[HN Gopher] Walmart Gets Into Health Care
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Walmart Gets Into Health Care
Author : awb
Score : 52 points
Date : 2020-02-25 18:55 UTC (4 hours ago)
(HTM) web link (www.bloomberg.com)
(TXT) w3m dump (www.bloomberg.com)
| JoeAltmaier wrote:
| Hm. Wife had eye check at big box store. The guy said "Oh, you
| have Macular Degeneration. Nothing to do about it sorry. Just go
| home and go blind".
|
| She came home in tears of course. So I said "Go to a reputable
| ophthalmologist and get a real opinion". So she did.
|
| Of course nothing is wrong with her eyes (despite the power-of-
| suggestion effects she experienced, but miraculously cleared up
| once she got a reliable exam). The Dr did say "I can see how they
| made the mistake; you have some small adhesions to your retina,
| but they'll clear up by themselves"
|
| So no, I'm not going to a big box store to get my medical care.
| Never mind the price. I'll get a professional, or go without.
| Can't be worse than our experience at the discount-home-goods
| place.
| fma wrote:
| For what it's worth...those eye glasses places are run by
| optometrists (usually) and not an ophthalmologist. An
| ophthalmologist has more medical training.
|
| They are all independent of the store and just pay rent. But
| they are all professionals...
|
| Edit: Also if you have a real medical issue w/ your eye,
| definitely see an ophthalmologist. Optometrists are for glasses
| and minor eye issues...they aren't going to be doing surgery on
| you.
| learc83 wrote:
| When you get your eyes checked for glasses you go to an
| optometrist. Doesn't matter if it's big box store or a local
| guy--they have the same credentials.
|
| An ophthalmologist is an MD who specializes in eyes, and that's
| who you want to go to when you have a more serious problem. 2
| completely different things, and not really anything to do with
| where the optometrist was located.
| JoeAltmaier wrote:
| So what were they doing, diagnosing and then saying there was
| no point in getting a second opinion?
| ghaff wrote:
| It sounds like a very incompetent optometrist (and if they
| weren't one, someone basically impersonating one). They're
| eye specialists after all who go to a 4-year post-
| undergraduate program, just not M.D. doctors. At a minimum,
| they should presumably have told your wife to book an
| appointment with an ophthalmologist immediately.
| pkaye wrote:
| So the big box employee was not a licensed professional? Maybe
| you should report them for dispensing medical advice without a
| license.
| artemisyna wrote:
| Very curious to see how this plays out.
|
| There's a bunch of underinsured (or outright not insured) folk in
| the very locations where Walmart is opening these, so it has the
| potential to kill a couple of different birds with one stone.
| From a public benefits side, it gives a path of medical care for
| those that otherwise wouldn't have it (beyond say, an emergency
| room visit). It also lower prices by competing against insurance
| bloat.
|
| In doing so, Walmart (may) be able to create a sustainable
| business by tapping a market (folk that aren't currently going
| for medical coverage anyway) that would otherwise be untapped.
| toomuchtodo wrote:
| This could also control costs if government managed systems
| (Medicare, Medicaid) partner with Walmart to provide payment.
| Easier to negotiate with Walmart as a single entity versus a
| network of vision and dental providers across the nation.
| WheelsAtLarge wrote:
| This is great. Walmart has a reputation to protect so at the very
| least I can trust what they say.
|
| I've had a hard time getting a dentist I can trust. The business
| reminds me of car mechanics that are always looking to sell you
| additional services. And as a layperson, it's hard to know when
| you are being sold services you don't need. They love people with
| insurance since they can get them to buy without much pushing.
| the_cat_kittles wrote:
| are you real? is this really a thing a human person is
| thinking? what?
| ebg13 wrote:
| > _This is great. Walmart has a reputation to protect so at the
| very least I can trust what they say. I 've had a hard time
| getting a dentist I can trust._
|
| Do you think that dentists don't also have a reputation to
| protect? What makes you take polar opposite views of the two?
| WheelsAtLarge wrote:
| It's not the same. I think it's a matter of scale. Walmart,
| because of its size, will often have more checks and
| balances. They will not take a chance to mar their
| reputation. Walmart wants to keep people's trust. It's worth
| billions to the company. It's not 100% but I feel more
| comfortable if I'm not constantly being pushed additional
| services to buy.
