Walmart's social responsibility
So how are they going to read or work out? They can't afford gym memberships or new books, and since Walmart's educated management obviously knows this, clearly they expect us to subsidize those things. God only knows how many millions or billions of dollars we taxpayers are paying to Walmart for schools, parks, and libraries, all for Walmart's employees.
Ridiculous, huh? The question is, of all of a person's needs and/or wants, how much should their employer pay for directly as opposed to paying cash and letting them buy/choose their own? Many seem to think that insurance ought to be one which the employer should provide directly, but even that is a misnomer. After all, the employer isn't buying "surgery" or "medicine": they are paying a third party to supply those things. A few arguments for and against employer-provided insurance:
- The employer can provide health insurance for less because of both volume discounts and because it protects the insurance company against adverse selection (unhealthy people will tend to buy more insurance, and since they know more about their health than the insurer, they will tend to get a better deal)
- Third party systems mask costs, so people tend to use more than they would otherwise. That's one reason why medical costs go up at multiples of the inflation rate.
- Healthy employees and employees with smaller families get screwed by employer-funded insurance because, while they pay the same amount in, they don't use it as much. In subsequent years, they pay more and more, but continue to use the same amount while others use more and drive prices up.
- What we call "health insurance" today is nothing like what we mean by "insurance" in other contexts. Car insurance doesn't pay for routine maintenance, oil, fuel, or other costs associated with ownership. Homeowners insurance doesn't pay for heating, water, basic repairs, or other costs associated with home ownership. But we expect health care insurance to pay for every doctor visit, every drug, every procedure that we need. We would be much better off using a cash-only basis for most visits, and catastrophic insurance for large bills (surgery, cancer, etc.). People who can't afford the latter could easily given a voucher to take to an existing insurer. A solution for people who can't afford the former would require a lot more thought than I'm going to put into this post because we would have to define preventive vs. reactive vs. defensive vs. unnecessary costs.
What about the steps they proposed taking to recruit and retain healthier employees? They specifically state that many of the problems they are seeing are obesity-related, a fact not incongruent with their poorly educated workforce. This is due, in part, to their aging workforce, and also in part to the fact that many people prefer expensive medical technology to changes in behavior. Their solution was to attract a "healthier, more productive workforce" by
- designing "all jobs to include some physical activity (e.g. all cashiers do some cart gathering)." The horror, the horror. Lack of physical activity in fact is the number one cause of obesity, not diet. This is the only one of these measures covered by the newspaper of record.
- "Offer savings via the Discount card on healthy foods (e.g., fruits and vegetables)." Oh, the humanity. The vicious capitalist pigs are going to turn their employees into mindless, emaciated vegetarians. Fascists! (By the way ... "the Discount card"? Um, how much is that perq worth?)
- "Offer benefits that appeal to healthy Associates (e.g. an education offering targeted at students)" - this is one of the signs of their move toward a more educated workforce, discussed below. Watch out, uneducated workers: the activists are coming to save you from your terrible jobs.
You would think Walmart would get a break for being the provider of low-cost groceries, clothing , and other necessaries to the lowest income Americans, but Nooooo! (to quote John Belushi).
One "bold initiative" in the memo was to introduce Health Savings Accounts (HSAs) for Associates. In other words, to control costs by eliminating the third party payer system. People who have to face costs directly are more conscious of those costs and will both shop around and weigh their options more carefully. In the present system, where out-of-pocket costs are either zero or a flat co-payment fee, people prefer the premium service to anything else because it makes no sense to take second-best when two options cost the same. After all, "this is your health we're talking about," and, " you don't cut costs when it comes to your health." Now light up another cigarette and have another bacon cheesburger!
Something barely mentioned in the Times article should set off alarms to activists. That is, the memo points out the fact that associates with 7 years seniority are 55% more expensive than those with one year of seniority, but they are no more productive. The memo then goes on to say, under "limited Risk Initiatives", that they should capture savings from current efforts to increase productivity, including reducing the number of hours per store, reducing the number of part time Associates per store, and increasing the number of hours per Associate. In other words, they are going to not hire as many low-productivity, part-time employees, and instead replace them with automation and people who can manage the automation. Translation: the largest employer of the unemployable is going to solve its reputation problem by shifting its workforce toward more educated, employable people and technology. As usual, activists are doing nobody a favor. Indeed, Walmart is so committed to this strategy that they are pushing for increases in the minimum wage because it won't affect them, but it will presure their less-technologically advanced competitors. Good job, activists: you've just threatened the meager livelihoods of the people who have the fewest choices. Now, get back in your BMW and go home to the 'burbs.
The brightest point in the memo to my eyes was an initiative to work with "high performance provider ... networks...."
The quality of care and cost of care vary significantly among doctors. We should be on the cutting edge of efforts to identify the best doctors by, for instance, working with payors to find new ways to identify these doctors.A later paragraph suggests they "continue to explore adding health clinics in stores." The world will be a much better place when someone figures out how to commoditize medicine, a solution which so far has been successfully thwarted by the most successful cartel the world has ever known: the AMA. Go get 'em, Walmart!
Labels: philosophy






