Wal Mart: A Iniciativa Privada na Saude

Walmart has a new take on retail clinics. These newly launched clinics will charge patients $40 for a visit—but only $4 for Walmart associates. Anybody, with or without insurance, can go into one of these clinics and be seen by a qualified health professional, without the usual paperwork. Although the mega-retailer has operated clinics in its stores for a few years now, the new ones are different in a couple of ways. First, Walmart’s previous clinics were collaborations with local hospitals, which had “mixed success.” So, it appears to have decided to go it alone. I am not surprised. Can you imagine a company like Walmart, which succeeds in an unregulated industry with ruthless price competition, trying to negotiate a deal with hospital executives? The communications challenges must be almost insurmountable—sort of a Mars and Venus situation. When hospitals acquire primary-care medical practices, they don’t end up reducing costs and increasing transparency. On the contrary, they use the acquisition to charge higher, hospital-sized fees to patients and insurers. That is exactly the opposite of what Walmart is trying to achieve. Second, Walmart looks to be rolling out these clinics in states that have not expanded the number of residents dependent on Medicaid (such as South Carolina). Obamacare itself is not responsible for the growth of these clinics. Rather, the failure of Obamacare to significantly reduce the number of long-term uninsured Americans is a cause of renewed investment in these clinics. Insurance is irrelevant to these clinics, which post and accept cash payments directly. Walmart and other businesses outside the government-medical complex increasingly understand that there are opportunities outside those bureaucracies, and healthcare enterprises that operate free of the dead hand of Obamacare can take care of their customers without getting bogged down in the old system.