|
| Most dentists I've dealt with run their practice as a small
| business. Usually, it's a few dentists. They need to
| constantly sell. I understand that they need to stay in
| business but it's so constant that you never know where you
| stand.
|
| I'm not saying that all dentists are like that it's just hard
| to find one that you can trust. Just like car mechanics.
| beambot wrote:
| Size & reputation seem just as relevant to all the existing
| medical providers, but that seems to have little impact...
| turc1656 wrote:
| I get what they're saying. Walmart is literally known by
| every single person in the country (and outside the country
| as well). It's much less effective to bitch about getting
| ripped off by the local DDS and have people see about it and
| also care about it. If a bunch of people went online and were
| talking about getting ripped off by Walmart, it could very
| easily get picked up by the media if the claims were legit
| and then could affect the stock price.
|
| I think people are also much more likely to talk to one
| another about the "shitty new Walmart healthcare service"
| because they know everyone knows Walmart and might use it.
| It's far less likely that you warn people about one single
| DDS office in your town unless perhaps that specific service
| provider came up in conversation.
| agumonkey wrote:
| Not totally agreeing with op, but I can understand a few
| differences: you don't complain the same way with a doctor
| and with a company. people tend to just switch. a brand like
| Walmart may be subject to a global scrutiny and raise the
| level globally.
| the_cat_kittles wrote:
| a large, aggressive for-profit org with a virtually unlimited
| warchest providing health care? sounds perfect. absolutely
| nothing bad could come of it.
| [deleted]
| [deleted]
| WhompingWindows wrote:
| I'm just waiting for these massive corporations to get into the
| automation of Pharmacy work. I know a number of highly paid
| (110k+) pharmacists who largely:
|
| A) count pills
|
| B) put pills into orders
|
| C) do retail
|
| D) answer questions/customer service
|
| Meanwhile, the industry is being flooded with new graduates from
| dozens of schools...If this isn't a case for automation of A-C, I
| don't know what IS a case for automation in healthcare.
| learc83 wrote:
| Most of A, B, and C are done by techs. Pharmacists are there to
| manage the techs. But predominantly they are there to be
| prevent or be held liable for mistakes and loses/thefts of very
| high value inventory.
| zachwood wrote:
| I'm pretty familiar with pharmacy roles and pharmacists do not
| count or fill pills. That is the job of pharmacy technicians.
| giggles_giggles wrote:
| Exactly, the pharmacist is there to provide expert advice
| when you have a complicated prescription or combination of
| prescriptions. You can tell by these comments that the HN
| crowd leans young -- not enough people dealing with chronic
| illnesses who have seen the value in having a consult with
| the pharmacist when you pick up your medication.
|
| My wife has a handful of chronic illnesses and I want her to
| be able to ask questions of someone who has been educated in
| the role, method of action, correct dosages, and possible
| interactions of her medications.
| WhompingWindows wrote:
| Exactly, they are there for customer service, not for
| retail, which is a huge proportion of their duties.
| zachwood wrote:
| I mean this may be partially true for a retail pharmacy
| setting, but is much different in a clinical one.
|
| Even in an place like Walgreens where customer service is
| a big part of the job, the idea that it's all a
| pharmacist does feels simplistic and reductionist and
| plainly wrong. There's lots of coordination with the
| patient's doctor and insurance and other pharmacies they
| might use.
|
| It's like saying programmers just type into a keyboard.
| jacobwilliamroy wrote:
| Why would you want to unemploy a bunch of people doing a cushy,
| fun, do nothing job? What's wrong with you?
| TheSoftwareGuy wrote:
| To provide lower prices to the millions of people who need
| medication? That money has to come from somewhere
| [deleted]
| jacobwilliamroy wrote:
| Now is not the time to start pretending like we care about
| sick people.
| gruez wrote:
| retail/pill counting is fun?
| jacobwilliamroy wrote:
| As someone whos worked both blue collar and white collar
| jobs, pharmacist is one of the better gigs out there.
