Wal-mart

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Hot off the press:

Walmart announced it would stop offering health insurance benefits to new part-time employees, the retailer sent out a request for information seeking partners to help it “dramatically … lower the cost of healthcare … by becoming the largest provider of primary healthcare services in the nation.”

Why would Wal-mart want to provide health care services?  Here are some reasons:

  • Many health care services are high margin.
  • With some exceptions (e.g., Kaiser), most current health care service providers do not take advantage of economies of scale, particularly with respect to information technology (IT) services.
  • Wal-mart could take advantage of their current IT infrastructure to readily create EHR.  In fact, Walmart has offered commercial EHR software & services to healthcare providers since 2009.
  • This effort builds on the success of walk-in clinics at stores like CVS (MinuteClinic).  These efforts increase brand loyalty (people usually have a good opinion of the places they get health care) and increases store traffic.  Further, between 2007 and 2009 retail clinic use increased 10-fold.
  • Wal-mart recently dropped health insurance for its employees.  This could be a public relations mechanism to provide some care to these employees.
  • Wal-mart recently dropped health insurance for its employees.  These people will need low cost primary medical care since insurance won’t cover these services.
  • It could create a service provider which is national in scope an already has an existing distribution network.  Wal-mart has 3,800 stores nationwide that it can use to house these clinical services.
  • Wal-mart already delivers prescriptions drugs through its low cost generics program and Medicare Part D drug plan.

The Wall Street Journal reports that Wal-mart is actively seeking partners for its health care expansion.  I would assume that Wal-mart with staff the clinics with low-cost nurse practitioners (NPs) and physician assistants (PAs).

Although some health reformers have aimed to bolster the role of primary care providers, Wal-mart’s actions may help NPs and PAs who provide primary care while putting competitive pressures on MDs who provide primary care.

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Some people believe Wal-mart supports universal healthcare because:

  1. Wal-Mart wants to change its image
  2. Wal-Mart wants to make its voice heard in the process, or 
  3. Wal-Mart is flummoxed by unpredictable health care costs.

Megan McArdle believes that there is only one reason Wal-mart wants universal health care: profits.  If all employers are mandated to provide health insurance, Walmart will have a significant health insurance economies of scale compared to its smaller rivals.

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Wal-Mart increases real incomes by lowering prices.  The purchasing power increase makes buying fresh fruit and vegetables more affordable for the average consumer.  At least this is what Charles Courtemanche and Art Carden found.

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Is the free market working?  Looks like.  Wal-mart just dropped its prices on pharmaceuticals.  According to a Marketwatch article (“Wal-mart…“) :

  • Wal-mart will fill prescriptions for as many as 350 generic drugs costing $10 for a 90-day supply
  • Over 1000 over-the-counter drugs are priced at $4 or less.  Many of these include Wal-mart own private label Equate brand.

Wal-mart must compete with some supermarket chains that are offering free generic drugs to draw consumers into the store.

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