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Walmart Humana Merger

While nurses like us and other clinicians have been worrying about patient care, documentation and the new CoPs, Walmart and Humana have been getting cozy in the back room working out the details of yet another mega-deal.

The idea has an upside. A full 90 percent of Americans live within 15 minutes of a Walmart. That could go a long way to eliminating any access to care problems. Walmart’s drug prices are often less than competitors’ and could possibly be lower if they were the preferred pharmacy for Humana. Folks could see a physician or nurse practitioner, ask that their scripts be electronically sent to the pharmacy to be filled and go shop for everything from an oil filter for their car to Roma tomatoes while they wait- how convenient.

This sounds so good that maybe the good people involved in this potential deal are blind to the downside. Or, maybe they have never been to a Walmart.

Why do you go to Walmart? I go because stuff costs less. I do not expect sales associates to ask if I need help or because they play catchy background music. I dont expect anyone to help me pair cheese and fruit although to be honest, Kraft singles go with just about anything. I go to Walmart because stuff is cheap and in return, I lower my quality expectations. Have you ever compared a Walmart T-shirt to one from The Gap? Gap T-shirt’s make me happy. I would have to be sedated if I found a better T-shirt.

Walmart employees tend to be good people but the retail giant’s recruiting strategy is putting a computer in a conspicuous spot in the store to interview prospective employees. There is rarely just one person answering the questions so they must be hard.  To be fair, Walmart offers mostly entry level positions – starter jobs. I have never worked for Google or Microsoft but I don’t think this is how they filter through countless applicants.

I have to ask myself if this is the approach they will take to hiring the health care professionals that staff the Walmart and Humana clinics. ‘Our Mediocre doctors and nurses are the backbone of our clinic’, their tagline might read. ‘We’ve lowered our standards so you can pay less’. Do you want a mediocre practitioner in a starter job taking care of your child or grandmother?

And if someone has the flu, a standard script (computer generated from Humana’s algorithm) is probably all that’s needed for a patient who will spend the next 45 minutes infecting everyone else in the store. Watch as Walmart clinics go viral. Literally.

When flu season comes to a halt, things get trickier. As a recovering Walmart shopper, I am confident when I say that pretty much every one in the store is a potential patient. Unlike Whole Foods where you may run into your Yoga friends wearing yoga pants, the Walmart shoppers squeezed into a Spandex Lycra blend are not practiced in the art of Ashtanga.

And Walmart goes out of their way to perpetuate an endless supply of patients. Ramen noodles sell for a dime a piece but it is cost prohibitive for low income families of four to eat a meal including boneless, skinless chicken breasts. Red beans and rice, a perfect protein thats easily affordable always has directions to add sausage which enhances the flavor as much as it plumps up those thighs. The cheap high fructose corn syrup disguised as fruit juice costs only a fraction of the price of the real stuff. In the South where Roman Catholic values prevail, grocery bills rise each time a sibling is added and these low prices are appealing even if they kill folks eventually.

What happens if one of the Walmart shoppers/victims with a history of eating on the Walmart plan

falls out in the store? Can you see the utter chaos as the mediocre care practitioners try to read their CPR pocket card and perform chest compressions simultaneously? How many potential patients will remain loyal to Humana after they see a patient die because, after 22 attempts, there were no more IV catheters left in the crash cart and emergency drugs could not be administered.

If this deal goes through, it will be a failure for everyone involved. Humana may save money on drugs but by the end of a year, Blue Cross will emerge as the premiere insurance carrier by default. Physicians and Nurse Practitioners with restricted licenses rendering mediocre care may be an effective cost savings approach but without being surrounded by competent colleagues who can teach them or at least watch their backs, million dollar payouts will become the norm.  After all, there will be a lot of witnesses.

Walmart needs to spend their cash on improving the experience of their employees and Humana might think about increasing the speed of paying claims. And I need to be able to sleep without worrying about receiving Walmart branded healthcare.

But the most important reason to speak out against this deal is because it is nothing more than business – a way to make money.  They could have respected us enough to at least pretend they were aiming to meet needs of the people who made them successful in the first place.

Your thoughts?

6 Comments Post a comment

  1. I agree with you wholeheartedly Julianne. We already have a crisis in quality of care as margins have continually been squeezed out of our healthcare system. This would likely bring about a new low. I’d guess physician access would be delivered via some form of Telehealth solution. Humana already offers phone access to physicians who will prescribe for some things after a phone interview if you are on their plan.

