NationStates Jolt Archive

http://www.economist.com/business/displaystory.cfm?story_id=9013554

Sounds like a pretty good idea to me. But what do you guys reckon? Is this one way to help fix the US health system?

It might be worth going into Satan's Store - but I'm po' (so broke I can't afford the last two letters) and I have no insurance. So quality health care on the cheap is a Good Thing.

Nope. Not even going to read the article. Wal-Mart is t3h evil!

Nope. Not even going to read the article. Wal-Mart is t3h evil!

I don't like them much, but you can save pennies there. And when every penny counts...

I don't like them much, but you can save pennies there. And when every penny counts...

Meh, I say this because even though my mom's a chronic spender and I myself am broke-ass poor, I have a real sense of community. I'd rather pay $40 to a local store for my purchase rather than go to some super-chain like Wal-Mart and pay $4. Small business ftw. Down with the Wal-Mart oppressors!

I do fine with Kaiser.. that's cheap enough for anything I'd need. But Wal-Mart has the resources to put something decent together if they're really serious about it. So good for them.

http://www.economist.com/business/displaystory.cfm?story_id=9013554

Sounds like a pretty good idea to me. But what do you guys reckon? Is this one way to help fix the US health system?

It's not a fix. It's a help, and in some ways, I think it's the wrong kind of help because it delays the implementation of a single payer universal system, which is what we need. The problem is that these places may be cheaper, but they still cost, and $50-60 is a lot even to a person making $10 an hour. That's pretty much a day's take home wages gone. And it won't be much help for those people who can't afford even that--they'll just go to the emergency room like they always do and then not pay the bill because they can't afford it.

In short, it'll be good for some, but not good enough for enough people.

Well, more access to health care is always a good thing. Besides, Wal-Mart's entry in to the sector will provide a needed boost in competition that might push prices down across the board.

It'll also help make it easier for people without health insurance to get care.

Well, strictly speaking the article is about cheap retail health clinics in general. Wal-Mart is of course mentioned, but there are more than just them involved in this new business.

If Meijer were to get in on this... And I think they will, if local Wally Worlds get the clinics, I'll be a happy camper. They already give out basic antibiotics free, which is a lifesaver when you have an ear infection.

My general instinct is one of revulsion, but American health care ain't Canadian health care. Still, I think even in Canada's environment, we could benefit somewhat from pay-for-health clinics that deal with minor ailments and the like, just to ease the burden on the health care system. People rushing to the emergency room when they have the flu or something.

Then again, maybe not. People would still more likely go to the government funded places to save the money, thus killing the market for for-profit health clinics. The concept of two-tier is still a feisty debate here.

For the US? I dunno. I still can't imagine going to Wal-Mart for what ails me.

http://www.economist.com/business/displaystory.cfm?story_id=9013554

Sounds like a pretty good idea to me. But what do you guys reckon? Is this one way to help fix the US health system?

Silly, you only fix things if they're broken!

Oh... Wait a second...

I'm not against it. But I don't think it is really going to do much to address the fundamental healthcare cost problem in the US.

I'm normally against the government running stuff, but in this case looking at the models in other countries, I have to conclude that it is probably time to chuck the US system and move to a UK/Canada style approach.

Meh, I say this because even though my mom's a chronic spender and I myself am broke-ass poor, I have a real sense of community. I'd rather pay $40 to a local store for my purchase rather than go to some super-chain like Wal-Mart and pay $4. Small business ftw. Down with the Wal-Mart oppressors!Maybe that's why you're poor. You're making a financial decision with your heart instead of your head.

I would rather not go to a store that will eventually hold a monopoly on almost everything, just to get cheap healthcare.

I would rather not go to a store that will eventually hold a monopoly on almost everything, just to get cheap healthcare.

That's a little extreme. And when do you predict Wal Mart will monopolize the world?

Boxhillnorth;12582032']That's a little extreme. And when do you predict Wal Mart will monopolize the world?

Not for at least several minutes. :p

Boxhillnorth;12582032']That's a little extreme. And when do you predict Wal Mart will monopolize the world?

About the same time that the Soviets overtake the US and Japan buys all of the US's assets.

