Last month WalMart sent out an invitation to health care partners to collaborate with the world’s largest retailer to come up with ideas for how they could become the nation’s largest primary health care provider. The goal, according to the leaked document, is to “lower the cost of health care.” The company document quoted by National Public Radio and Kaiser Health News was quickly, sort of, partly, kind-of, qualified by WalMart spokespeople as being “overwritten.”

It should not be surprising that WalMart is looking at health care as it’s next big venture. Many analysts predict that the demand for the services of primary care providers will explode as those of us currently without insurance access coverage under the new health care law. It is assumed that since we will all quickly run to the doctor for treatment, a shortage of doctors and others who care for runny noses, sprained ankles and ear aches will result. Do the Waltons and their executives seek new markets because they really think life costs the rest of us too much? No, they enter markets because they see opportunity to make a profit. WalMart executives are always looking for the next market sector promising an increased demand.

There are many companies who thought they were on the road to big things when they got a contract to supply WalMart. Many, like Schwinn, Snapper, Rubbermaid and many others soon found that their new partner only wanted their products if they could be supplied at an ever shrinking cost. WalMart has pressured companies to compromise the quality of their products as a way to cut those costs. Companies have been forced to use inferior components to meet price specifications. Some companies, desperate to hang on to what had become their biggest, or even their only buyer, moved their production facilities to countries where people work for a fraction of the pay of American workers. In some cases even that has not been enough to keep WalMart buying and some companies have gone out of business as a result.

One has to wonder what “efficiencies” WalMart will require of physicians who work for them in their possible new medical departments? Will there be a limit on time spent washing hands? How about time spent researching the best treatment for a specific ailment? Who will decide how long a doctor or nurse spends with a patient? Will WalMart have a “preferred provider” status with major health insurance companies? Will they be able to negotiate special rates with those insurance companies based on the volume of their services? Will this result in marketing services to people who really are not sick to generate more volume? Who will make the decisions about your care, you and the doctor or WalMart upper management and efficiency experts?

Analysts question if providing cheap primary care will have much effect on the overall cost of health care in this country. We already have free clinics, public health facilities, affordable screening options. Primary care physicians and nurse practitioners are not paid exorbitant salaries (possibly partly the reason there is a shortage of medical school graduates seeking these specialties) compared to surgeons, emergency room physicians and other specialists. The really expensive care occurs once primary care providers refer patients to specialists. WalMart’s proposed venture into primary care will have little effect on these costs.

Having never had a positive shopping experience in a WalMart store leaves me feeling anxious about the possibility of seeing a doctor there. The Walton family have become some of world’s wealthiest people by selling low cost, low quality stuff to millions. I will bet that the Waltons themselves will not be using the “lowest price-always” for their primary care.

Ironically, WalMart also announced last week that they would no longer be offering health care benefits to their new part-time employees. It’s a good thing those new employees will be working in a WalMart where they may soon be able to stand in line in one of the company-owned clinics. Perhaps the company could just offer coupons for in-store health care, groceries, pharmaceuticals and clothes in lieu of a paycheck.

Copyright © 2011 Janet Jacobson and Sustaining the Northern Plains