| inpharmaticist wrote:
| It's an okay gig on average, currently. Chains keep
| buying the smaller guys out, reducing hours and support
| staff, increasing demands of metrics, and offering lower
| and lower pay to new grads. It doesn't help that new
| schools keep opening and applicant numbers do not
| increase in quality or quantity. The BLS anticipates 0%
| job growth in the next 10 years.
| wil421 wrote:
| Probably not but $110k a year can buy a whole lot of fun.
| Pill counting is not soul crushing, work to live don't live
| to work.
| fma wrote:
| Like this? https://www.youtube.com/watch?v=j-bNu1yICMw
|
| I saw this (or one like this) in action in China at a hospital.
| There were 15+ windows to line up for the pharmacy and each one
| had a lot of 10+ people. I was in shock because in the US even
| 2 people in like would take forever.
|
| The procedure is, you scan your ID at a machine attached to a
| pillar. The screen tells you which line to line up in. When you
| get to the front of the line you hand your card to the nurse
| the medicine comes down a chute.
|
| The line moved fast. I received my medicine in a matter of
| minutes. Also I paid for the medicine w/ the doctor that
| prescribed it - so none of this BS about "oh your insurance
| doesn't cover this, you haven't met your copay" talk that half
| the pharmacists seems to spend their time with. The doctor told
| me what to do with it and fielded any questions.
| ColanR wrote:
| Fantastic, if this isn't regulated out of existence.
| protomyth wrote:
| They are following others at this point. A lot of places have
| "minute clinics". The pharmacy part has more legal problems in
| some states like ND.
| Analemma_ wrote:
| This is great news. Every six months I go to the dentist for a
| checkup and teeth cleaning, and it's always the same: they look
| at my teeth for a few minutes with the mirror thing, scrape off
| some plaque with the pointy thing, polish my teeth with the
| spinning thing, then I do the flouride rinse and leave. It
| usually takes less than half an hour, and then they bill my
| insurance $275 for it. It's ridiculous, and there's no way this
| requires a graduate medical degree, it could be done by someone
| who took a three-week mail-in training course. Keep dentists'
| offices with DDS's around for major surgeries or unusual
| situations, but for routine checkups this is fine.
| schiang wrote:
| That's why some dental offices hire dental hygienist to clean
| teeth while the DDS focus on more major procedures.
| Ididntdothis wrote:
| I thought they all do that. I never had a dentist do my teeth
| cleaning. The dentist shows maybe for two minutes at the ned
| and takes a quick look.
| schiang wrote:
| It probably depends on the dentist. I've never even see a
| dental hygienist at my dentist's office. It's always the
| dentist that does everything.
| ghaff wrote:
| That's not the norm in the US. Maybe some old-timey solo
| practices but having dental hygienists do cleaning is all
| I've ever seen.
| FireBeyond wrote:
| Took my step daughter to the dentist this morning. An x-ray and
| impressions. Whole process took 14 minutes. And that includes
| having her pose for front face and side face photos. Not a
| dentist in sight, just an assistant.
|
| $600.
| rayhendricks wrote:
| They billed my insurance $750 for a cleaning, I had to pay
| $0. Healthcare really is Monopoly money.
| crankylinuxuser wrote:
| And the fraud there is that they claim it's the dentist
| whom does it.
|
| Why don't insurance companies crack down on fraud like
| that?
| ghaff wrote:
| I'm pretty sure that my insurance company has a standard
| rate that they will pay out for procedures. And I'm also
| pretty sure they wouldn't pay for a $750 cleaning.
| ghaff wrote:
| That sounds bizarre. Lots of people with medical insurance
| don't have dental insurance. I do and it covers cleanings
| but, as I recall, a cleaning is around $100 or so. (I get 3
| cleanings a year and at different times the insurance I've
| had sometimes covered the third and sometimes didn't.)
|
| Crowns are around $1200 which I end up covering half of.
|
| In my experience, dental is actually relatively free
| market. Some providers (like mine) charge a bit more than
| insurance covers for things like fillings and I just pay
| it. But, even if you don't have insurance, rates are pretty
| reasonable for 30-60 minutes of a professional's time. My
| accountant certainly isn't any cheaper.