I wonder if Walmart employees get any discounts, probably not.

Boxhillnorth;12582032']That's a little extreme. And when do you predict Wal Mart will monopolize the world?
Monopolize the world? I think you added a little something to my post.

I'm not against it. But I don't think it is really going to do much to address the fundamental healthcare cost problem in the US.

I'm normally against the government running stuff, but in this case looking at the models in other countries, I have to conclude that it is probably time to chuck the US system and move to a UK/Canada style approach.

I'm glad to see more and more people on board at least with the idea. There are some things that governments are just more able to deal with I think, things that are too big for individuals and companies to handle, and basic level health care is one of them. I'm not opposed to allowing rich people to supplement a government system if they wish, so they get better care--that's going to happen in any capitalist society--but there really does need to be some basic level preventive and catastrophic system in place for everyone no matter how much or little they earn.

Boxhillnorth;12581981']Maybe that's why you're poor. You're making a financial decision with your heart instead of your head.

That Wal-Mart shit isn't really all that cheap, when you factor in all the social costs and lost tax revenue to local governments. Wal-Mart doesn't build a store unless they get a deal from the local government to be tax free for a certain period--not sales tax, but property tax and the like. The sales tax increases from building a Wal-Mart are marginal because they tend to put so many local businesses out of business--it's not new money, just a reallocation. And the new jobs created aren't great, so you may lose money in local income tax (if you have it) but it costs the locality in increased infrastructure costs.

I think that this is a positive development. The more entrepreneurial developments we have in healthcare the better. This is not to say that a single payer system is the worst idea, I would just like to avoid it if possible and try a more market based, entrepreneurial model with possible attention to subsidizing the healthcare expenses of the poor somewhat. I tend not to think that US would get its crap together in any meaningful way in a government system nor do I think that bureaucracy would foster innovation and economic calculation as might be desired.

I tend not to think that US would get its crap together in any meaningful way in a government system
Universal healthcare really isn't that hard to implement and manage. Also, it would save money.

nor do I think that bureaucracy would foster innovation and economic calculation as might be desired.
Its not like advancements in medicine would stop, people would still be able to do research and development.

Its not like advancements in medicine would stop, people would still be able to do research and development.

Indeed. The public sector cooperates with the private sector in R&D; universal healthcare wouldn't change that, because people are still going to demand products above and beyond what the universal system would provide. The only difference is that everyone now gets basic care, and those that can afford it can go farther. A basic system with significant options for people willing to pay more would provide far more benefit to all people and use resources more efficiently, freeing up money for research, development, and expansion of the system.

If anything, a universal healthcare or universal insurance system is a lot better because the public sector has more power to do the research in fields the private sector lags in, and the private sector can go ahead and develop the really revolutionary stuff since their market is now focused on the people willing to pay large amounts of money for what they have to offer.

Universal healthcare really isn't that hard to implement and manage. Also, it would save money. This is the US government here. Not only that but I think that competition between various sources would help more so long as we allow such a market to flourish. A lot of expense exists though because it is chosen and other bits of it exist because our current system isn't competitive enough to weed out inefficiencies.


Its not like advancements in medicine would stop, people would still be able to do research and development.
No, however, innovation in healthcare options can be provided by the private sector in as much as how to improve options for patients and such. They have an incentive to be efficient if possible.

Indeed. The public sector cooperates with the private sector in R&D; universal healthcare wouldn't change that, because people are still going to demand products above and beyond what the universal system would provide. The only difference is that everyone now gets basic care, and those that can afford it can go farther. A basic system with significant options for people willing to pay more would provide far more benefit to all people and use resources more efficiently, freeing up money for research, development, and expansion of the system.

If anything, a universal healthcare or universal insurance system is a lot better because the public sector has more power to do the research in fields the private sector lags in, and the private sector can go ahead and develop the really revolutionary stuff since their market is now focused on the people willing to pay large amounts of money for what they have to offer.
Really though Vetalia, the question is not purely on R&D, it is on the provider of healthcare. We can have subsidies, we can have private pharmaceutical companies, we can have all of that or not so. The question still ends up falling down on what we want to drive our medical system. I would argue that we could maintain privatization if we try to work on making the private systems work more efficiently and recognize that some of the issues exist because of issues with existing contractual systems. R&D subsidies can be argued for in the context of either system though.

