It is astounding to me how locked down certain medical tests are.
Like, if I want an EKG, why can't I just walk in to a place and get it done at a reasonable price? And without a doctor's approval?
And I pay for insurance. But I just want to be able to monitor my vitals myself, whenever I feel like it.
It seems like it would drive higher utilization of equipment and lower prices if these types of diagnostic tests were readily available at a place like a CVS or a Walmart.
I would gladly even pay $50 per month for unlimited access to a place to just come in, get my blood sugar, kidney function, heart function, liver function, etc. tested once per month!
As important as health is, and as much as Americans spend on it, it is shocking to me how gated everything is.
It hurts my health and my pocketbook simultaneously!
I've always wondered why a company like Walmart doesn't just provide $20 EKGs, and $25 tooth cleanings.
Like, why is so easy to get a hamburger at any time of day, but like pulling teeth to just run somewhere and get a quick, inexpensive EKG to make sure everything is ok with your heart..?
What am I missing? Are there legitimate safety reasons these mundane diagnostics are so locked down?
Or are these services available and I just don't know about it?
Again, I pay for health insurance, but I still feel like if I want a quick EKG, it will take me 3 weeks to see a doctor, and by then I might be dead. I don't want to see a doctor, I just want an EKG done for my own peace of mind.
But health Care is not my area of expertise. So perhaps there are very legitimate reasons these diagnostics and labs are so difficult to self-request at reasonable prices.
Medical tests can also be counter productive. Hear me out. There's studies that regularly show the optimal age for i.e breast cancer screening. Screening too early can cause an increase in misdiagnosis I believe. There are other such cases for not just cancer screenings - I know not exactly what you're talking about. EEG and blood test make sense. But for more advanced tests, you could be right in saying "there are legitimate safety reasons" - maybe not so much from the test itself but from the impact of a false positive.
> I would gladly even pay $50 per month for unlimited access to a place to just come in, get my blood sugar, kidney function, heart function, liver function, etc. tested once per month!
(I agree with the other commenters that frequent asymptomatic blood testing is unlikely to help, even more so when done alone - not because of false positives, just because CBC results vary a lot for no detectable reason/problem)
It's a massive waste of money and resources to get an EKG without a clinical presentation. It's a massive resources to get a CBC and CMP without some positive predictive value. Why don't we throw every test at you? Because there's a significant chance you will be a false positive/negative. This is dangerous to look at this way.
Because it fell off everybody's radar, I assume CVS MinuteClinic hasn't been as revolutionary as originally hoped. OTOH, if Walmart is joining the fray then either the retail clinic market has been steadily growing in general, or Walmart thinks they can do something different.
This argument is comparable to thinking that a painting is only worth the materials it’s made out of, and everything else is worthless. A doctor and their staff have trained for decades in order to handle your health, why in the world do you think you can do it after some googling?
Compare it to your own job - if I had the same tools as you, could I walk in and do the same job you do?
> Like, if I want an EKG, why can't I just walk in to a place and get it done at a reasonable price? And without a doctor's approval?
You're also paying for interpretation of your EKG at the same time. There are plenty of places happy to sell you home BP/HR/EKG monitoring kits, but you have to remember that you are paying for a doctor's time and clinical expertise when getting them in a hospital. It's not like a single EKG will tell you all that much about your heart anyway.
> As important as health is, and as much as Americans spend on it, it is shocking to me how gated everything is.
Agreed I had this issue as an uninsured university student with an Xray, and as one covered by my employer's insurance with an MRI.
In both cases I was stone walled to just get either, in the former I had to go to a clinic see an MD, come back get a physical and then get a referral for imaging off-site. And in the latter, I had to see 3 specialists, get a physical, have several weeks of Physical therapy and Xray imaging before the Insurance would cover it.
> Again, I pay for health insurance, but I still feel like if I want a quick EKG, it will take me 3 weeks to see a doctor, and by then I might be dead.
