By John Goodman
Texas Insider Report: AUSTIN Texas Under the health reform bill that was enacted last year you are soon going to be forced to buy insurance coverage for the very services Wal-Mart is giving away for free! This past weekend Wal-Mart was offering health care screenings to male customers at no charge. Sams Clubs across the country gave any customer willing to take the time the following:
- BMI Index measurements
- Blood pressure tests
- Cholesterol readings
- PSA (prostate cancer) tests and
- TSH (thyroid stimulating hormone) tests.
And thats not all. Sams Clubs have more free screenings planned for the future.
Heres the schedule:
- July: Kids Health Screenings
- August: Vision Health Screenings
- September: Diabetes Screenings
- October: Womens Health Screenings
- November: Digestive Health Screenings
Further at the store I visited there was no waiting. And if there happened to be a wait I suspect it would be handled the way Wal-Mart handles prescription drugs. In order to reduce both the time cost and the money cost of care Sams Club Pharmacy promises:
- Hundreds of generic prescriptions for just $4
- Prescriptions filled in just 20 minutes and
- Text alerts to tell you when your prescription is ready so you can shop while you wait.
Now if this doesnt knock your socks off you must be living in a cave somewhere. Certainly you havent been paying attention to health policy news.
How many times can a man turn his head
And pretend that he just doesnt see.
Under the health reform bill that was enacted last year:
- In just three years you are going to be forced to buy insurance coverage for the very services Wal-Mart is giving away for free!
- My rough guess is that you (though your premiums) and your health plan (directly) will pay $500 to $1000 for these services alone; and if you can get them with only 20 minutes of waiting at a doctors office or community health center be sure and tell the rest of us your secret.
- I would also guess that after getting your blood drawn at a conventional site you will wait at least a week before you learn the results in contrast to the almost immediate feedback at Sams.
- As for the drugs ObamaCare will probably force you to buy first-dollar coverage for a whole slew of generics and the cost will be a lot more than Sams $4 charge.
Texas Medicaid for example pays a fee of more than $7 to pharmacists just to dispense a prescription on top of the cost of the drug!
Whats happening at Sams Clubs is yet another instance of a general trend I have noticed. Almost all of the things health reformers say they want to happen are already happening outside the third-party payer system.
They are happening not because of the third-party payers but in spite of them!
Consider that:
- Concierge doctors are consulting by email and telephone keeping electronic medical records (EMRs) prescribing electronically and offering same day or next day appointments all characteristics of the Commonwealth Funds vision of ideal primary care.
- Walk-in clinics are posting (transparent) prices using evidenced-based medicine by following computerized protocols and keeping EMRs as well.
Cosmetic and Lasik surgeons routinely offer bundled" prices compete for patients based on price and quality and have lowered the real price of their services over the past decade.
- There are lots of successful examples of coordinated care integrated care managed care medical-home care and home-based care (see for example here) almost all of it developed despite third party incentives not to do so and in some cases saving third-party payers millions of dollars without a dimes worth of compensation.
- And now we have primary care without deductible or copayment!
Isnt the lesson here obvious? Theres nothing wrong with the market for health care. Its the third-party payers stupid.
Now I want you to close your eyes and try to imagine how a rational world would deal with all this information.
Here are some of my fantasies:
- Commonwealth Fund press release: Karen Davis Praises Wal-Mart; Says ObamaCare endorsement was a mistake."
- HHS press release: Secretary Cancels Millions in Pilot Project Funding: Why spend money looking for answers Wal-Mart has already found."
- Texas HHS press release: State to Contract out Medicaid Services to Wal-Mart."
- New York Times Economix blog: I was wrong" is the lead for the latest Uwe Reinhardt column.
- Incidental Economist post by Austin Frakt: On Wal-Mart show me the evidence."
