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Tuesday Talk: Can health care reform happen?

November 15, 2011 By Joe Sheeran, Communications Director

Whether you like Walmart or not, its proposed move into health services could have a major affect on primary care delivery in many communities. While the idea isn’t new—Walgreens, CVS and other pharmacies have been providing some basic level of primary care—Walmart's purchasing power will impact health care pricing.

Is this a step in the right direction? How could the federal government use its purchasing power to strengthen the country’s primary care delivery system? 

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13 Comments:

  • Rob says:

    November 15, 2011 at 9:43 am

    Socialized medicine is the answer. The European, Japanese and Ausie models have strict governmental controls and are roughly half the per capita cost. Capitalism has limitations when industries become oligarchies. Free market capitalism is dangerous.

  • Joanne says:

    November 15, 2011 at 9:59 am

    No, no, and no! We’ve got to get out of the profit model of health care for uninvolved, 3rd party brokers like Walmart or insurance companies. Every penny that lines a gazillionaire CEO’s pocket is a penny that was denied to the care of a sick person.

  • Bernice Vetsch says:

    November 15, 2011 at 10:22 am

    I agree completely that a single-payer health care system would be THE answer to the private insurance mess we now have.  Nationally, it would save us as a country $400 billion per year (Harvard Med.School researchers) while providing care to every person.  A plan for Minnesota is now being studied to see what the savings would be for our state to enact it here. 

    Until we have a legislature that will support a governor (like Dayton) who wants single payer, physicians at community clinics charge minimal fees based on the ability to pay.  And the Minute Clinics in drug or big box stores provide inexpensive basic health care to those who can’t afford to buy insurance.

    A few years ago, their fee was about $50. This may have changed, but is still far less than a doctor’s office visit or a really expensive trip to a hospital emergency room. 

    The nurse practioners who staff these clinics are licensed to diagnose and treat the 15 most common ailments that bring adults or children to seek care. They also know when to refer a patient to an emergency room or a doctor.

  • Judy says:

    November 15, 2011 at 10:38 am

    Socialized Medicine?  Where does that take us - back to being under a King and Queen?  That is absurd!  The problem lies in many reasons.  One is the physicians are doing more costly tests so that they don’t get sued and we as consumers need to ask questions - namely why do I have to have this test?  It is not only the insurance companies that are getting fat!  We have way too many government programs - stay out of health program - PLEASE!

  • Paul says:

    November 15, 2011 at 10:57 am

    I think the Minute Clinic approach to providing basic health services is a good one.  They can handle the most common ailments and are more convenient and efficient than urgent care and especially hospital emergency rooms.  When I’ve been referred to higher levels of care, it’s always been at no cost from the lower provider level.  Some large employers even have these clinics on site.

    I agree that the profit motive should be taken out of our health care system, but it won’t happen all at once, and is more needed for payers (insurance) than providers (clinics and hospitals).

    Expanding Medicare would be a good first step in that direction.  It must not fall prey to the super committee budget axe.  Medicare for all would be ideal.  We can either attain it by first allowing everyone to purchase Medicare coverage, or by implementing something like it on a state by state basis as currently planned for Vermont and proposed for us in the MN Health Plan.  We also need to avoid procedure-based reimbursement and encourage end of life planning/counselling to reduce costs.

  • Rob says:

    November 15, 2011 at 11:10 am

    Judy wants the government to keep their hands off of her medicare. Wow. Ask Germany if they want the American corporate medicine model. We are the laughing stock of the world. Do some homework. The U.S. ranks near the bottom of almost everything. It is little wonder the country is tanking with conservatives having the right to vote.