It was so exhausting just trying to make all the appointments and follow ups with a full work schedule that I haven't been able to get that MRI after all. I just assumed the worst and started to take matters into my own hands and started to do my PT exercises into my daily gym routine and will monitor the results myself.
> What am I missing? Are there legitimate safety reasons these mundane diagnostics are so locked down?
Its a protected Industry, the very supply of MDs is drastically capped in this country, its a controlled cartel.
Because they are too incompetent to be trusted to handle anything more complicated than shoes and canned food. As a former employee I could tell you stories.
> I would gladly even pay $50 per month for unlimited access to a place to just come in, get my blood sugar, kidney function, heart function, liver function, etc. tested once per month!
I've noticed my gym offers somewhat regular screening days which offer some (or all?) of that stuff, but it still costs extra. Reasonable (~$30?) but it would probably be something used more regularly if it was just part of the membership, and considered a normal thing. I don't even think they offer it monthly - I think it's quarterly.
> and as much as Americans spend on it, it is shocking to me how gated everything is.
It didn’t always use to be this way. Then people started getting poisoned, sick and dying.
It’s not like the FDA existed when they ratified the constitution.
The opium epidemic proves the system is flawed and broken, it does not however prove that just throwing everything away will make things better.
>Are there legitimate safety reasons these mundane diagnostics are so locked down?
Healthcare is not my area of expertise either, but my understanding is that the short answer to your question is yes.
For a longer introduction to the issues surrounding letting anyone get whatever diagnostics they want to pay for, this Medlife Crisis video that came out today seems appropriate:
https://youtu.be/yNzQ_sLGIuA
There's a bunch of underinsured (or outright not insured) folk in the very locations where Walmart is opening these, so it has the potential to kill a couple of different birds with one stone. From a public benefits side, it gives a path of medical care for those that otherwise wouldn't have it (beyond say, an emergency room visit). It also lower prices by competing against insurance bloat.
In doing so, Walmart (may) be able to create a sustainable business by tapping a market (folk that aren't currently going for medical coverage anyway) that would otherwise be untapped.
This could also control costs if government managed systems (Medicare, Medicaid) partner with Walmart to provide payment. Easier to negotiate with Walmart as a single entity versus a network of vision and dental providers across the nation.
Hm. Wife had eye check at big box store. The guy said "Oh, you have Macular Degeneration. Nothing to do about it sorry. Just go home and go blind".
She came home in tears of course. So I said "Go to a reputable ophthalmologist and get a real opinion". So she did.
Of course nothing is wrong with her eyes (despite the power-of-suggestion effects she experienced, but miraculously cleared up once she got a reliable exam). The Dr did say "I can see how they made the mistake; you have some small adhesions to your retina, but they'll clear up by themselves"
So no, I'm not going to a big box store to get my medical care. Never mind the price. I'll get a professional, or go without. Can't be worse than our experience at the discount-home-goods place.
Your experience (or rather, your wife's experience) seems to be about the difference between seeing an optometrist and an ophthalmologist.
I don't know if the optometrist she saw was unusually incompetent or if any optometrist would have done the same, but in any case, everyone she dealt with was a "professional" (even if, maybe, different professions. These big box retailers are not - and can not - hire people without qualifications to provide these services.
I think you may be drawing an unsound conclusion here.
For what it's worth...those eye glasses places are run by optometrists (usually) and not an ophthalmologist. An ophthalmologist has more medical training.
They are all independent of the store and just pay rent. But they are all professionals...
Edit: Also if you have a real medical issue w/ your eye, definitely see an ophthalmologist. Optometrists are for glasses and minor eye issues...they aren't going to be doing surgery on you.
When you get your eyes checked for glasses you go to an optometrist. Doesn't matter if it's big box store or a local guy--they have the same credentials.
An ophthalmologist is an MD who specializes in eyes, and that's who you want to go to when you have a more serious problem. 2 completely different things, and not really anything to do with where the optometrist was located.