No, however, innovation in healthcare options can be provided by the private sector in as much as how to improve options for patients and such. They have an incentive to be efficient if possible.

A good example of the positive effect that private-sector competition can have on the public sector is in the USPS. The most efficient part of the USPS is its package delivery service, because it has to compete with the private sector for market share.

I feel a similar thing would happen if the private sector competed against the government in healthcare. Both sides would be as efficient as possible, with a significant net benefit overall.

Really though Vetalia, the question is not purely on R&D, it is on the provider of healthcare. We can have subsidies, we can have private pharmaceutical companies, we can have all of that or not so. The question still ends up falling down on what we want to drive our medical system. I would argue that we could maintain privatization if we try to work on making the private systems work more efficiently and recognize that some of the issues exist because of issues with existing contractual systems. R&D subsidies can be argued for in the context of either system though.

I agree. I personally would prefer universal insurance rather than universal healthcare, since the private sector itself is highly efficient when it comes to managing its systems in a competitive environment; the only problem is that it also makes the system expensive and difficult for those unable to afford it to pay for it.

One of the biggest problems for the private healthcare system is lack of insurance; by providing basic coverage for all, their costs decrease and the overall efficiency of the system increases with minimal intervention.

A good example of the positive effect that private-sector competition can have on the public sector is in the USPS. The most efficient part of the USPS is its package delivery service, because it has to compete with the private sector for market share.

I feel a similar thing would happen if the private sector competed against the government in healthcare. Both sides would be as efficient as possible, with a significant net benefit overall.
But does such a positive effect require a public sector? The only thing that a public sector really will provide I see is public funds and subsidies. I would rather just have a private sector in this and simply improve lagging outcomes for poor people than switch to an entirely different system. I would rather try to cut down on bureaucratic tape, perhaps have work done to improve information access in health care and try to push for innovation in healthcare markets. That way individuals can pick a healthcare to suit their desires.

the only problem is that it also makes the system expensive and difficult for those unable to afford it to pay for it.

One of the biggest problems for the private healthcare system is lack of insurance; by providing basic coverage for all, their costs decrease and the overall efficiency of the system increases with minimal intervention.
Simply provide a subsidy or voucher system of some form to help those at the bottom pay for their problems. Some healthcare aspects of our system are very unnecessary but still desired and a public system would deny choice in these issues I would think. If we simply provide limited aid to the poor on some level then we can help them while still maintaining a competitive health care service and choice in terms of frivolous healthcare wastes.

Simply provide a subsidy or voucher system of some form to help those at the bottom pay for their problems. Some healthcare aspects of our system are very unnecessary but still desired and a public system would deny choice in these issues I would think. If we simply provide limited aid to the poor on some level then we can help them while still maintaining a competitive health care service and choice in terms of frivolous healthcare wastes.

That's more or less what I mean. The money and efficiency being lost by private healthcare isn't from people (like me), who will be getting advanced, optional, and quite expensive medical and bioenhancement procedures because we want it, it's from people who have no insurance who go to emergency centers because they won't have to pay for the treatment. That costs the private healthcare providers money and prevents the poor from having access to many other options, hurting their health as well as bogging down the system in inefficiencies and wasted money.

So, I see government health insurance/vouchers as a way of closing the gap and saving private healthcare efficiency and money and also improving the health of poor people, which in turn would have a positive effect on the greater economy.

I agree. I personally would prefer universal insurance rather than universal healthcare, since the private sector itself is highly efficient when it comes to managing its systems in a competitive environment; the only problem is that it also makes the system expensive and difficult for those unable to afford it to pay for it.

One of the biggest problems for the private healthcare system is lack of insurance; by providing basic coverage for all, their costs decrease and the overall efficiency of the system increases with minimal intervention.

Actually, one of the biggest current problems in the private healthcare system is the tension between insurance companies and healthcare providers--insurance companies never want to pay (understandable, since it eats into their profits) and providers want them to (since they're usually providing for services up front). Most practitioners have to employ someone whose sole job is to fight with insurance companies over payment--and this is at the basic level. We're not talking about fighting over experimental treatments or vanity treatments here--just basic preventive care.

