. I had a rash on my hand that looked a lot like shingles…

            Dr bigT says stop tuggin it.

        2. Some states allow NPs to function as independent practitioners (e.g. Virginia) others will allow NPs and/or PAs to function largely independently, but under protocol. In such situations the responsible physician may not have to be on site, but is supposed to be routinely reviewing the patient charting done by the mid-level. Mainly to ensure that the mid-level is not treating issues/conditions outside the scope of the protocol.

      2. Where did you score the morphine?

      3. we are urgent in need of kdney donors for sum of 3 cr ,if you are interested pls take my number from profile and call or whats app chat dr praveen raj

    2. The CVS example is the actual real world example. But if you look at their stock chart, you can see what Wall St actually thinks about the idea of distributed local health clinics/care/supplies. BEFORE this crisis created the opportunity to get all sorts of bailouts and subsidies and crony opportunities to ensure that any ‘reform of the medical system’ is done primarily to serve the financial interests of the big/established.

      1. CVS stock price right now and of late has more to do with people waiting to see how well they digest Aetna than the success or lack thereof of the minute clinics.

        1. Look at their chart for the last five years. Wall St has been enamored of online as the replacement. All face-to-face will only need to happen at hospitals. The only thing that happens outside hospitals is drugs. Let’s give that to Dr. Bezos. Or maybe we’ll call that customer service guy in India – Dr Welby.

          However much WalMart may talk about this ‘new idea’ – now that coronavirus crisis has provided the opportunity for bailouts/subsidies/cronyism – the nanosecond they get that in hand, they will turn around and spend it on the stuff they were already spending it on (see post below)

          Don’t misunderstand. I really admire what CVS is doing here. They’ve been on my watchlist for a couple years as a value trap and I nibbled a bit today though prob too early. Clinics and primary care/prevention type stuff is exactly where we need to go to in this country. But the notion that WalMart or even CVS should be driving these medical reform ideas – for govt to pay for – is just cronyism and corruption. Unfortunately I don’t think the US is capable of anything other than corruption and cronyism now. We only do ‘reform’ now by inviting a bunch of CEO’s to DC to meet with the poobahs and discuss these important issues. Well golly.

          1. Look, if all you want are foreign doctors that normally get paid in rupee’s what is stopping you from calling them up directly?

            Oh, right, the local pharmacy doesn’t take prescriptions from Dr. Dre.

            You do hit on one real solution to healthcare, which would be relaxing the requirements of American MD’s but somehow people like you never alight on the obvious market solution. Probably because people are irrational and want to weigh down American MD’s with more requirements than a rocket scientist because ‘safety’ while also wanting the same price point as a Korean-made TV that breaks after a year or two.

            1. fuck you. The solution is to throw away the fucking Flexner Report from 100+ years ago that has driven our medical training. An idea that met the specific needs of the donor class then (Canregie and Rockefeller) – lots of scientifically top-notch specialists competing to improve their skills on rats/peasants – in over-equipped hospitals – all paid for by those donors so that when THEY need those specialists they will know who is the best and will move to the front of the line. But no GP’s. And let me repeat – THEY PAID FOR IT THEN. The hospital – the equipment – the specialist salaries.

              Now they expect the rats/peasants and taxpayers to pay for it. But what the rats/peasants mostly need is GENERAL PRACTITIONERS. What the taxpayer (Medicare) needs is geriatricians (basically GP’s for the older). But those don’t exist in a system that is completely geared to turning out what Carnegie/Rockefeller decided was needed 100+ years ago.

              Those ‘requirements’ were not created by bureaucrats or pols or citizens. They were created by following the diktats of two long-dead billionaires (who it should be noted were both of retirement age then) and the technocrats who put flesh on their vision.

              1. Wow, that’s some grade A psychosis right there. Honestly, seek help.

  5. Sculley predicts Walmart-style health clinics can lead to a “consumer revolution.” That’s no doubt true—provided government gets out of the way and allows it to happen.

    That may well be. But this really is totally theory that does nothing but support a top-down CEO driven form of trickle-down ‘capitalism’.

    IN THE SHORT-TERM, WalMart and every other company is gonna find that Wall ST has frozen up. There is no financing from them. And WalMart is gonna find that it can’t keep paying the shit wages it pays its employees when no one is going into WalMart for anything other than TP. And with those shit wages, those employees are going to be far more concerned about protecting their families than being motivated to help WalMart earn more profits that those employees ain’t ever going to see.

    So guess what – all those companies and their CEO’s are going to call up the pols and lobbyists they own. And they are going to press for this bailout and that bailout and the other bailout. TARP on steroids. And the nanosecond they have that money in hand, then THEY are going to be the decision-makers about how that money is spent. The think-tank ‘libertarians’ who are their whores will find ways to justify those bailouts and be silent about alternatives and, like TARP in 2008, find ways to quickly sweep all the distortions under the carpet and proceed in their Randian plutocrat worship ways.