My wife and I both often have trouble hearing, especially in noisy environments. My hearing level is those environments is much worse than anyone else around. At a bar, I effectively can't understand what anyone is saying unless they're shouting right next to me. With no noise, I have amazing hearing.
I went to Costco with my Wife and we both got our ears checked because they offered free hearing checks. Both of us were told we hear amazing, and were subjected to jokes about our marriage.
We concluded that their only goal was to sell hearing products, and if they couldn't fix the problem, they didn't diagnose it.
I suspect your wife's experience at the "big box store" was the same: Not anything they could fix, so they just sent her away.
I'm just waiting for these massive corporations to get into the automation of Pharmacy work. I know a number of highly paid (110k+) pharmacists who largely:
A) count pills
B) put pills into orders
C) do retail
D) answer questions/customer service
Meanwhile, the industry is being flooded with new graduates from dozens of schools...If this isn't a case for automation of A-C, I don't know what IS a case for automation in healthcare.
You've got it backwards. Pharmacists are hired because it's legally required. They're there to catch the dosage mistakes, look out for potential interactions, and to answer questions about medication and the proper usage. You cannot legally distribute prescription medication without a pharmacist physically present.
CVS and Walgreens would love to get rid of the pharmacists -- they hate that each store needs a couple $110k/year pharmacists just to handle the legal requirements and to be on-site for the few cases where something needs extra attention. That's why they put them to work doing the manual retail side of it to get the most for their dollar.
I saw this (or one like this) in action in China at a hospital. There were 15+ windows to line up for the pharmacy and each one had a lot of 10+ people. I was in shock because in the US even 2 people in like would take forever.
The procedure is, you scan your ID at a machine attached to a pillar. The screen tells you which line to line up in. When you get to the front of the line you hand your card to the nurse the medicine comes down a chute.
The line moved fast. I received my medicine in a matter of minutes. Also I paid for the medicine w/ the doctor that prescribed it - so none of this BS about "oh your insurance doesn't cover this, you haven't met your copay" talk that half the pharmacists seems to spend their time with. The doctor told me what to do with it and fielded any questions.
That's one thing I've wondered about as well. Most of what pharmacists do can be automated and should be automated. That doesn't mean pharmacists should be without work. Their expertise should be applied elsewhere. What's the point of getting so much education to simply count pills?
Better yet, why can't your doctor just send the request to a pharmacist facility and have them fill the order and deliver it to your home? Why does he hand you a piece of paper that you have to bring to a pharmacist? When you give blood, you don't take the vials/tubes to the testing facility. The doctor's office sends it where it needs to go.
Most of A, B, and C are done by techs. Pharmacists are there to manage the techs. But predominantly they are there to be prevent or be held liable for mistakes and loses/thefts of very high value inventory.
The automation of pharmacy needs to happen in two areas:
1. Count pills and package them.
2. Drug interaction detection.
1 can be automated. In fact the warehouse style pharmacy can do all that. The doctors (or you) send the prescription to the pharmacy warehouse. They ship the medicine to you.
2 can also be automated. Drug interaction are sets of rules and the detection can very well be done with machines.
This is great. Walmart has a reputation to protect so at the very least I can trust what they say.
I've had a hard time getting a dentist I can trust. The business reminds me of car mechanics that are always looking to sell you additional services. And as a layperson, it's hard to know when you are being sold services you don't need. They love people with insurance since they can get them to buy without much pushing.
Given the quality I've seen in American megastores (I've seen bicycles seem really dangerous to ride -- is there no institution that regulates vehicles?), my knee-jerk reaction is that this is a terrible idea.
At the same time, I'm all for accessible and good healthcare, so let's see how this plays out.
Even if it's middle of the road service performed by inexperienced people starting out their careers and looked down on by professionals with more experience (i.e. basically how Walmart tire center is viewed in the automotive world) it still provides an alternative keeping the prices of higher class options in check.
