Let Wal-Mart fix US health care

Lower costs, less paperwork

Again, the strategy reflects a close study of the vulnerabilities of the existing health care industry. The clinics will be low-cost, of course, charging just $45 for a get-well visit. That price is again below the co-pay in many health care plans.

And it gets even more attractive when you remember that it comes without all the paperwork so typical of the modern co-pay, deductible, delayed-reimbursement health insurance system. No appointment necessary, so harried consumers can get a kid vaccinated while shopping. No insurance necessary either. Got cash or a credit card? You can see a doctor.

And let me tell you, anyone who thinks this isn't an attractive way to deal with a minor problem -- for customers in every demographic and with every kind of health insurance -- hasn't tried to get an appointment to see an overworked doctor to check out what might be strep throat or an ear infection. I've got good health insurance, but I've used clinics like these in stores belonging to Wal-Mart competitors for exactly that kind of problem.

Wal-Mart's clinics also promise to be a major step toward the goal of a national network of electronic health records. Wal-Mart is part of a consortium of eight big employers, including AT&T (T, news, msgs) and Intel (INTC, news, msgs), that are putting their employees' health records online. And Wal-Mart is requiring that all of its in-store clinics use electronic health records to track the patients they treat. The software, from private company eClinicalWorks, keeps an electronic record on each patient that doctors in any Wal-Mart clinic can pull up easily at the next visit. The system also gives clinic practitioners diagnostic cues to aid in treatment.

This sounds like a big step toward the goal President Bush laid out in 2004 for most Americans to have electronic health records by 2014.

Spurring on the competitors

The best thing about letting Wal-Mart do it is that the company won't have to fix the health care system all by itself. Wal-Mart's entry into this field has already galvanized competition from retailers such as Target (TGT, news, msgs) and CVS Caremark (CVS, news, msgs).

Some, like Target, are matching Wal-Mart step by step. Some are arguably ahead of the giant retailer. Clinic operator MinuteClinic is a CVS subsidiary that operates more clinics than Wal-Mart has opened to date.

What Wal-Mart does, though, is take the game up another level. If you're playing against Wal-Mart, it's compete or die. Walgreen (WAG, news, msgs), Rite Aid (RAD, news, msgs), CVS and other drugstores have to run at full speed with their best ideas or get turned into roadkill. Same for Costco Wholesale (COST, news, msgs), BJ's Wholesale Club (BJ, news, msgs) and Target. Think e-health information companies such as WebMD Health (WBMD, news, msgs) haven't noticed? Especially when Google (GOOG, news, msgs) and Microsoft (MSFT, news, msgs) have recently launched Internet-based e-health services. (Microsoft is the publisher of MSN Money.)

And if all those companies are competing, that will force the drug makers, the insurance companies, the health care providers and the health management companies into motion, too. It won't be enough for these companies just to lobby in Washington anymore.

Evolving program for employees, too

There's more than a little irony in seeing Wal-Mart take the lead in the health care market in the United States. The company has received well-deserved criticism for the way its rules prevent part-time workers from receiving health insurance.

For example, part-time workers had to work at the company for two years before they were eligible for health insurance. In 2005, WakeUpWalMart found that 300,000 Wal-Mart workers and their families had received publicly funded health care -- because they didn't have any company insurance -- at a cost of $1.4 billion.

That's begun to change. The company has cut the waiting period on health insurance for part-time workers to 12 months. (For 2007, the company set a goal of having 50% of its employees covered by company health insurance. The national average at big companies in the United States is 63%.) Children of part-time workers will be eligible for company health benefits. And co-pays on generic medications for common conditions such as diabetes, hypertension, high cholesterol and infections have been reduced to $3 from $10.

Has Wal-Mart changed enough on the inside? No way. But you don't have to like the company to think it might be able to do what no one else has been able to do: fix health care in the United States.

Continued: Developments on past columns

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