Posted on 09/18/2019 10:27:08 PM PDT by aquila48
I live in exactly the right location to see the outcome of a grand experiment. The pilot Walmart Supercenter is located in Dallas, Georgia. So am I.
On Friday the 13th, the CEO of Walmart cut the ribbon at the grand opening. Sadly, I only learned about this grand opening on the morning of September 14. There had been no publicity while the store was being remodeled over the last 12 months.
So, what you are about to read is based on original research conducted on the cheap on the afternoon of September 14.
1. A Right-Hand Turn
My house is about 60 seconds from the highway.
If I turn to the right and drive approximately 1.7 miles, I arrive at the Walmart Supercenter.
I walked into this Supercenter through a new wing: Walmart Health. There, I found a health care delivery system that is far more comprehensive than the standard walk-in clinics that have sprung up in America's mini-malls. Here is what is available.
- Primary care
- Dental
- Counseling
- Labs & x-rays
- Health screening
- Optometry
- Hearing
- Fitness & nutrition
- Health insurance education & enrollment
I have seen it. I am impressed.
Here is Walmart's press release.
The Walmart Health center will offer low, transparent pricing for key health services to provide great care at a great value, regardless of insurance coverage. Customers will be notified on the estimated cost of their visit when they book their appointment.
The Walmart Health center will be operated by qualified medical professionals, including physicians, nurse practitioners, dentists, behavioral health providers, and optometrists. Walmart Care Hosts and Community Health Workers onsite will help customers navigate their visit, understand resources and be a familiar presence for regular visits.
(Excerpt) Read more at mises.org ...
You made a good point in comment #76. The competition presented by Walmart was a good thing in many areas. We do need to see new competition again, though. Walmart management has become involved in social activism for the left.
Similar to a government catatropic insurance plan... good idea - it has merit. Guidelines around it would take uncertainty out of the mix.
The problem with most 'health care' ideas is they come from groups with vested interest more to do with advantages that help their groups... insurance companies, government control freak socialists, large hospital organizations etc.
On the $600 - should it be rolled over for the following year if it's not used? Maybe invested in a Vanguard Index fund after year four... Or 10% of what's left is sent to the family in check form at the end of the year - with the rest rolled over? That's an incentive for being healthy...
Sounds like what is going on with my husband's glasses right now.
They were not from Walmart but a high priced optomatry clinic.
Oh, and they have already started to corrode after about three months.
Frames are always chancy. For years I bought them from exactly the same place. I have had some that fell apart after a few months and some that have lasted years as I just had the lenses replaced.
Where you evaluate an optometrist is on how well the do the exam and how well your lenses preform. When I had to switch to a new optometrist because we moved I went with a name brand place. The exam was sub-par and the lenses were ground wrong with one area feeling like I was looking through water. They refused to regrind saying I would "get used to it."
Needless to say I switched optometrist.
Yeah those are interesting ideas. Why not roll it over? All the small details I may not be in a position to answer. I thought of it sort of like a “charge card” or ATM card or EBT card - you take it to the doctor and the doctor’s charge it to Medicare up to $600 a year. But this idea can take many forms, and sure why not let it roll over? You could even charge it to Medicare or your own private insurer which would then seek reimbursement. Use it for cash, or co-pays, or deductibles.
Yes of course you are right on the money about why things are so complex. The lobbyists for industries are the ones who get heard and they push for legislation that benefit them. This is called “regulatory capture” and it happens with just about everything Congress and the federal agencies do.
Rare is the public servant who thinks only of what is best for the people. The 2 party system has devolved to where now party takes priority over policy and partisanship take priority over principle. The people are pickled. Some of these problems are a lot easier to fix - this thread has 3 or 4 market-based solutions to problems that people are demagoging in their campaigns for office. But they don’t need a total overhaul to fix these problems as mentioned - 1) a law preventing anyone from being bankrupted by medicine 2) an FDIC type system to insure the providers from excessive loss from non-payment for those protected by #1 3) Market based community clinics with low cost preventive care programs 4) $600 a year to cover preventive care or other health care costs. Bam. The 4 biggest problems, besides uninsured, are solved.
Obamacare was just ridiculously complex. I read a brief summary of Obamacare that made me laugh: 1) Problem is not enough people are insured. So 2) We cancel everyone’s insurance. Then 3) We jack up the price of insurance so we can cover the costs to get the previously uninsured to be insured at the expense of those who were cancelled. 4) Then get the people who were previously insured to pay the higher price for the insurance they were forced to cancel. So convoluted. Damage 150 million private insurance holders to fix a problem of 20 or 30 million uninsured. As you said, its about control. Not about sense and sensibility.
I think that price is absurd as well. When I go to get my teeth cleaned it takes at least 3/4 hour. There is no way that the hygienist could make a decent wage if she gets paid from that charge.
I wonder if, as familyop posits, there is an ulterior motive here, undermining the small business individual clinic’s prices until they force them to become Wally World employees...
I worked temporarily in a drug store for a friend in the ‘90s. He did well for quite a while before Walmart opened in his town. He complained about being unable to compete with a store that narrowed margins so much. He went out of business.
I’m also acquainted with a former pharmacist who works as a department manager in a Walmart, and it’s not the pharmacy department. At least some of the other employees in other departments say negative things about him, for example, “He acts too much like a manager.” [He’s too old fashioned for them and likes to focus on the work instead of social games.] At least a couple of cleaner cut women (no bizarre fad clothes, grooming or skin “ink”) in his department do seem to like him.