If I can walk in without an appointment, see a doctor after a reasonable wait, and then get a prescription for antibiotics that can be filled on the spot, then I’m 100% on board with this.
This is hilarious. I'm no universal healthcare idealist, but there is something to be said about health services having the wrong incentives in doing it for-profit. What incentives do for-profit pharmaceuticals have to keep people healthy? Potentially none. What incentives do they have to keep people sick? Probably billions of dollars if not more.
The problem is you can't risk your health. When buying a product you can risk a "clever" company that sells you a subpar product, but you can't really risk a "clever" pharmaceutical that sells you a subpar medicine or service.
I have been thinking for years that the only economic entity that might be able to take this on is Wallmart.
I believed that if there was a single thing Barack Obama could do, it would have been to convince Wallmart to heavily invest in healthcare, the point of building clinics.
Walmart is quite a different beast than other companies. Walmart, by strategy, does not compete on margin, they compete on volume. Since high margins are a problem for volume, they actively try to suck out margins in a product all along the value chain.
Walmart pushes suppliers to improve their own cost metrics and has enough power to do it. They basically use their leverage to force down prices, knowing they'll make it up in the long run on volume.
This is a very, very different approach to business than basically anywhere else, and possibly has ever existed and it's one of the few magic things that makes Walmart what it is.
The 'literati' classes love to hate on Walmart, but consider how powerful this machine is: it basically sucks profits and inefficiency out of the value chain like a vacuum, handing over the surpluses to consumers. They basically enable 100 million Americans to live at a standard of living not otherwise possible.
Health Care is the most bloated sector in the entire world, and there's so much juicy fat to be cut, if there's any operational entity has the scale, operational ability, customer reach, efficiency to pull this off it's walmart.
I hope they expand into basic medicine, family medicine, all of the basic kind of testing, and insurance.
I can't say I'm otherwise a huge fan of Walmart, but if they end up raping and pillaging healthcare in the US, they could literally be creating the biggest benefit capitalism ever provided for Americans.
I'm a huge, huge fan of this. I haven't stepped into a Walmart in years, but I'm thinking I need my teeth cleaned ...
I'm a graduate student in a small city. I would gladly use this dental cleaning service. I haven't been to the dentist in like 2 years because I really can't afford it. I actually get my prescriptions via Walmart already without insurance because it cheaper than using the insurance given to the grad students.
I heard a podcast on this recently where they cynically concluded that Walmart is doing this primarily to have more control over the healthcare costs of its employees. Will a Walmart doctor recommend AN expensive MRI for a Walmart employee if his boss doesn't like that?
Walmart using their market power in one industry to charge below market rates in another, driving out competition. This is going to destroy health care options in areas that are already under served.
[+] [-] ijidak|6 years ago|reply
It is astounding to me how locked down certain medical tests are.
Like, if I want an EKG, why can't I just walk in to a place and get it done at a reasonable price? And without a doctor's approval?
And I pay for insurance. But I just want to be able to monitor my vitals myself, whenever I feel like it.
It seems like it would drive higher utilization of equipment and lower prices if these types of diagnostic tests were readily available at a place like a CVS or a Walmart.
I would gladly even pay $50 per month for unlimited access to a place to just come in, get my blood sugar, kidney function, heart function, liver function, etc. tested once per month!
As important as health is, and as much as Americans spend on it, it is shocking to me how gated everything is.
It hurts my health and my pocketbook simultaneously!
I've always wondered why a company like Walmart doesn't just provide $20 EKGs, and $25 tooth cleanings.
Like, why is so easy to get a hamburger at any time of day, but like pulling teeth to just run somewhere and get a quick, inexpensive EKG to make sure everything is ok with your heart..?
What am I missing? Are there legitimate safety reasons these mundane diagnostics are so locked down?
Or are these services available and I just don't know about it?
Again, I pay for health insurance, but I still feel like if I want a quick EKG, it will take me 3 weeks to see a doctor, and by then I might be dead. I don't want to see a doctor, I just want an EKG done for my own peace of mind.
