As the election cometh, we’ve spent the last few weeks exploring a specific policy idea – how we should navigate the mesh point between the government and the market, especially in healthcare. It is a high form of intellectual denial, allowing us to say we are addressing an important election without having to actually think about the clown show.
Quick digression for a pubic service announcement: As the debate commission ponders rule changes to improve candidate behavior, might we suggest they consider moving the debate to Weehawken, New Jersey, on the banks of the Hudson, but instead of pistols, give the candidates and their seconds a bag of Nerf bats and let them go at it (see Hamilton v Burr, 1804).
The role of government in healthcare is always an election topic and all COVID has done is expand that. Now the two vying campaigns are debating not only coverage of the uninsured and drug prices and anti-trust enforcement and employer mandates, but also public health strategies and vaccine approval stances.
Then right on cue comes news to remind us not to get too focused over here and miss what is happening over there.
Quick digression for some random trivia: Back in the early 1900s, silent movies would insert captions, later called sub-titles, between scenes to help the audience follow along. There were some stock phrases that theater operators could insert, things like ‘A year had passed’ or ‘Later that day.’ One such reusable caption was, ‘Meanwhile, back at the ranch,’ which then meant a literal ranch.
Meanwhile, back at the ranch (figurative kind) …now you know where that came from. You’re welcome.
Walmart announced last week that it has joined with Clover Health to offer a Walmart-branded Medicare Advantage (MA) PPO plan in eight Georgia counties.
If that sounds insignificant compared to the big national policy issues, let me reframe this for you:
- There are almost 25 million MA enrollees, a number that grows substantially every year. By comparison, just over 8 million are covered by ACA plans.
- Clover, the tech-enabled MA player, is about to be taken public with a $3.7 billion valuation. That ain’t nothing.
- The eight Georgia counties surround the first location of the full-service Walmart Health facilities. The company has announced that they will have 22 of these operational by the end of 2021.
- The Walmart MA plan will have zero-dollar monthly premiums; free primary care visits, lab tests, dental exams, and annual physicals; and access to the Walmart centers, 31 hospitals and over 8,000 providers.
Two years ago, right after Haven Healthcare was formed by Amazon, Berkshire Hathaway and JP Morgan, I noted in a talk I gave that Walmart, not Haven, would be the company most disruptive to healthcare.
I’ll double down on that and go one further…sure, keep an eye on what the government folks want to do, but back at the ranch market players are not snipping, but acting. None more so than the big yellow asterisk from Bentonville, AR.