It’s interesting to ask questions and listen to people. One can learn some interesting things that way.
People have moral compasses, or not. Companies are made up of people. Therefore, some companies have fine moral compasses. Others will fire employees, right up to the CEO and down to the stockboy making $10 per hour, to attempt to save money or score points.Ref: CEO of Overstock, fired for explaining the U.S. intelligence community tried to enlist him in the coup against candidate Donald Trump. Example: Walmart routinely fires employees days before their first anniversary, so they don’t qualify for health insurance.
Flipside, Walmart also keeps tens of thousand of diabetics alive by offering $25 insulin. It’s an older version than the $150 insulin that you need a prescription to get, which adds another $30 - $150 to get. So - $25 today, or $300 after you finally get a doctor’s appointment some weeks in the future.
I like the card idea... that doesn't stop the balance from being rolled over and it's easier...
The problem is that’s a fix for the high volume, low cost, side of health care, which entails government having to dig up all that money so it can be sent back. The $600 and below part of health care is actually within the resources of most people.
The real politically sellable issue that’s a risk shared by all, is the expense associated with serious illness or injury. Few average citizens have the ability to handle that major heart attack, kidney failure, traumatic brain injury, by tapping the bank account. Those are all areas where we’re at risk of running out of personal resources far before the disease or injury has run its course. Pretty much every American is at risk of financial destruction in those areas. That’s where there’s arguably a role for wide-spread taxpayer involvement. In fact, many states have had disability coverage for years intended to provide some relief to those medically unable to work.
I’ve long advocated state funded major medical coverage with a high deductible that comes to the aid of those seriously in trouble. It addresses a risk that’s common to all of us, is relatively easy to administer, and can be funded by a payroll tax or an income tax override. Limiting it to every individual who files, or appears as a dependent, on a tax return also acts as an incentive for tax dodgers to file. They actually get something back for paying their taxes. It also has a strong positive impact on the high-risk pools, drives down the cost of individual insurance, and reduces the degree of government supplementation of uncollectable ER costs, since a large percentage of high cost patients will have coverage.
Coverage for those who view medical insurance as a pre-paid medical program, including those in the “bottom $600” group you’re seeking to serve can be provided by current private and employer plans, with some adjustments to allow considerably more design flexibility. The cost of those plans will be a lot lower because they’re not assuming the biggest risks.
In California about a decade and a half ago, we actually got a bill in the hopper for a program of this type. The Democrats, at the same time, proposed “single payer” again. When the hearings came, they got a full day extravaganza, we got 15 minutes. Single Payer passed, but got vetoed, and we saw a proposal that would have provided real financial protection to California’s working class replaced by Obamacare, a program to seize the wealth from California’s working class and hand it over to Obama’s non-productive constituency.
There’s some interesting studies that appear to show that “preventive care” on bulk actually has a negative impact on health outcomes.
Interesting. As an amateur statistician with an interest in sciences I’d like to see those studies. It could be that people seeking “preventive care” already have an underlying condition or suspicion of one, thus the outcomes are worse. But I’d be just speculating.
In theory, preventive care if properly followed up and treated should result in better outcomes. The theory being you catch diseases early enough to treat. It’s anecdotal, but the missus had a routine exam and they saw something odd so followed it up with more rigorous tests. What they saw turned out to be nothing - but the follow up uncovered something quite serious in a totally different location - but very early. Spared us all a lot of heartache. So we consider ourselves lucky to be so unlucky.
But as everything, garbage in garbage out. These studies could have any number of built in biases. And I mean bias in the statistical and scientific sense not as a judgement of any kind. There are many kinds of biases that can be built into any study especially post hoc studies.
Yeah, could be a cohort that’s biased by its nature, there’s also conditions like prostate cancer where the net impact of unnecessary treatment as a result of the inability to determine what needs to be treated exceeds the benefit of discovery during routine checkups. You get into the issue of what’s the greatest benefit to the public as a whole versus what a given individual might want. So discovery of the impact as a whole may not provide a publicly accepted policy prescription. Look into PSA testing disussions.
It’s been some time back since I saw that outcome study, but similar studies usually assume that in the cases where there’s no routine preventive checks, conditions ARE treated when they become symptomatic.
Here’s an article on improper use of preventive services. https://www.acpm.org/page/pschoosingwisely
Excellent points.
It's the difference between toxic socialist incentives and clean cut healthy capitalism's incentives.. If enough Americans are hunting for ways to spend their $600 wisely ( and yes, this will be mostly young people because those of us with group policies using this for copays will not change incentives as much) - the young will change the nature of medical care in the United States.
Really - incentives ARE that powerful.
Also WE as a party have to offer something to offset the pie in the sky crap democrats are putting out... Why does that matter? Because if we don't we'll be stuck with a democrat running socialized medicine... kind of like a bad VA system... long waits, surlily doctors, patients treated like charity wards etc. Piggyback on the step Walmart has made - it's a winner.
I had all my teeth crowned, capped, veneered, two or three implants... oral surgery... $32K. Insurance chipped in $4500. We paid the rest. = high end dentistry. Cost as much as a car. Man, results are great. No more pain! But considered cosmetic. Oh I see, to eat without intense pain = cosmetic. High end = price.
Try $32K for my whole mouth. That’s brutal.
Try $32K. My mouth $$$$$
$32K???
Did you get veneers on every tooth?
That’s a LOT of $$$$.
Idiocracy. Love that movie.
Just saw your explanation post.
Extensive!!
Had you put off dental work for a while?
Glad you are feeling better, now.
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