A couple of Saturday’s ago, Jon Stewart, Comedy Central’s liberal-leaning host, and Fox News’ Bill O’Reilly, the conservative commentator, held a mock debate where they mixed in hilarity and irreverence with a discussion on serious, substantive issues.
When the topic of healthcare emerged, the two, as expected, took polar opposite positions. Bill O’Reilly called government largely incompetent and not set up to manage complicated issues like the nation’s healthcare system.
Stewart called for a single-payer, government-run healthcare system. He went on at length about the topic, arguing how healthcare should be divorced from employers. In other words, employers should not be in the business of managing their employees’ care while worrying about costs.
In fact, the Congressional Budget Office estimates that after President Obama’s healthcare reform law goes into effect, some employers will rather pay the fine in lieu of providing healthcare for its employees.
One company that won’t be joining them, and is also proving Stewart wrong regarding his take on employer-based insurance, is Wal-Mart Inc.
Last week, Wal-Mart announced that it would be offering its U.S. employees free heart, spine and transplant surgeries at six U.S. health centers: Cleveland Clinic in Cleveland, Ohio; Geisinger Medical Center in Danville, Pennsylvania; Mayo Clinic sites in Rochester, Minnesota, Scottsdale/Phoenix, Arizona and Jacksonville, Florida; Mercy Hospital Springfield in Springfield, Missouri; Scott & White Memorial Hospital in Temple, Texas; and Virginia Mason Medical Center in Seattle, Washington.
This expands the Centers for Excellence program that previously only covered transplants. The program provides the same care for dependents of employees enrolled in Wal-Mart’s medical plans. What’s more, the retailer will also cover travel, lodging and food for the patient and a caregiver to go to these locations.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
“Through these hospital systems, our associates will have no out-of-pocket expenses and a greater peace of mind knowing they are receiving exceptional care from a facility that specializes in the procedure they require,” said Sally Welborn, senior vice president of global benefits at Wal-Mart, in a news release. “This is the first time a retailer has offered a comprehensive, nationwide program for heart, spine and transplant surgery,”
Of course Wal-Mart is a business and this move needs to make financial sense. Without revealing the financial mechanics of the program, the retailer also said:
In providing this service at no cost to its enrolled associates, Wal-Mart has worked with these Centers of Excellence health systems to provide exclusive and unique bundled pricing arrangements for these types of procedures. Through Centers of Excellence, Wal-Mart is working with all the healthcare organizations to collectively share best practices that will allow collaboration around best measures of service and new industry findings in comparison to industry practices.
Atul Gawande, the surgeon and author who has written extensively and eloquently about medicine, healthcare quality, delivery and costs, captured Wal-Mart’s move in a simple tweet:
This will change medicine.. Walmart cuts deal for no-cost heart, spine surgery at 6 top hospitals for 1.1M workers bit.ly/QqYDV3
— Atul Gawande (@Atul_Gawande) October 12, 2012
