What's Wrong with Healthcare?

Thinking inside and outside of the healthcare box. After 41 years of family practice, what's happened to Canada's healthcare system?

Saturday, December 23, 2006

Wal-Mart One, Stelmach Zero

I love Wal-Mart. Whoever they have running their ship knows how to keep ahead of the crowd. In the last year, some left leaning groups (various unions and their leaders, the competition, and at least two democratic senators), have been bad-mouthing Wal-Mart for not providing their employees with medical benefits. Recently, a plan has been devised by this terrible capitalist entity that I think has significant merit, and may revolutionize primary health care.
It is common knowledge that 50,000,000 Americans do not have health coverage and many, many Canadians cannot find family doctors. Emergency wait times are many hours long and even walk-in clinics in Canada cannot keep up to the demand, with many of them limiting their hours because of staff shortages. Recently, governments in Canada have been in discussions with pharmaceutical associations in Canada, and physician Colleges, to allow pharmacists to prescribe medications for minor conditions. The medical associations have concerns about pharmacists diagnosing, but, what if the pharmacist could work closely with a doctor------closely, as with “ connected electronically”?
Recently my daughter had a rash. She not only told me about the rash, but also E-Mailed me a colored picture of it. Apparently Wal-Mart is looking at electronically providing some primary medical care to it’s workers and its customers. These customers could talk to the pharmacist, the pharmacist would E-Mail a doctor the complaints, a proforma questionnaire would be E-mailed back to the patient (or the pharmacies could have them on hand), they would be filled out by the patient, with comments/pictures added by the pharmacist (or nurse/pharmacy practitioner, and a collaborative decision as to a course of action would be made. The physician could charge half as much (no overhead to speak of), and the pharmacy would get the business from a pharmaceutical and other business perspective. My understanding is that a few physicians would service all of the Wal-Mart stores in a state or province (or health region). Moneys would be collected by Wal-mart and the physicians would be paid by Walmart. The result would be a significant decrease in the cost of a large portion of primary care, and partly subsidizes by Wal-Mart.
Now, to be fair, I’m not sure if the above is precisely what Wal-Mart is proposing, but from what I have heard, it comes close. Many pharmacies have already expanded their services to include health promotion. To facilitate this, the provinces in Canada should allow and encourage health savings accounts; a tax deductible account similar to an RRSP.
The bottom line is this: I don’t think our governments will ever solve our health care dilemma in Canada. Mr. Stelmach got elected recently in Alberta because, at least in part, he promised nothing. Moving forward generates criticism, doing nothing keeps the politician under the radar screen. So be prepared for “nothing” in terms of health care reform in Alberta in the foreseeable future.
In business, maintaining the status quo is a death knell. As demand increases, solutions must be found, or the competition passes you by. My prediction for 2007 and beyond: “Big business will help us find solutions to healthcare, the demand is there, governments simply have to unlock the door”.


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