This story from the LA Times is not directly about Walmart, but it's worth a read anyway. It details the problem associated with workers who don't have paid sick leave and may be disciplined for taking time off of work when they get sick. The Senate is currently working on a bill that would provide paid sick leave for most employees in the country which is not only a great relief for many working folks, but really good public policy to boot. It will help folks out who really shouldn't be working and help to stem the spread of the flu and other contagious viruses. Of course it is unfortunate that companies aren't doing this on their own. You would think that businesses, especially retailers like Walmart, would want to make it a point to not spread the flu among their employees, not to mention their customers.

Of course it should come as no surprise that Walmart's policy strongly encourages employees to come to work sick through demerit points and loss of wages. We wrote about their policy here. We're also working with Moms Rising on this issue, and you can go sign their petition and send Walmart a demerit badge for their terrible sick day policy.

Read the full story from the LA Times here.

I don't know a Walmart executive who couldn't use more pieces of flair.

Luckily, MomsRising.org is on the case. They are calling on Walmart to amend its unfair sick day policy through a new online petition, and there is a creative twist. Sign the petition on their site and your letter will be given to Walmart HQ, along with real demerit badges for Walmart's executives.

Don't let your favorite Walmart executive go without: send them a badge of shame today!

One of the best ways to stop the spread of the flu (like H1N1) is for sick people to stay home. But Wal-Mart gives employees "demerits" that can lead to termination if they call in sick!

We think the real demerits should go to Wal-Mart for their bad sick days policy, which risks making the public sick and their employees sicker.

Give Wal-Mart a "Demerit Badge" by signing the petition today! We'll deliver your signatures, along with real demerit badges, to Walmart executives to call them out for their terrible sick days policies.

Sign the petition:

Wal-Mart: Stop your policy of giving employees demerits for taking sick days. It's bad for your employees, your customers, and for public health.

Last month, Walmart Senior VP Ken Senser issued a company-wide memo on flu season 'preparedness.' His memo claims "the wellbeing of our associates... is a top priority," and offers guidance on how to "plan ahead" in case the flu virus strikes.

Be prepared for illness: know the company's sick day policy, the memo advises.

Of course, there is a catch-22 here. Walmart's sick leave policy boils down to a simple formula: if you get sick, you find trouble. Each sick day taken by a Walmart employee results in a "point" (demerit), enough of which will get you fired.

Walmart's sick policy results, as this week's NLC report shows, in a culture that pressures employees to work while ill. This isn't just grossly unfair, it's unbelievably stupid. Given the rapidly expanding H1N1 pandemic, steering sick workers out of bed and into the aisles is a catalyst for spreading sickness among employees and customers alike.

Which genius in Walmart management could possibly think this is a good idea? Ken Senser.

Here's a little background on Walmart's spymaster turned health "advocate." Before Mr. Senser was concerned with influenza, he was spying on employees and activists alike as Walmart's security chief. His crowning acheivement came when company operatives planted a long-haired employee in an "Up Against the Wal" activist meeting. The bugged employee transmitted audio from the meeting to a surveillance van circling eerily outside.

Senser's department also spies on employees who are suspected of violating company policy. His investigators have tailed executives across Central America, for example, to out them publicly for extramarital affairs. This is the guy entrusted with safeguarding the wellbeing of Walmart's 1.4 million U.S. employees. Bizarre.

His de facto role, it would seem, is safeguarding Walmart's $13 billion in yearly profits. By any means necessary.

Senser is known for bare-knuckle enforcement of policy. Unfortunately, Walmart's rigid attendance rules are not productive for anyone. Not even Walmart's top shareholders. It's simply a recipe for spreading disease among employees and members of their communities.

At least some government officials are looking out for Walmart's employees. HR 3991 could cause Walmart to reconsider its policy by requiring large employers to give 5 days paid leave to sick employees.

It might well be called the "Walmart Swine Flu Bill"--with policy enforcers like Ken Senser, Walmart is unlikely to make productive changes to its sick policies until regulations force it to.

When you get sick, do you take the day off? You should, especially if you have the flu or other viruses that are easily spreadable. The Centers for Disease Control and Prevention agree, but Walmart, through its corporate policies, are not heeding that advice. In fact, a new mini report from the National Labor Committee shows that Walmart employees regularly come to work sick because they can't afford the loss in wages or because they are afraid of being fired for taking 'too many' sick days. The whole report is worth a read, but here are a few key pieces:

But it is Wal-Marts policies on sick leave that are the problem. Wal-Mart has a punitive point (demerit) system that punishes workers who cannot come to work because they are ill or their children need care. Associates who miss a day due to sickness (or for any other reason) will receive a one point demerit, along with the loss of eight hours wages. Moreover, employees who “have more than three absence occurrences in a rolling six-month period…will be disciplined.” (“Attendance/Punctuality Policy (PD-52) New York,” January 2008.) Workers with four absences in any six-month period—no matter what the reason—will be disciplined. A fifth occurrence—like a sick day—will result in “active coaching” by management, and a sixth occurrence” will activate a “Decision Day,” when an “associate” can either be terminated or put on a year-long trial period, during which a worker can be fired for any infraction, no matter how insignificant. During this year-long probation the worker cannot receive a promotion.

Wal-Mart must immediately end its punitive point system, which gives workers demerits that can lead to firing for taking a sick day, while also docking their wages. More than any other Wal-Mart policy, it is the point system and loss of wages which routinely drives employees to work no matter how sick they are, including if they are suffering flu-like symptoms...

...The vast majority of current Wal-Mart employees are too terrified to speak openly and on the record, or even to name their stores for fear of retaliation. "Everyone knows you have to be quiet," as one associate put it, "We cannot talk. Everyone is afraid and will never say anything critical" of Wal-Mart. A senior Wal-Mart employee agreed: "Fear and need will keep things as they are."

