Self-insurer Walmart flies its sick employees to out-of-state specialists to avoid local price-gougers

Originally published at: https://boingboing.net/2019/03/15/allopathic-avoidance.html

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That is… amazing! And sad. And wonderful. And sad.

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It’s important to remember that Walmart also rations hours so folks don’t qualify for benefits. The majority of Walmart employees are part-time without company subsidized healthcare.

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If I understand the example, it’s:

  1. Local doctor recommends a pricey operation.
  2. Walmart balks at pricey operation and puts up some money to see if they can get a better roll.
  3. Turns out it’s a cheaper medical condition, so everyone wins in this case.

If the original doctor had prescribed a cheap solution, would Walmart have sent them on an all-expenses trip to “make sure” it shouldn’t be a more expensive treatment? I somehow doubt it.

This doesn’t seem like a feel-good story to me. The Walmart employee was just lucky the cheaper option happened to be the better one for them medically.

Walmart’s not putting the employee’s health as the priority here, so it’s hard to see how they’ve earned any kudos.

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Now add telemedicine to this equation.

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This sounds positive, but in general, companies that self-insure, like Wal-mart, sidestep a whole bunch of regulations that apply to insurance companies, and some of those benefit consumers. I think that if it looks like an insurer and acts like an insurer, it should be regulated like an insurer.

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Except for the fact that the poor guy has Parkinson’s which is a horrible, lifelong debilitating disease with no cure. I’d much rather have the surgery.

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why_not_both.gif /joke

Could this be another corporate “example” to show why single payer is such a bad idea (for them)?

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Good for Walmart. It doesn’t take a very big pool (1000+ (plus families)?) for you to have all the risk you need to be indistinguishable from the whole population. Most big companies are actually self-insured, even if they engage Blue Cross or someone else to operate as their Third Party Administrator.

Most of the medical tourism (domestic and international) that occurs at all is from Self-Insured companies trying to lower their overall costs. I myself need a couple of dental implants and it’s very likely to be cheaper to fly to/from Boise or Kansas City or something from the Bay Area than it is to have them done here.

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It’s better, in this one anecdote, that his Parkinson’s was diagnosed, instead of missed. There’s no question about that.

I just don’t think Walmart helped find it because they were being altruistic. They were trying to pay less. That’s not always going to benefit the employee.

“My first doctor said I needed a wheelchair and a month off work. My benevolent employer found a doctor that said I only need a skateboard and a couple of days off. Thanks boss!”

Shopping around can help a company find a better deal, that’s a proven business practice. But for-profit medicine means employer, insurer, etc are pushing to find the cheapest outcome, which is not always the healthiest.

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But they didn’t just shop around for a cheaper back surgery, or send him to another local provider for a second opinion. They flew him + wife all expenses paid to a top medical center.

If he still needed the surgery and had the option to utilize a more advanced facility… that’s great for him.

Also, duder being diagnosed with a life long debilitating condition is hardly a cost savings win for Wal-mart. They may be profiteering scum, but in this instance profit motive actually benefited an employee. Wonderful! But also sad…

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I am very suspicious of articles like this that purport to show how “freedom” from medicaid, insurance companies, regulations, etc. lets companies do GOOD things. Yes, it does. However it also allows companies to royally screw their employees, who in theory have the freedom to work somewhere else, but in reality are wage slaves that are shackled to their mobile homes and cheap apartments.

PROPAGANDA, that’s what I call this.

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now imagine what profit making corners they are cutting on the generics in their pharmacy because I’m sure whatever regulatory agency if any supervises that aspect has had it’s budget decimated by Congress

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Absolutely, “in this instance”.

Keep in mind that this is a cherry-picked quote, in a report written by Walmart, to show how Walmart can save money by controlling who gets spine surgery and who doesn’t.

The reason they’re funnelling people to a Walmart-contracted doctor, is because they can then override any advice they’ve gotten from the employee’s doctor. And they do. The one happy anecdote doesn’t account for the many people denied surgeries by this program.

This is a corporate spin document, written by Walmart. It’s not a story about a charity.

They flew him to a medical center that is under contract to Walmart, in Walmart’s “Centers of Excellence program”.

This isn’t revolutionary. It’s a “Company Doctor” set-up. And Walmart uses it to push people to pick the cheapest of treatment paths.

Getting treatment is great, but this is For-profit propaganda, written by Walmart themselves.


FTA

Associates who are eligible for the program can choose not to use it — but at a cost. Beginning in 2017, those opting for spine surgery outside of the COE network (to avoid travel, for example) had to pick up half the total cost; the amount climbed to 100% in 2019. The same applies to associates who want surgery even though the COE concludes it’s not needed.

This means anyone who doesn’t use the company’s doctor has to pay 100% of the cost of the surgery, in most cases.

It also means they only pay if the company doctor agrees it’s a necessary procedure. That’s fine if you feel that Walmart-contracted doctors are more honest about which operations Walmart should pay for, or that all the non-Walmart doctors are probably lying thieves.

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I think the study could be used either way depending on how you look at it and what part you emphasize.

The lefty in me read this and immediately thought, “this is just the kind of data we need to show that healthcare prices need to be regulated!” I didn’t even think of the anti-regulation angle until you brought it up, but you are right, spin it a different way and it supports that argument too.

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Any single payor in a gut-biome triggered brain disease that is treated with mostly weight training pills (and elastic?)

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[Arby’s Spokesperson:] Always the kidder, Krieger! What depths do I have to sink to for you not to tell me the exception to a hideous condition?

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Phew, for a second there I was apprehensive that the takeaway was going to be “Walmart Treats Its Employees WIth Dignity,” which would have greatly upset the worldview it has taken me many years to acquire.

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It’s not an unbiased study. It’s a Walmart press package.