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Megan McArdle

Welcome to Wal-Mart, the Doctor Will See You Now

Milk, toilet paper, health care.
Milk, toilet paper, health care.

As its retail business matures into slower growth, Wal-Mart Stores Inc. wants to disrupt another mass market: health care. The company is piloting what it hopes will be a broad network of primary-care clinics. The company already has urgent-care clinics in about 100 stores, but the new facilities will provide much broader services such as chronic-disease management that are normally provided at a doctor's office. And it is doing so at an admirably low cost: A doctor's visit at one of its primary-care clinics costs just $40, in cash -- the only insurance they take is their corporate health plan and Medicare.

This model makes a lot of sense to me. Doctor's offices are, as the Affordable Care Act's designers frequently stressed, remarkably inefficient compared to most of the rest of the economy. There are a lot of efficiencies that can be brought to the market by a big company employing staff physicians and centrally coordinating things such as purchasing and information technology. And what is Wal-Mart very good at? Central coordination of purchasing and IT.