    April 3, 2018
  2. Traci Clinton RN #

    I don’t know where to begin. The amount of insults toward Walmart and Humana employees as well as their shoppers were quite extensive. How about potentially staying on point as to why you were against the merger would have been pertinent during your article? CVS, Rite Aid and Kroger have clinics in their stores and do they also start a pandemic because they treat patients for the flu or respiratory viruses? Also nice to know you feel all Walmart employees must be mediocre or below to work there thus any healthcare employee of Humana joining forces will be on a restricted license and also just a “mediocre” employee that couldn’t possibly have sense enough to medically treat a patient or triage someone to a higher level of care if necessary. Why don’t you have someone “consult” on how to write an informative healthcare related article that will assist your readers. Very disappointed and still pondering your point.

    April 3, 2018

    • Traci,

      My understanding is that Walmart does not value their employees. The floor level employees only recently received a modest raise but a reduction in higher paid employees was part of that restructuring that wasn’t part of the press release. Our local Sam’s Club closed at the same time and employees learned about the closing when they showed up and found a note taped to the door. I cannot imagine a parent learning they lost their job like that.

      If Walmart takes the same approach to hiring healthcare professionals as they do in hiring other employees, it will be disastrous. If they treat them like disposables as they do their other employees, it is insane to think that anyone other than mediocre practioners would work there.

      In our area, we have no pharmacies that house clinics. If we did, I would avoid them during flu season. To me, it seems reasonable not to encourage contagious people to visit crowded areas. Your feelings are obviously different.

      My point, quite simply was that discount retail and healthcare are not compatible. The skill set and culture of Walmart management is not conducive to healthcare. You may disagree and I’m fine with that.

      I appreciate that you took the time to leave a comment and I welcome alternative viewpoints. I regret that you are disappointed. Everyone’s opinion matters even when we don’t agree with them.

      April 3, 2018
  3. Carol #

    Wow. Really biased. I have been uninsured and I know what it is like to have to decide what bills to be late paying so you can pay for a medical bill. Even a routine PCP office visit is too expensive for many people.

    We have a quick care clinic in both local Walmarts and they are great! There are also many things that I would not have if it were not for Walmart. It is functional, not glamorous, that is how they have become what they are, and that is how they keep costs down.

    I think the key to cost control in health care is to recognize that we do not always need high-end care, high cost new drugs, and a hotel-like experience in the hospital. The bare, stark, white hallways of the past were always good enough. The expectations of spoiled American consumers has driven these skyrocketing costs that unfortunately, hurts us all directly or indirectly.

    I am sorry, but I do not agree. I see so many people go without even the basics of health care, neglecting themselves until they end up in the ER or worse. We desperately need new options, and I applaud all efforts to find them. Find a need and fill it, that is the American way and the way to success and free market economics.

    April 5, 2018

    • I understand what it is like to decide which bills to pay when healthcare bills are weighing down your desk. I pay more than 7k per year for insurance and am whittling away at my 5k deductible for costs related to a fractured humerus. Plus, my work has been limited and there is the cost of meal and grocery delivery and LYFT to get me back and forth from the Doctor’s office. My lifestyle and more importantly, my savings has taken a hit since passage of the ACA.

      I agree that we need to explore options to lower healthcare costs. To that end, I would recommend reading ‘An American Sickness’ by Elisabeth Rosenthal. It explores the underlying reasons that our healthcare costs grew to where they are.

      I take dire exception to your characterization of patients as ‘Spoiled American consumers’. I think most people would avoid the hospital if they could. It is not spoiled consumers with admission privileges or rolling suitcases of meds hawking them to physicians.

      Mostly, I take exception to the fact that you do not seem to differentiate patients from consumers. Patients place a high level of trust in their healthcare providers. Healthcare providers enter into a relationship with patients when they are vulnerable. The come to us with different levels of income and education and it takes time and effort to provide effective care. People who are selling stuff do not garner the same trust as healthcare providers; no do they share with them the most private details of their lives.

      Depending on how you define ‘consumer’ it may be that insurance companies, Medicare and Medicaid are the nations’ largest consumers of healthcare. Part of my job is to fight for payment when claims are arbitrarily denied. I cannot imagine working hard for a client and then being told I wasn’t getting paid because I forgot to date my signature. In fact, I would likely win if I took it before a judge.

      There are freestanding urgent care clinics. I can’t compare the costs of a physician visit to that of a Walmart visit because our Walmart’s do not have clinics and costs vary by region. But insurance companies and discount retail managers are not equipped to handle healthcare.

      But as always I welcome alternative viewpoints. It could be that I am wrong. Nothing would make me happier. I don’t think that will be the case.

      PS – Do you work at Humana? Someone emailed to say that the nurse, Traci Clinton, who posted before you, was employed by Humana. I think that sort of thing should be disclosed. There’s nothing wrong with it but it certainly has 5he potential to create a bias.

      As you implied, healthcare does not have to cost as much as it does. But blaming spoiled American consumers is a limited insight opinion.

      April 5, 2018
  4. Carol #

    One more thing- Wal Mart has a nice giving program and I am applying for a grant through them that will benefit the whole community!

    April 5, 2018

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