"Free Health Care" – Must-Read from National Center for Policy Analysis

Want “free” ObamaCare?  Read on…

This is a must-read from National Center for Policy Analysis’ John Goodman.  Receive more of Mr. Goodman’s health policy alerts here.

Free Health Care

Written by and reposted here with permission by

John Goodman, the “Father of Health Savings Accounts”

This past weekend, Wal-Mart was offering health care screenings to male customers at no charge. Sam’s Clubs across the country gave any customer willing to take the time:

  • BMI Index measurements,
  • Blood pressure tests,
  • Cholesterol readings,
  • PSA (prostate cancer) tests, and
  • TSH (thyroid stimulating hormone) tests.

And that’s not all. Sam’s Clubs have more free screenings planned for the future. Here’s the schedule:

  • July: Kids Health Screenings
  • August: Vision Health Screenings
  • September: Diabetes Screenings
  • October: Women’s 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, Sam’s 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 doesn’t knock your socks off, you must be living in a cave somewhere. Certainly, you haven’t been paying attention to health policy news.

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 (through your premiums) and your health plan (directly) will pay $500 to $1,000 for these services alone; and if you can get them with only 20 minutes of waiting at a doctor’s 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 Sam’s.
  • 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 Sam’s $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!

What’s happening at Sam’s 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 Fund’s 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 dime’s worth of compensation.
  • And now we have primary care without deductible or copayment!

Isn’t the lesson here obvious? There’s nothing wrong with the market for health care. It’s 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.”
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