| pkaye wrote:
| The dentist office has to roll up all their costs under the
| services they provide. So the $275 contributes to all the staff
| wages and benefits, office space, etc. That is why for example
| the HVAC repairman charges $300 for changing a $5 capacitor in
| your AC. Places like Costco/Walmart can reduce the costs by
| keeping a steady stream of customers and sharing building
| space, etc.
| anotherman554 wrote:
| In theory the dentist is supposed to glance over your mouth and
| screen for gum cancer or other issues. So a three-week mail
| course is certainly an exaggeration.
| throwaway3157 wrote:
| > it could be done by someone who took a three-week mail-in
| training course.
|
| Sounds like you have healthy teeth, but your comment is fairly
| ignorant of the fact that nearly everything you described isn't
| done by someone with a graduate medical degree, but generally
| is done by a dental assistant/hygienist . I wouldn't want
| someone to touch my teeth if they haven't practiced using the
| instruments in a classroom. This isn't a programming course..
|
| > Dental assistants receive their formal education through
| academic programs at community colleges, vocational schools,
| technical institutes, universities or dental schools. Graduates
| of these programs usually receive certificates. Although the
| majority of academic dental assisting programs take nine to
| eleven months to complete, some schools offer accelerated
| training, part-time education programs or training via distance
| education. [0]
|
| [0] https://www.ada.org/en/education-careers/careers-in-
| dentistr...
| refurb wrote:
| Isn't it normally hygienists who do the routine work? With a
| DDS overseeing the process and doing the final exam?
|
| From what I've gathered, dentistry is still very lucrative. I
| knew a DDS who work 3 days a week and clears over $500K per
| year.
|
| It will be interesting to see how long that lasts.
| lowercased wrote:
| needed a root canal a few years back. went to the first local
| place. got an estimate of $2500. way too much for my blood.
| called around, got someone else to do it for around $1300.
| Found out there's actually a guy closer who does most for
| around $900+. But... I went with the $1300 lady. She was fine,
| and have been going back since. It's a bit of a drive, but the
| initial price was enough of a 'trust' factor for me, and I
| trust now that if/when I need something done, I need it done,
| and that her price will be reasonable. It might be a bad
| assumption on my part, but I did have that initial savings
| years ago. She'd be having to jack up everything else quite a
| lot to be trying to gouge me, and I don't think it's happening.
| She's just in a less expensive part of town, generally sees
| less affluent patients, and everything is priced for that
| market. That it's a 20 mile drive to get there doesn't bother
| me.
| protomyth wrote:
| I can tell you from experience that an improperly done root
| canal can come back to bite you years later. Had one done by
| IHS[1] when I was in 6th grade. During my 1st year in college
| I woke up with mouth pain that was really, really bad. Had to
| get a parent to come get me and drive me to a dentist. He
| took x-rays and found out I had an infection growing since
| the initial root canal[2]. He prescribed antibiotics and a
| massive pain reliever (Percodan[3]). It took four weeks for
| the infection to go down enough for surgery. The doctor said
| it might come back because they might not get it all. It took
| two more operations (5 and 10 years later) to fix it all.
|
| 1) given what's happened to so many other people, I feel I
| got off cheap.
|
| 2) no, the IHS dentists did not see this growing and it was
| probably slowed by the multiple antibiotic prescriptions for
| step throat in high school.
|
| 3) Took it for two weeks, I'm still amazed I was functional
| enough to take tests and program. That stuff is a whole lot
| of don't care in one bottle.
| lowercased wrote:
| understood. the procedure referenced above was from... gosh
| now, 9 years ago. no issues with it (I've had other teeth
| issues but not her fault). Wife had a bad root canal done
| by a 'fancier' place which went bad a few years later.
|
| Sort of feels like a total gamble, really.
| neonate wrote:
| https://archive.md/5r5Q2
| hiredman wrote:
| Walmart using their market power in one industry to charge below
| market rates in another, driving out competition. This is going
| to destroy health care options in areas that are already under
| served.
| dsfyu404ed wrote:
| Even if it's middle of the road service performed by
| inexperienced people starting out their careers and looked down
| on by professionals with more experience (i.e. basically how
| Walmart tire center is viewed in the automotive world) it still
| provides an alternative keeping the prices of higher class
| options in check.
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