  • KJC says:

    November 15, 2011 at 12:33 pm

      It would appear to be a matter of competitiveness and human fairness. 
      Most of our economic competitors have health care costs about half of ours.  We are the only ones with the the “employer provided” model (an artifact of using it being used as an incentive, as something not covered in the wage and price controls during WWII.  Our system “design” basis?  Not to be the best, but to Get Around a Temporary Regulation.  If we want to be globally competitive we need to get this cost off the direct backs of our businesses, and also raise taxes accordingly… it will still cost less, about half, for the whole country, if done well… and everybody will be covered, too.  Really, how do you argue against that?  We have better things to do with that $400 Billion.
      Let’s also admit this on other grounds?  The private incentive model has just failed on this one.  We’re the highest cost and also have some of the worst actual measured health outcomes in the Western World.  There is no argument about those facts, how can you defend these results?
    The answer of “why” is not complicated.  In so many areas, our ability to say “no” is reasonably effective to control costs.  The price of a dvd player or car too high?  Say “no.”  There are alternatives, you can.  You’re standing in the emergency room with a loved one, what ability do you have to say “no?”  You don’t, and you won’t.  This is one area where you can not expect “choice” to a sufficient cost containment model.  We’ve already proved that, haven’t we?
    We must continue health care reform, or possibly fail as a society. We the People.

  • Rob says:

    November 15, 2011 at 12:58 pm

    Bravo KCJ,

    Get that message to Obama.

  • Greg Kapphahn says:

    November 15, 2011 at 3:09 pm

    In the end, Walmart will likely successfully use the “free market” to accomplish what congress would never DARE attempt with government programs - a substantial reduction in the incomes of medical practitioners nationwide.

    As with all other businesses they enter, it will be Walmart’s goal to drive the local clinics out of business, while seducing the public into accepting healthcare with quality as low as the merchandise available in their stores.

    No doubt Walmart will also successfully manage to win approval to import pharmaceuticals from outside the borders of the US, thereby accomplishing price reductions that, again, congress would never dare attempt (except for the VA system, of course).

    It’s my impression that many (though certainly not all) doctors are wealthy enough to fall into the myopic “I, me, mine” perspective currently favored by the Republican Party and the Tea Party.

    With that attitude, they have cheered as Wall Street and Walmart worked diligently to offshore what used to be well-paying jobs with good benefits and, thereby, driven down both the wages of the average worker and seriously reduced the availability of jobs for average Americans, not to mention killing off a lot of local businesses that provided far higher quality goods and far better service.

    I can’t help but wonder how the AMA will feel as medical care now begins to be Walmartized and services that were once provided by actual doctors come to be provided by far less qualified people; as a lot of the traffic at their local clinics starts heading to Walmart, their jobs disappear, and they’re forced to do work that once made them prosperous at whatever wages Walmart is willing to pay.

    I suspect Walmart “Same-Day Surgery Centers” will follow in the not-too-distant future.

    Can an “Invest for your Retirement” counter prominently located in every Walmart be far behind?

    Let’s see, what was that old Niemoller piece? 

    First they came for middle class union workers,

    but I wasn’t in a union, so I did nothing…

    Something like that, anyway.

  • Rick says:

    November 16, 2011 at 3:35 pm

    Even the 2 CEO’s of BCBS admitted Universal HealthCare is coming. I’ve worked in Healthcare and studied it for a long time. To entertain a “Walmart Approach” to treating us is irresponsible and it doesn’t address the main problem which is Access, with Cost close behind. Some in other parts of the world just must shake their heads at us.  Especially Germany.

  • Dan Conner says:

    November 23, 2011 at 8:50 am

    I totally agree with KJC.  I believe single-payer health care will be coming to Minnesota.  Vermont is asking for a waiver in “Obamacare” and is looking to implement single-payer healthcare in Vermont.  I believe Minnesota will follow, if we have a legislature for amenable to actually helping people.  Our current system of healthcare is plainly not working.  It is responsible for too many unwarranted deaths.

  • Bernice Vetsch says:

    November 23, 2011 at 11:55 am

    Hi Dan:

    If you believe that health care is a human right and you’d like to work for universal health care in Minnesota, you can do so by volunteering for an organization that educates people on how it would work and how it would benefit everyone. Even though no one would be left without care, for instance, we would still save money (study in process will show how much). 

    See the web site for the Minnesota Universal Health Care Coalition (www.muhcc.org)—- name changing soon to Health Care for America - Minnesota.

  • Dan Conner says:

    November 23, 2011 at 1:29 pm

    Hi Bernice—Already working with them.