If Meijer were to get in on this... And I think they will, if local Wally Worlds get the clinics, I'll be a happy camper. They already give out basic antibiotics free, which is a lifesaver when you have an ear infection.

If Walmart get clinics I'm sure Meijer will too. Fred Meijer is a crafty old man.

Also, note that I have to intentionally not type it as "Meijer's". Damn the Michigan accent where company names are possessives!

we have a walk in clinic about 10 minutes walk from where i live. its great - been there a few times, no need for an appointment, seen within an hour (ok its a bit of a wait but whaddya expect?), and the best part is with the NHS its totally free! (at the point of consumption)
tis also great as its 2 minutes away from a pharmacy, and its part of 'the system' meaning they can refer you, with appointment, to the local doctors' surgery or the hospital if you need a follow-up or they can't sort your ailment there


as for the article.. its a good idea. i never understood the american system. will you still need health insurance to go to these clinics? or is it just drop-in-and-pay like any other store?

we have a walk in clinic about 10 minutes walk from where i live. its great - been there a few times, no need for an appointment, seen within an hour (ok its a bit of a wait but whaddya expect?), and the best part is with the NHS its totally free! (at the point of consumption)
tis also great as its 2 minutes away from a pharmacy, and its part of 'the system' meaning they can refer you, with appointment, to the local doctors' surgery or the hospital if you need a follow-up or they can't sort your ailment there


as for the article.. its a good idea. i never understood the american system. will you still need health insurance to go to these clinics? or is it just drop-in-and-pay like any other store?It's drop in and pay, which is great if you have the money, not so much if you're a member of the working poor, and make just too much to get Medicaid (not difficut, by the way).

It's drop in and pay, which is great if you have the money, not so much if you're a member of the working poor, and make just too much to get Medicaid (not difficut, by the way).

well my point was that surely paying just when you need it, or when you have the service, is better than having to pay monthly for health insurance, without which you wouldn't get treated in most places (as far as my understanding of the US system goes)?

i personally dont think health care should be ran like a business. when your sick you want to be a patient not a customer.

I also dont go to the doctor for minor stuff. if i get a paper cut i let it heal on its own. if i start to feel like im getting a cold i take all the measures i can to help prevent it from getting worse. from some stories i hear it sounds like some people go to the doctor every month. i havnt been in a couple of years.

It's drop in and pay, which is great if you have the money, not so much if you're a member of the working poor, and make just too much to get Medicaid (not difficut, by the way).

we have an urgent care clinic around here, it's like $30 to be seen, it's for when you can't wait for a dr. appt but don't need to go to the ER. I have used it before, it wasn't a big deal, in fact they billed me and I had the option of paying it out in $5 a month installments interest free. (although I just ponied up the $30 when I got paid)

I doubt the clinic mentioned in the article is the same though.

We also have a lot of free clinics run by local churches here, it's hard to get in to see them sometimes though (I take my neighbor in when she needs to go) but, they do good work.

well my point was that surely paying just when you need it, or when you have the service, is better than having to pay monthly for health insurance, without which you wouldn't get treated in most places (as far as my understanding of the US system goes)?

Not really, because those people who can't afford the drop in and pay places generally don't have insurance either, so they wind up at emergency rooms where they have to treat you regardless of your ability to pay.

Anybody catch the quality control comment? Makes me not want to go to Arbys.

I think it will help some people, and that's a plus, but it's not going to fix the healthcare system entirely.

If Walmart get clinics I'm sure Meijer will too. Fred Meijer is a crafty old man.

Also, note that I have to intentionally not type it as "Meijer's". Damn the Michigan accent where company names are possessives!

You know, I always said Meijers, until my sister started working there. Then she started correcting us, and I guess it stuck! But I love Meijer - they just built a new Wal-Mart across from the Norton Meijer here in Muskegon, and I only go to Wally World to cash my checks. (It's complicated, involving the fact that our bank holds anything over $100 for three business days, and Meijer doesn't cash ManPower checks.) I'd say we spend something like 98% of our grocery money at Meijer - they ROCK!