“Response to this has been nothing short of spectacular. We've generated $290 million in cost savings on drugs for our customers,” said Mr. Scott. In the last year, “35% of all orders we fill are for $4 prescriptions, and nearly 30% of these are filled without insurance.”
Mr. Scott pulled no punches about Wal-Mart's intention to push generics.
“It's about pharmacists and doctors working in new ways. The pharmacists will work with the doctors to determine if generics might be better choices. And we educate consumers about the efficacy of generics. We post full price disclosures. We encourage them to talk to doctors and to learn about generics,” he said.
If his belief in generic drugs is firm, his faith in information technology is nigh on evangelical.
Mr. Scott, who began his Wal-Mart career nearly 30 years ago in the trucking logistics department, is like many corporate leaders in nonmedical industries, who simply cannot understand why the bar-code tracking systems and standardized consumer databases that revolutionized retail and manufacturing several decades ago have not become the norm in health care.
“Wal-Mart applies technology very intensively. We can track stuff all over the world. This lowers cost and streamlines operations, improves the quality of life for employers and customers. Wal-Mart can pinpoint a pallet of laundry detergent anywhere in our supply chain. I wish it were as easy for doctors to pull a patient's electronic files. They're still using manila folders! Wal-Mart uses [radio-frequency identification] on everything, but today only 5% of hospitals are using bar codes to track medications and patient samples. That's unacceptable.”
He seems baffled by the discrepancy between medicine's 21st-century therapeutic technology, and it's early 20th century paper-based information systems.
The criticism is fair enough, provided one overlooks the fact that unlike retailers, physicians and other health care givers have little to gain financially from updating their information systems, and unlike pallets of laundry detergent, human beings have concerns about what sorts of information are recorded about them, how that information is used, and by whom it might be seen.
Though willing to acknowledge the pushback, he's not willing to settle for it. “We need to challenge ourselves and move forward,” he said. To this end, Wal-Mart is partnering with Pitney-Bowes and other major corporations to launch Dossier, an independent, not-for-profit company that will provide secure personal electronic medical records to employees and retirees who own and control their own records.
“It is safe, secure, always up to date, and doctors can have easy access to up-to-date information on their patients,” promised Mr. Scott. “If we commit to health care IT we can improve the quality of life for all 300 million Americans.”
Echoing what's become something of a mantra among corporate leaders concerned with health care, Mr. Scott argued that better information about health care pricing and quality will lead to more intelligent consumer choices.
“People don't have the tools they need. They're prevented from being good consumers of health care. There's a big disconnect between providers, patients, and the cost-value proposition. People can't compare quality. They don't know if one surgeon or hospital or medication is better than another. Imagine if Wal-Mart ran like U.S. health care, where there were no obvious differences in the products we sold, no pricing information, and the customers only saw a very small fraction of the cost of the items they bought.”
Arguably, Mr. Scott's most audacious move in the health care arena was his recent call for federally funded universal health insurance coverage. The call, issued jointly by Mr. Scott and Andy Stern, president of the Service Employees International Union, was in the context of a new coalition called “Better Health Care Together.”
In addition to Wal-Mart and SEIU, the coalition's founding organizations include AT&T; the Howard H. Baker Jr. Center for Public Policy; the Center for American Progress; the Committee for Economic Development; the Communications Workers of America; Intel; and Kelly Services. Its four “common sense” principles are:
▸ We believe every person in America must have quality, affordable health insurance coverage.
▸ We believe individuals have a responsibility to maintain and protect their health.
▸ We believe that America must dramatically improve the value it receives for every health care dollar.
▸ We believe that businesses, governments, and individuals all should contribute to managing and financing a new American health care system.
Mr. Scott said coalition members have set a deadline of 2012 for “major improvements in the health care system.”
“Ninety percent of patients going to these clinics are satisfied or very satisfied with the service,” says Wal-Mart CEOLee Scott, who plans at least 2,000 such clinics. ©Wal-Mart, Inc.