But health Care is not my area of expertise. So perhaps there are very legitimate reasons these diagnostics and labs are so difficult to self-request at reasonable prices.
[+] [-] yellow_lead|6 years ago|reply
[+] [-] troydavis|6 years ago|reply
Walk-in labs like AnyLabTestNow and Quest will gladly do a CBC as often as you want: https://www.anylabtestnow.com/tests/complete-blood-count/ , https://questdirect.questdiagnostics.com/products/complete-b...
Other tests: https://www.anylabtestnow.com/test-finder/
(I agree with the other commenters that frequent asymptomatic blood testing is unlikely to help, even more so when done alone - not because of false positives, just because CBC results vary a lot for no detectable reason/problem)
[+] [-] Medicalidiot|6 years ago|reply
[+] [-] wahern|6 years ago|reply
Because it fell off everybody's radar, I assume CVS MinuteClinic hasn't been as revolutionary as originally hoped. OTOH, if Walmart is joining the fray then either the retail clinic market has been steadily growing in general, or Walmart thinks they can do something different.
[+] [-] soared|6 years ago|reply
Compare it to your own job - if I had the same tools as you, could I walk in and do the same job you do?
[+] [-] quantumwoke|6 years ago|reply
You're also paying for interpretation of your EKG at the same time. There are plenty of places happy to sell you home BP/HR/EKG monitoring kits, but you have to remember that you are paying for a doctor's time and clinical expertise when getting them in a hospital. It's not like a single EKG will tell you all that much about your heart anyway.
[+] [-] dickeytk|6 years ago|reply
But I agree with your overall point regardless
[+] [-] Melting_Harps|6 years ago|reply
Agreed I had this issue as an uninsured university student with an Xray, and as one covered by my employer's insurance with an MRI.
In both cases I was stone walled to just get either, in the former I had to go to a clinic see an MD, come back get a physical and then get a referral for imaging off-site. And in the latter, I had to see 3 specialists, get a physical, have several weeks of Physical therapy and Xray imaging before the Insurance would cover it.
> Again, I pay for health insurance, but I still feel like if I want a quick EKG, it will take me 3 weeks to see a doctor, and by then I might be dead.
It was so exhausting just trying to make all the appointments and follow ups with a full work schedule that I haven't been able to get that MRI after all. I just assumed the worst and started to take matters into my own hands and started to do my PT exercises into my daily gym routine and will monitor the results myself.
> What am I missing? Are there legitimate safety reasons these mundane diagnostics are so locked down?
Its a protected Industry, the very supply of MDs is drastically capped in this country, its a controlled cartel.
[+] [-] michaelmrose|6 years ago|reply
[+] [-] lowercased|6 years ago|reply
I've noticed my gym offers somewhat regular screening days which offer some (or all?) of that stuff, but it still costs extra. Reasonable (~$30?) but it would probably be something used more regularly if it was just part of the membership, and considered a normal thing. I don't even think they offer it monthly - I think it's quarterly.
[+] [-] killjoywashere|6 years ago|reply
[+] [-] catblast|6 years ago|reply
It didn’t always use to be this way. Then people started getting poisoned, sick and dying. It’s not like the FDA existed when they ratified the constitution. The opium epidemic proves the system is flawed and broken, it does not however prove that just throwing everything away will make things better.
[+] [-] WillDaSilva|6 years ago|reply
Healthcare is not my area of expertise either, but my understanding is that the short answer to your question is yes.
For a longer introduction to the issues surrounding letting anyone get whatever diagnostics they want to pay for, this Medlife Crisis video that came out today seems appropriate: https://youtu.be/yNzQ_sLGIuA
[+] [-] unknown|6 years ago|reply
[deleted]
[+] [-] artemisyna|6 years ago|reply
There's a bunch of underinsured (or outright not insured) folk in the very locations where Walmart is opening these, so it has the potential to kill a couple of different birds with one stone. From a public benefits side, it gives a path of medical care for those that otherwise wouldn't have it (beyond say, an emergency room visit). It also lower prices by competing against insurance bloat.
