The Walmart Stampede

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I know this may come off bad.   I am trying not be judgmental of any class or type of person in this country.  Instead, I am being judgmental of our country and our culture.   When I hear people scream for a national healthcare system or socialized medicine, I try to point out that we live in a place where people’s attitudes are different.  Americans want what they want, when they want it and they want it for free.  Other cultures can handle waiting lists.  We can’t.  Other cultures don’t abuse their free medical systems.  We do. Sure, eventually and with lots of time, maybe we could change but I seriously doubt it.   I am reminded of this every time I see something like the recent “Walmart Stampede“:

Springhill and Mansfield, La. saw a stampede and a shelf-clearing rush Saturday after a computer glitch for food stamp recipients led to benefit cards allowing unlimited purchases. Police were called as entire shelves were being cleared out, until the glitch was fixed and low-income residents using the cards were no longer allowed to make purchases.

I know this wasn’t an exact example of abuse of our healthcare system but it is pretty close.  You see, people in this country will take what they can get.  They rationalize that they deserve it.  They rationalize that it is only fair because the man or the government has kept them down or never gave them a shot.  They rationalize it because they aren’t paying for it and some faceless rich person is.   The funny thing is that I believe that anyone, in our country, would do the same thing, even the rich.  I am reminded of this from John Stossel:

In my rich New York City neighborhood, politicians recently decided to hand out bike helmets, free of charge. A federal grant helped them pay for the giveaway. They told me they’ve handed out 45,000 bike helmets the past few years. I dropped by the event, and the line was around the block. Not everyone was wealthy, and I didn’t see my famous neighbors like Jerry Seinfeld and Sting in line. But I did find my city councilwoman proudly shaking hands and giving the helmets to voters. She insists that she just wants to promote public safety. But when the country is going broke, why should federal tax money pay to give free bike helmets to people in America’s richest neighborhoods?

My fear is that a national healthcare system would create a stampede just like the one at Walmart or lines around the block just like in the bike helmet giveaway.  That is why it would never work here.  Without some skin in the game, Americans would overwhelm the system so much that NO ONE would benefit.

I await your opinion on this.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  15 comments for “The Walmart Stampede

  1. Brian
    October 18, 2013 at 8:01 am

    Are Americans age 65 and older fundamentally different from the rest of the country? I don’t see the problems you worry about in the Medicare population.

    • Doug Farrago
      October 18, 2013 at 8:36 am

      Are you asking if the Medicare patients abuse the system as a comparison? Little secret, they do. Only when the money comes out of their pocket (drugs, etc) do they start cutting back. Until then, they want what they want, when they want it and they want it for free. Ditto in triplicate for Medicaid patients.

      • Pat
        October 18, 2013 at 11:48 am

        Amen. Medicare and the dependency mindset it has fostered, is an enormous ripoff. Spare me pleas that the seniors paid into it all their lives. This fatal program is a pyramid scheme that has its biggest adherents spending other peoples money. And every ER, every day and night, receives deserving seniors for minor complaints, happy to not have to pay for their convenience.

      • Brian
        October 18, 2013 at 11:50 pm

        Doug,
        Usually I’m in agreement with you but I take exception to your stance here.
        Yes there are patients who are demanding, entitled and overall P.I.A.’s, but they are a minority. I think our interactions with them jade us to people in general. Most people just want good care and will comply with advise from a doctor they have a good relationship with.
        I think it is more likely that universal health coverage would be more likely to allow certain patients to obtain necessary care that was previously unavailable to them, rather than encourage patients to pursue tests and procedures which are not needed.

        • Doug Farrago
          October 19, 2013 at 5:26 am

          Agree to disagree. And I don’t believe it would just e the PIA pts who are abusing or would abuse the system. I believe ALL AMERICANS would take advantage of it and get what they can get. Your mom, my mom, you cousin, my brother, etc. It is what we do.

  2. Nancy
    October 17, 2013 at 6:49 pm

    I am a nurse that works in Utilization review and Case Management. I too, fear the stampede for “free” healthcare. I also fear the angry outcries we will hear when they find that the procedure isn’t medically necessary or that they have to wait extensive lengths of time. We have been programmed for instant gratification. That will be gone. I have already seen “affordable” policies that have a $20,000 deductible if the insurance company wasn’t notified within 24 hours of admission (this was on a college student who didn’t have a card or a clue when admitted). And no, we could not get the insurance to accept this as an excuse and his poor parents were stuck with the horrendous deductible (people really need to read their policies). We have already seen the length of stay for many surgical procedures shortened to unrealistic short stays. Medicare patients won’t be able to have a knee replacement because soon, they will only be allowed a 2 days LOS and cannot afford the nursing home placement they will need since they aren’t physically ready to return home. They haven’t met the 3 inpatient days to qualify for Medicare skilled care so this would be at their own expense. We have seen (in my state anyway) Medicaid cut from 4 days to 3 and now 2 days for knee replacements. Our Medicaid will not even pay for physical therapy. How pointless it that? Sorry for the rant.

