Doctor Walmart

by: Sue Prent

Tue Nov 15, 2011 at 14:22:34 PM EST

Apparently healthcare is poised to be the next industry to be "Walmartised."

We all know how Walmart has moved into offering deep discounts on a limited range of common medications.  

Some may be aware that this move, and corresponding promotions by other big box retailers, has further marginalized smaller pharmacies to the brink of extinction, as drug companies make-up their Walmart losses in pricing applied only to the little guys.  

With those dying independent pharmacies goes not only the traditional relationship of patient to trusted family pharmacist, but also some of the quality assurances that formed the basis for that trust.  

You may recall a bizarre story a couple of years ago, of a couple of undocumented drivers in southern Utah ferrying discount drugs from Walmart store to Walmart store in open packages and an unsecured vehicle.

Anyway, having gutted U.S. manufacturing in order to provide cheaper and cheaper goods to an underemployed and undercompensated America; and having strip-mined the poor both as consumers and labor, Walmart then turned its attention to gas and groceries, two of the three essential categories beyond shelter that remain when all other spending must be curtailed.  

Now Walmart is eyeing that third essential, healthcare.

Following the premature release of a 14-page request from Walmart to healthcare service and goods providers, seeking input to the planning of a major healthcare initiative, the company quickly back-pedaled:

Wal-Mart issued a statement Wednesday saying its request for partners to provide primary care services was "overwritten and incorrect." The firm is "not building a national, integrated low-cost primary health care platform," according to the statement by Dr. John Agwunobi, a senior vice president for health and wellness at the retailer.

Does Walmart not protest too full?  Could anyone now doubt where this is heading?

The release of this internal document came roughly two weeks after The New York Times reported that Wal-Mart was "substantially rolling back coverage for part-time workers and significantly raising premiums for many full-time staff." Wal-Mart informed its "associates" working less than 24 hours per week that they would no longer have health care coverage at all. Deductibles for many workers are rising steeply.

Walmart's excuse for scrooging its "associates?  Not enough profits:

Wal-Mart had operating income of $25.5 billion in fiscal year 2011. They have been telling workers for years that giving them better health care would jeopardize the growth of the company. Meanwhile, the Walton family uses its vast wealth to open up a glitzy art museum this week near Wal-Mart's headquarters. Health care? Let them eat art!

Could we be glimpsing a future in which care providers must compete to provide lower and lower cost care every year or be ejected from the rolls, a practice that already outsourced most U.S.manufacturing jobs?  

But what happens when those personal care jobs cannot be outsourced and all possible efficiencies have been achieved with a fully qualified staff?  Will quality healthcare and patient welfare be sacrificed, Walmart-stye, to the bottom line?

So, the next time you hear someone complain about the wait in a local emergency room, try imagining it run like the check-out at your nearby Walmart store.  Price-check on aisle nine!