In doing so, Walmart (may) be able to create a sustainable business by tapping a market (folk that aren't currently going for medical coverage anyway) that would otherwise be untapped.
[+] [-] toomuchtodo|6 years ago|reply
[+] [-] JoeAltmaier|6 years ago|reply
She came home in tears of course. So I said "Go to a reputable ophthalmologist and get a real opinion". So she did.
Of course nothing is wrong with her eyes (despite the power-of-suggestion effects she experienced, but miraculously cleared up once she got a reliable exam). The Dr did say "I can see how they made the mistake; you have some small adhesions to your retina, but they'll clear up by themselves"
So no, I'm not going to a big box store to get my medical care. Never mind the price. I'll get a professional, or go without. Can't be worse than our experience at the discount-home-goods place.
[+] [-] Lazare|6 years ago|reply
Your experience (or rather, your wife's experience) seems to be about the difference between seeing an optometrist and an ophthalmologist.
I don't know if the optometrist she saw was unusually incompetent or if any optometrist would have done the same, but in any case, everyone she dealt with was a "professional" (even if, maybe, different professions. These big box retailers are not - and can not - hire people without qualifications to provide these services.
I think you may be drawing an unsound conclusion here.
[+] [-] fma|6 years ago|reply
They are all independent of the store and just pay rent. But they are all professionals...
Edit: Also if you have a real medical issue w/ your eye, definitely see an ophthalmologist. Optometrists are for glasses and minor eye issues...they aren't going to be doing surgery on you.
[+] [-] learc83|6 years ago|reply
An ophthalmologist is an MD who specializes in eyes, and that's who you want to go to when you have a more serious problem. 2 completely different things, and not really anything to do with where the optometrist was located.
[+] [-] pkaye|6 years ago|reply
[+] [-] unknown|6 years ago|reply
[deleted]
[+] [-] wccrawford|6 years ago|reply
I went to Costco with my Wife and we both got our ears checked because they offered free hearing checks. Both of us were told we hear amazing, and were subjected to jokes about our marriage.
We concluded that their only goal was to sell hearing products, and if they couldn't fix the problem, they didn't diagnose it.
I suspect your wife's experience at the "big box store" was the same: Not anything they could fix, so they just sent her away.
[+] [-] jsjddbbwj|6 years ago|reply
[+] [-] unknown|6 years ago|reply
[deleted]
[+] [-] WhompingWindows|6 years ago|reply
A) count pills
B) put pills into orders
C) do retail
D) answer questions/customer service
Meanwhile, the industry is being flooded with new graduates from dozens of schools...If this isn't a case for automation of A-C, I don't know what IS a case for automation in healthcare.
[+] [-] ng12|6 years ago|reply
CVS and Walgreens would love to get rid of the pharmacists -- they hate that each store needs a couple $110k/year pharmacists just to handle the legal requirements and to be on-site for the few cases where something needs extra attention. That's why they put them to work doing the manual retail side of it to get the most for their dollar.
[+] [-] fma|6 years ago|reply
I saw this (or one like this) in action in China at a hospital. There were 15+ windows to line up for the pharmacy and each one had a lot of 10+ people. I was in shock because in the US even 2 people in like would take forever.
The procedure is, you scan your ID at a machine attached to a pillar. The screen tells you which line to line up in. When you get to the front of the line you hand your card to the nurse the medicine comes down a chute.
The line moved fast. I received my medicine in a matter of minutes. Also I paid for the medicine w/ the doctor that prescribed it - so none of this BS about "oh your insurance doesn't cover this, you haven't met your copay" talk that half the pharmacists seems to spend their time with. The doctor told me what to do with it and fielded any questions.