    And hmmm – we now have all this money. Maybe the best way to spend it is to give more stock options – or buyback shares – or this or that. Everything except that idea of public health clinics that don’t really pay for themselves. Because if those clinics DID really pay for themselves, then they would already be pervasive everywhere and all the potential problems we face now would not be problems AT ALL.

    1. Let’s see, hundreds of CEOs competing with each other vs monopolistic incompetent corrupt politicians whose only interest is in getting re-elected. Who has more incentive to deliver care that people like?

      Help me out here, I just can’t figure it out.

      1. Except here in reality, the incompetent corrupt politicians are going to be there regulating regardless of what CEO is trying something ‘new’. Expect that ‘new’ to be regulated shortly after it’s inception. And the CEO trying something ‘new’ will slam the door shut behind themselves in concert with the politician.

        Not that opening clinics is at all ‘new’, though. The only ‘new’ part is the clinic is also happy to sell you a six pound brick of Velveeta on top of your x-ray.

        1. “Except here in reality, the incompetent corrupt politicians are going to be there regulating regardless of what CEO is trying something ‘new’. Expect that ‘new’ to be regulated shortly after it’s inception…”
          Yes, and even an increase it ‘regulated’ clinics will be more competitive than the alternative.

          “…And the CEO trying something ‘new’ will slam the door shut behind themselves in concert with the politician…”
          Are you familiar with the term “nihilism”? Perhaps suicide is your only answer.

      2. CEO’s ‘competing’ re how to spend taxpayer money? And yes these are taxpayer money because these are people who don’t have doctors and can’t afford to go to hospital and where most what they spend is actually out-of-pocket. WalMart is not providing a service for concierge GP’s via no-deductible no-copay all-you-want-for-free executive health plans here.

        Looks to me more like pigs ‘competing’ at a big trough of money. Which mostly ensures that everything in that trough will be gone more quickly with no accountability. But hey – if you think that’s actually free market – well tomato tomahto

  6. ” …. it’s silly for an insurance company to be forced to provide my wife and me, who are in our late 50s, with birth-control coverage.”

    Oh? Hmmm.

    Well, let’s see how much your premiums are when people in their 20’s and 30’s can buy insurance that doesn’t cover things like arthritis, heart disease, diabetes, and various other maladies that tend to start afflicting people as they hit their late 50’s and 60’s than they do younger folk.

    1. … or let’s see how much your premiums are when you or your wife acquire some “condition” – and there’s no younger people (who have different health care needs) in your risk pool to share that cost with you. Kind of “socialistic” you say? Well, yeah … so is MediCare.

      Know why they started MediCare? Because insurers didn’t want to cover the costs of people over age 67. They start acquiring medical issues around that age and start becoming really expensive to cover. But you’re going to opt-out of that “socialistic” program … right? Good luck to ya!

      1. “…Know why they started MediCare?…”

        Yeah, it’s cheap to buy votes with other peoples’ money.
        Fuck off, slaver.


  7. Healthcare is tough because everyone needs access to life-saving surgeries and drugs. Unfortunately, our policymakers look at the problem through the wrong lens.

    Specifically, the lens where they think it’s possible for everyone to have access to those things.

    I’ve read the cited stories for this post, and I’ll be damned if I can find a single thing that says how Wal-Mart intends to sell diagnostics at below market rates. It’s simply taken as a given that they can.

    My guess? Wal-Mart had enough capital to buy some machines and plans to do exactly what other outlets do, only with the added draw of buying groceries at your doctors office.

    1. No they do not need to buy machines. They just provide space and subcontract.

      They negotiate with the companies, pharmacy, optometry, medical providers, insurance, who do.

  8. I never asked the price of my appendix surgery last year, nor did I care. Blue Cross paid the tab.

    Seeing as most appendix surgeries are of the “emergency” variety, it’s not unfair to suspect your lack of caring had more to do with the crippling pain from your appendix spontaneously trying to murder you, and less to do with the economic consequences of not trying to “shop around”.

    1. I agree with you on this. I do find it somewhat amusing that ‘Blue Cross paid the tab’ though. I really doubt they paid for the whole thing.

      It’s a truism in medical that no one looks at the price until you’ve saved their life, then they get mad at how much you think their life is worth.

  9. Safeway is trying the same in SF, and the SF city gov’t has yet to find a plausible reason to interfere.

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  12. Freak-en awesome… Those “evil” “greedy” corporations are busting up the Nazi (National Socialist) GOV monopoly and doing it for about 1/100th of the price. Go Walmart – We could all use that “affordable healthcare” we’ve been promised over and over again since 1928.

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  14. So although I theoretically have a GP who owns his own clinic… The last few years I’ve gone to a place called ZoomCare almost every time I needed anything. Same day appointment, comparable/lower cost than regular doctors, cheaper than anybody working at a big hospital, they take insurance, OR you get a cash discount if you pay cash on the barrel head.

    It is soooooo much more efficient and pleasant than dealing with the BS of a big hospital system it isn’t even funny. I bet if everybody switched even just common stuff to places like this 1/3 of medical costs would go away overnight.

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