Check this...
Phil Tedesco’s post, “Giving Health Care Away,” reminded me of yesterday’s New York Times article about CheckUps, a privately owned, for-profit chain of walk-in medical clinics housed primarily in Wal-Mart stores throughout the country. The article announced that CheckUps has shut down 23 of its Wal-Mart-based clinics, “apparently running short of cash to pay its bills,” according to a lawyer for one of its creditors.
CheckUps is just one company among several in a rapidly expanding model of health care delivery, often called “retail health care,” that is proliferating in grocery store and drug store chains throughout the country. While some of the clinics are head up by doctors, most are run by nurse practitioners who are limited to providing only routine medical care, like giving flu shots or prescribing drugs for sore throats. Visits are estimated to range between an average of $40-$60.
Some praise the clinics as convenient and affordable alternatives to having to wait in a long line at the emergency room just to treat a common cold, or having to wait days before getting the appropriate medication for strep-throat. Traditional primary care doctors, who are threatened by these clinics, disagree, and argue that they destroy the longer-term doctor-patient relationship that is necessary for quality care. What do people committed to financial security for most American families think about these clinics?
I don’t know what I think. My instinct is to be concerned that this model actually exploits lower and middle income families, charging them exorbitantly for the same care that they could get from WebMd. (besides the prescription).
Last year, the Wall Street Journal reported that there were 325 of these retail clinics operating nationwide, seventy-six of which were in Wal-Marts in 12 states. Last April, Wal-Mart announced its plan to expand to 400 clinics by the end of the decade and 2,000 in five to seven years. Investors are pouring hundreds of millions of dollars to finance the expansion of these companies.
Who uses these clinics? Yesterday’s article says, “operators say their main clients are mothers with small children, and that about 30 percent do not have a family doctor.”
Retail health care is a darling among many who believe that “the market”—by itself—will do just fine solving our health problems. CheckUps’ collapse provides a moment in which we should ask important questions about the model. First, how do these clinics affect lower and middle-income American families? Are these the health-care analog to payday lenders? Are they are they financially sustainable? And finally, what does their proliferation mean in the context of the nation ever moving towards a policy of government-subsidized universal health care?
Such walk in "consultarios" are widely available here in Mexico, often associated with pharmacies, of which there are very many. Likewise there are dental consultarios.
They provide an economical and convenient means for folks to receive a diagnosis.
The doctors in the USA could use the competition.
February 2, 2008 7:53 AM | Reply | Permalink
Here is something to consider when thinking about universal healthcare...
Step by step we are moving toward a system in which the federal government will pay for all health care, and regulate it from the top down. You will have no choice . . .
• You will have to pay for this monopolistic system, whether you like it or not.
• The price you pay, and the kind of care you receive, will be determined by government dictates, crafted behind closed doors, in consultation with powerful corporate interests.
This is a recipe for health care fascism. One of the hallmarks of fascism is the use of partnerships between government and corporations, controlled by regulatory boards. Benito Mussolini described the theoretical framework, as follows . . .
"The corporate State considers that private enterprise in the sphere of production is the most effective and useful instrument in the interest of the nation. In view of the fact that private organization of production is a function of national concern, the organizer of the enterprise is responsible to the State for the direction given to production. State intervention in economic production arises only when private initiative is lacking or insufficient, or when the political interests of the State are involved. This intervention may take the form of control, assistance or direct management." (pp. 135-136)
—Benito Mussolini, 1935,
Fascism: Doctrine and Institutions, Rome: 'Ardita' Publishers.
In practice, such a system amounts to corporate welfare combined with price fixing and protectionist measures to restrain competition. It is best defined by the concept of "regulatory capture" by which corporate interests gain partial control of the state.
A good example of how this works in practice is shown in a clip from "60 Minutes" ( http://www.cbsnews.com/sections/i_video/main500251.shtml?id=3108688n ) about corporate involvement in the creation of the prescription drug entitlement.
This is the system we are building. This is what we must prevent.
Many things need to be done to fix our health care system, but first we must stop further steps in the direction of corporate fascism. As the doctors say, "First, do no harm." Toward this . . .
Even those who favor further government involvement in health care should strongly oppose . . .
Any additional funding of personal health care expenses at the federal level.
Federal funding means top-down control with one-size-fits-all policies. Federal involvement means policies crafted by K Street lobbyists for the benefit of powerful special interests. Federal involvement equals corporate fascism.
If you favor government funding for personal health care expenses, seek it at the state level, and oppose it at the federal level.
Everyone, regardless of their overall position on health care, needs to tell Congress to have a healthy regard for the 10th Amendment, which reads . . .
"The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people."
The Constitution grants no power for the federal government to either fund or regulate health care. The fact that the feds are already doing so provides no justification for compounding the wrong by doing more of it.
February 21, 2008 12:38 PM | Reply | Permalink