  3. tad hominen
    October 16, 2013 at 9:01 pm

    Doug: You DID try to be an equal oportunity critic of both the poor and the upper middle class. But massive generalizations are always dangerous, especially when being fitted for use in a philosophy. BTW, I am pretty cynical about the future and the people who will likely shape it, their overall ignorance and lack of effort to “find out why” (it is easier to just watch Fox News or MSNBC).
    Personally, I have not seen the type of behavior in the healthcare system but I live in a rural area underserved by the system and for which access to “big medicine” is difficult.
    So, somebody has to be a “gatekeeper” and “just say no” when the people show up. We tried HMOs and the business model, but that era is over. I am open to ideas about who / what that should be. The ACA may not be the answer or even a good start but it is likely the only avenue open to address a problem 20 years in the making with billions at stake for lots of already – wealthy people and corporations. Greedy does not start at the bottom of the food chain.

  4. Scribe
    October 16, 2013 at 8:25 pm

    Why is it that most physicians only now seem to be realizing the cute little monster they once favored now has grown into Godzilla? I remember a lot of physicians when this was in the works talking about how great it was, or at least how they had hopes that it would lead to better care. Yeah, everybody hates insurance companies but that isn’t an excuse to turn the whole shebang over to the IRS. How could they not see all the new rules and regulations coming down the pike? I don’t recall even the Placebo Journal/Authentic Medicine disparaging this thing to the degree it deserved.

    I am truly concerned that the ultimate end of this is computerized medicine with only the IT guys working. Crunch the numbers, dole out the prescription for the cheapest cure or remedy, and make sure Grandma doesn’t get her hip but just a few pain pills (but not too many unless she opts for the suicide option). Yes, I’m exaggerating, but we see the push, the demonization of physicians as “the rich,” Once all the statistics have been gathered for every outcome for every treatment, we can boil all medicine down to computer crunched codes that a liberal arts major could operate.

    • Doug Farrago
      October 16, 2013 at 8:49 pm

      Now, now. Don’t make me break out the old PJs. Remember the See That Patient parody or the Sixty Second Watch or The Administrators broadway play. I take offense.

  5. Lisa Gwin
    October 16, 2013 at 11:09 am

    Doug! Thank you for always publishing what I’m thinking!

    • Doug Farrago
      October 16, 2013 at 11:12 am

      No problem!

  6. Dennis
    October 16, 2013 at 10:31 am

    Walmart was informed immediately of this and could have cut off the cards after a short period, but they gave the go-ahead to continue accepting cards they knew had a fatal flaw.

    Yes, what they did was wrong, but I don’t think it was entitlement, it was a bunch of poor schleps getting something they have never had in their lives, nor will they likely ever have. They will go back to their miserable existence in their hovels while we sit in our glass houses and pass judgement on people who have never had anything. No car, no vacation, no middle class…nothing.

    Now, if you want a debate on how to end this perpetual cycle of low IQ and “entitlements”, I’m game, but sitting and passing judgement with no idea or plan to change the system makes you the entitled one. I get more pissed off on what kind of society do we have where people are so poor they knowingly take advantage of this glitch just to get ahead for however brief a time.

    How about raising the minimum wage to the bare minimum of what it would take to rent an apartment without govt assistance, or subsidized food, or subsidized income.

    • Doug Farrago
      October 16, 2013 at 10:59 am

      Please reread my blog entry. You and I are not on the same page on this. I said that ALL AMERICANS would abuse this and even gave an example (bicycle helmet). Or did you not see that? Did your unbelievably biased view ignore almost everything I wrote and some how decide that I was picking on poor people? Wow.

  7. Pat
    October 15, 2013 at 10:38 am

    This story has been told time and again…it reminded me of the “plan” enacted for a factory in “Atlas Shrugged”, one that is now playing out macro in the U.S. If the purpose of medicine is to help people feel, and bee better, then via large collective solutions, we are failing miserably.

    … But the shiftless and irresponsible had a field day of it. They bred babies, they got girls into trouble, they dragged in every worthless relative they had from all over the country, every unmarried pregnant sister, for an extra ‘disability allowance,’ they got more sicknesses than any doctor could disprove, they ruined their clothing, their furniture, their homes – what the hell, ‘the family’ was paying for it! They found more ways of getting in ‘need’ than the rest of us could ever imagine – they developed a special skill for it, which was the only ability they showed.”

    Society is on one big Michelle Obama-styled fun run toward collective wellness, where the finish line will not represent victory or even completion, only dismal equality of need.

    And I’m grabbing that last bag of jumbo Reese Cups…

  8. Jerry Brown MD
    October 15, 2013 at 7:51 am

    We now live in an entitlement culture in full bloom. The father/son attorney duo in my home town airs dramatizations of folks who’ve been “harmed” in auto/truck accidents, touting the monstrous awards they’ve won for clients because of their legal prowess. In short docudramas plaintiffs are always portrayed as being gleeful young adults and with their settlements, partying in a full throttle mode, comparable with Las Vegas “high rollers.” This law firm loves to roll their loaded dice for you and convincingly argues your payout is waiting for you, just be sure you’ve been “harmed.”

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