Wal-Mart (NYSE:WMT) Medicine Is The Solution To The Health Care Crisis

Americans have known that we have had a health care crisis since our country was created.  We have chosen to depend on doctors and nurses and hospitals to provide care in times of illness and injury and epidemics.  At some point we developed health insurance to provide some financial coverage so that people would not have to pay for the entire cost of their medical care.  This was the time that health care inequality became more commonplace.  Before health insurance existed, the very rich had the best care that money could offer and the rest depended on whatever urban and rural health care systems could provide.

The government entered health care with the creations of the Public Health System and its national system of Departments of Health, The National Institutes of Health, The FDA, The National Cancer Institute, The Centers for Disease Control along with Medicare and then Medicaid.  The crisis continued because there were always too many people who could not afford health care or insurance. 

At the start of the Clinton administration a comprehensive health care proposal failed to pass.  Big Business was watching however and saw this as a way to create “managed care systems” to take advantage of the perception that patients and their doctors were wasting money making decisions based on the personal care relationship model.  Big Business knew that any money they could take out of the system would be a windfall for their management team and very soon their public stockholders.  Soon doctors were signing with these HMO organizations because they were afraid that they would have no patients otherwise. 

Time passed.  The savings promised by big insurance companies went into the coffers of businessses and not those trained in healing the sick or preventing illness.  The HMO model morphed into dozens of acronyms that allowed the patient to have less choice or spend more money. The percentage of our GDP spent on healthcare continued to increase in spite of the promise of the Holy Grail of managed care.  Big business in the health insurance sector has thrived. CEOs of major health insurance companies have become millionaires many times over. Fewer people could afford insurance and others were uninsurable because of pre-existing conditions and the crisis continued.

The versions of the Health Care Reform Bill that are now under consideration are focused most on the 43 million  uinsured Americans.  The plans proposed would insure this group of people and allow people who are currently insured to keep their insurance . Big insurance companies will no longer be allowed to deny coverage to anyone based on pre-existing conditions.  Anyone in America can have insurance if one of these bills is passed.  And, it is possible that everyone will be required to have insurance.

 There is no tort reform proposal. The tort system has continued to enrich the trial lawyers, many of whom are in state and national positions of political prominence.  The lobbyists hired by the Trial Lawyers Association who wine and dine and give to the campaigns of the rest of the members of Congress who represent our citizens is highly effective and incredibly well funded. At this time the current Administration has indicated that malpractice reform is of no interest. If the Administration is truly focused on reigning in the costs of health care, let the government take on the responsibility of malpractice coverage and evaluation of bad medical outcomes. The reduced cost of medical care will add to the goal of shrinking the percentage of health care’s percentage of the GDP. If the President and this Congress were to take such an extraordinary step, it would allow all doctors to provide some free and reduced fee care, encourage young doctors and doctors who have been forced to retire because of the malpractice costs but love the work they were called to do, to work in areas of great need where the chance of malpractice actions are often highest.  This Administration could be known  as the one that not only provided insurance coverage to all Americans but restored the joy of  healing to the doctor-patient relationship. 

Americans know that any government bureaucracy exists to provide civil service jobs for life.  It takes more people and more time to get anything done when the government is involved.  Medicare and Medicaid are entrenched.  But, we don’t have to depend on the government’s performance for the proposed new level of insurance for those without coverage.

Let Wal-Mart take over the creation of an insurance program for those who are currently not insured instead of waiting for a government program.  Wal-Mart knows how to be efficient and its customers are loyal and trust the brand.

 Wal-Mart is already in the business of providing pharmacies, health care screening and emergency care on a limited basis, along with screening for diabetes, heart disease, back to school physicals for children and immunizations to people of all ages.  Let Wal-Mart offer the basic care that could become the example for preventive medicine that is so badly needed in this country.

Wal-Mart stores are within driving distance of the great majority of the population.  Wal-Mart can give insurance discounts in a community setting by offering incentives to those who choose to decrease risk taking behavior in exchange for lower premiums.  The health care providers who would work for Wal-Mart would know the behavior of the patients that they were caring for well enough so that compliance for reduction in cost of insurance could be much more assured.

Wal-Mart has had a bad reputation because it has a history of employing low cost labor and has been rightly accused of  unfair competition with local businesses, many of whom could not afford to buy goods as inexpensively as Wal-Mart.  But, many of those opposed to Wal-Mart don’t live on incomes or in places where money for basics was always tight. And the current jobless market makes Wall-Mart an attractive employer in these times.

Our Administration has enough to do with wars in Iraq and Afghanistan, the support of an economy that is frail and in and out of the ICU, the search for ways to end each month’s rise in unemployment and the disaster of foreclosures and increasing poverty and homelessness.  Funding the insurance program for the increasing number of uninsured who are now jobless is an urgent matter for the government.  We can’t wait for, nor do we need to wait for, the creation of a government insurance bureaucracy that will provide the insurance for the 43 million and increasing uninsured. The government needs to use the taxpayers’ money to find the least expensive and most efficient way to insure those who are uninsured who can then acquire  basic health care.

Americans need to become responsible for choices that affect their health. The creation of an outreach program managed by citizens with Wal-Mart (NYSE:WMT) is a great way to begin.  Wal-Mart screening and disease prevention with standard health care delivery provided by insurance from Wal-Mart is a sensible alternative to another government agency. 

 Wal-Mart “Make Americans Healthier” wellness programs could offer community forums for health education and provide local opportunities for change and hope. Social isolation increases with job loss and shame. Community support can prevent this unrecognized cause of  depression and emotional paralysis that increases stress and decreases the will to find another way to find work. Wal-Mart could set up community exercise, weight loss and nutrition programs.  It could create support groups for smoking cessation, depression, alcohol and drug abuse, along with a plan for intervention and referrals to specialists. Each community under the umbrella of Wal-Mart Insurance and Care could create jobs using Federal stimulus money to train the unemployed to become community health care workers who could care for the ever increasing geriatric population , provide transportation for those who are home bound and visit the sick at home. These programs could be created in concert with national goals for control of obesity, prevention of diabetes, heart disease, mental illness and the health consequences of bad life choices that cost all other citizens money. 

Health care costs are high, in part, because people choose to overeat,  be sedentary,  ignore the recommendations of the National Institutes of Health and The Centers for Disease Control and Prevention  for basic public health issues such as universal influenza vaccinations, condom and contraceptive use and smoking cessation.   The federal government’s new insurance program could be implemented in a local and controlled way in a community-based Wal-Mart Insurance and Care Program. The Wal-Mart Insurance program could provide coverage at reduced cost for those who take part in the “Make Americans Healthier” program.

The health care crisis is now mired in political infighting.  Choices are being made at the federal level that all Americans will pay for and live with for decades.  We must be involved in this conversation and use our voices to communicate with our representatives and our government. 

Wal-Mart could become the most respected company in America by extending its commitment to those who have less and by providing the model for basic 21st century health insurance and care to those  who have none. The federal government can then focus on the business of taking care of those things that its citizens cannot do for themselves. Sam Walton would be proud.

Patricia Yarberry Allen, MD