Doctor Walmart Will See You Now

American retailers see opportunities in the primary-care business. With his long white coat, stethoscope, genially soothing manner and wonky eagerness to discuss “population health management” and “patient-centred” medicine, Ronald Searcy seems the Platonic ideal of a primary-care doctor. The most unusual thing about him is where he works: a compact facility complete with examination rooms, dentist’s office, phlebotomy lab and X-ray room tucked into a Walmart in north-west Arkansas. Since 2019, Walmart has opened 32 of these “health centres” in five states; by the end of next year it plans to more than double that number, and expand into two more states. Walmart is not the only big company expanding its medical offerings.

[…] What do these companies see in the medical business? The answer, befitting America’s Byzantine and rent-filled health-care system, is both simple and complex. The simple answer is money. Americans spend a stunning amount of it on health: roughly 18% of GDP in 2021, far exceeding the rich-country average of about 10% and more than double the ratio of some, such as South Korea, with healthier and longer-lived populations. Americans’ spending is forecast to rise by 5.4% per year over the next eight years, outpacing economic growth and accounting for almost 20% of GDP by 2031. The bulk of that spending will come from Medicaid and Medicare, federal programmes that cover health-care costs for, respectively, poor people and over-65s. The complex part reflects changes in how insurers, including Medicaid and Medicare, pay for coverage; as well as changes in how consumers are willing to get it.