[+] [-] refurb|6 years ago|reply
It used to be a ticket to an upper middle class life. Pharmacies were desperate to hire and starting wages were well above $100,000.
Then pharmacies schools popped up. Lots of them. Wages are dropping and not everyone who graduates gets a residency or a job.
It’s been fascinating to watch because I considered pharmacy school a long time ago.
Glad I never did it.
[+] [-] zachwood|6 years ago|reply
[+] [-] dntbnmpls|6 years ago|reply
Better yet, why can't your doctor just send the request to a pharmacist facility and have them fill the order and deliver it to your home? Why does he hand you a piece of paper that you have to bring to a pharmacist? When you give blood, you don't take the vials/tubes to the testing facility. The doctor's office sends it where it needs to go.
[+] [-] learc83|6 years ago|reply
[+] [-] ww520|6 years ago|reply
1. Count pills and package them. 2. Drug interaction detection.
1 can be automated. In fact the warehouse style pharmacy can do all that. The doctors (or you) send the prescription to the pharmacy warehouse. They ship the medicine to you.
2 can also be automated. Drug interaction are sets of rules and the detection can very well be done with machines.
[+] [-] WheelsAtLarge|6 years ago|reply
I've had a hard time getting a dentist I can trust. The business reminds me of car mechanics that are always looking to sell you additional services. And as a layperson, it's hard to know when you are being sold services you don't need. They love people with insurance since they can get them to buy without much pushing.
[+] [-] rustybolt|6 years ago|reply
At the same time, I'm all for accessible and good healthcare, so let's see how this plays out.
[+] [-] ColanR|6 years ago|reply
[+] [-] dsfyu404ed|6 years ago|reply
[+] [-] koolba|6 years ago|reply
[+] [-] proc0|6 years ago|reply
The problem is you can't risk your health. When buying a product you can risk a "clever" company that sells you a subpar product, but you can't really risk a "clever" pharmaceutical that sells you a subpar medicine or service.
[+] [-] jariel|6 years ago|reply
I believed that if there was a single thing Barack Obama could do, it would have been to convince Wallmart to heavily invest in healthcare, the point of building clinics.
Walmart is quite a different beast than other companies. Walmart, by strategy, does not compete on margin, they compete on volume. Since high margins are a problem for volume, they actively try to suck out margins in a product all along the value chain.
Walmart pushes suppliers to improve their own cost metrics and has enough power to do it. They basically use their leverage to force down prices, knowing they'll make it up in the long run on volume.
This is a very, very different approach to business than basically anywhere else, and possibly has ever existed and it's one of the few magic things that makes Walmart what it is.
The 'literati' classes love to hate on Walmart, but consider how powerful this machine is: it basically sucks profits and inefficiency out of the value chain like a vacuum, handing over the surpluses to consumers. They basically enable 100 million Americans to live at a standard of living not otherwise possible.
Health Care is the most bloated sector in the entire world, and there's so much juicy fat to be cut, if there's any operational entity has the scale, operational ability, customer reach, efficiency to pull this off it's walmart.
I hope they expand into basic medicine, family medicine, all of the basic kind of testing, and insurance.
I can't say I'm otherwise a huge fan of Walmart, but if they end up raping and pillaging healthcare in the US, they could literally be creating the biggest benefit capitalism ever provided for Americans.
I'm a huge, huge fan of this. I haven't stepped into a Walmart in years, but I'm thinking I need my teeth cleaned ...
[+] [-] Avalon42|6 years ago|reply
[+] [-] LatteLazy|6 years ago|reply
[+] [-] neonate|6 years ago|reply
[+] [-] theshadowknows|6 years ago|reply
[+] [-] usaphp|6 years ago|reply
I would get more anxiety just by looking at my watch if I am being charged per minute
[+] [-] doggydogs94|6 years ago|reply
[+] [-] briandilley|6 years ago|reply
[+] [-] zer0faith|6 years ago|reply
[+] [-] hiredman|6 years ago|reply