It's not a huge surprise, really. We hear from workers every day who can't take sick time. But as flu season rolls around, and as H1N1 adds an additional level of concern, it's time to take a look at Walmart's policy again. Not only is this bad policy in general, bad for the workers and bad for the customers, it is potentially bad financially for Walmart. If, instead of going to work when they have the flu and getting seriously ill, Walmart allowed their workers to take a few days off and get better, perhaps Walmart's work force would be more efficient and they wouldn't have to pay so much in health care costs.

If you are an Ohio taxpayer, you may be footing the bill for Walmart's unaffordable health care plans.

Newly released data shows that Ohio spends roughly $68.5 million each year covering for Walmart. The numbers are staggering. Over 15,000 Walmart employees and their dependents use Medicaid, 12,000 are on food stamps, and thousands more utilize other state-run programs.

Ohioans, Walmart doesn't need your money to support its employees. With nearly $14 billion in profits last year, Bentonville can clearly afford to do better.

Don't allow Walmart to fail its employees and your state. Please take action today: inform your local newspaper about Walmart's exploitation of Ohio's health and welfare programs.

Write Your Newspaper: Let Your Community Know That Walmart is Failing Ohio

Walmart claims to support health care reform and the employer mandate. Yet, In spite of astronomical profits, Walmart fails to cover nearly 700,000 of its employees and offers plans too costly for its average employees to afford.

Walmart claims that only 2.6% of its employees use Medicaid. Yet, in Ohio, the number appears to be much higher.

Walmart's claims simply don't add up, and your state needs to know about it.

Why is Ohio subsidizing the #1 company in the Fortune 500? Let Ohio know that you won't allow your tax dollars to be a stopgap for Walmart's low wages and unaffordable health coverage.

Write a Letter to the Editor Today

With your help, we can make Walmart live up to its responsibilities to its workers and to Ohio.

The Team,
WakeUpWalMart.com

Yesterday the Ohio Department of Job and Family Services released a report ranking major employers by their employees' reliance upon various state run programs like Medicaid and food stamps. With health care reform on the front burner of the American political agenda, this is obviously a pretty important report. It shows that large companies are shirking their responsibilities and forcing tax payers to subsidize them, and guess who was at the top of the list in Ohio.

That's right, Walmart has more than 15,000 employees and their dependents in Ohio on Medicaid, costing state taxpayers $68 million a year. Walmart has higher Medicaid and food stamp numbers than any other company on the report.

If you read this blog regularly, you know that Walmart is attempting to convince the American people that their company is a positive force when it comes to health care. They've run ads, started programs, attempted to open health clinics in their stores, and more. But stories like this throw Walmart's credibility in to question. How can we trust a company on health care when it fails to cover nearly half of its own employees? How can we trust a company on health care when they are slashing benefits for their own employees? How can we trust a company on health care when they claim that only 2.6% of their workforce in America relies on Medicaid when, in Ohio, the number appears to be so much higher? If Walmart really believes in health care reform, they need to lead by example. If Walmart really believes in health care reform, they need to offer quality affordable health care to their workers.

The Health Care stories just keep coming! A little over a year ago, Walmart announced that they would open several hundred walk in health clinics in their stores. They touted this as part of a solution to our health care crisis in the US. If you haven't noticed a walk in clinic popping up in your local store, that's because the plan tanked. The company who was supposed to open clinics in Walmart stores instead closed their existing clinics and walked away from Walmart. Today, Walmart only has 33 clinics (down from 78 in the beginning of '08) and is now looking to build that number back up.

Of course this is part of Walmart's PR push to get their name associated with 'health care' in a positive light after taking years of flack for not offering their associates quality affordable health coverage (and of course, to make a lot of money). Walk in clinics fit right in with Walmart's low price model too, but many see clinics as a limited solution. They can only treat specific kinds of ailments, and, like Walmart's mail order, many worry about the quality and continuity of care patients will get.

Here's what the New York Times has to say about Walmart's renewed efforts to establish walk in clinics:

Wal-Mart’s medical clinics are coming out of rehab.

Early last year, the company spoke of having 400 walk-in clinics by 2010. But later in 2008, that plan went into reverse. Of the 78 clinics Wal-Mart had in operation at the beginning of 2008, all but 17 were closed.

Now it is rebuilding that business, this time largely in partnership with hospitals.

Originally, H. Lee Scott Jr., the Wal-Mart chief executive who retired this year, had assigned a big role for the clinic project to RediClinic, a privately held company backed by Steve Case, the AOL co-founder. But last December RediClinic, citing the poor economy, abruptly shut down its 15 Wal-Mart centers.

One of the major issues this campaign, and others like it, had with Walmart when they first started up, was its lack of quality, affordable health care. It was a major issue then, and it's still a major issue, but Walmart has spent a considerable amount of time and money trying to detach that negative stigma from their name. One of the ways they've done this is by opening health clinics in their stores, selling Electronic Medical Records Software, and running disingenuous ads. Essentially, Walmart is trying to do anything they can to get their name connected with "health care" in terms of consumers rather than workers. But, because Walmart is obsessed with low prices over all else and because many of these stunts are about the PR and not the product, the results end up being shoddy.

Some Pharmacists are worried that Walmart's new mail order prescription drug program will similarly be sacrificing quality for profit and, in our opinion, PR.

Here's what The Grand Rapids Press has to say,

Wal-Mart touts it as expanding access to affordable prescriptions along with its existing $4-for-30-days generic program.

But the National Community Pharmacists Association issued a statement saying the program raises questions about patient safety and the cost of treatment when drugs are used improperly, which has been estimated at $177 billion a year.

"Clearly, more patients risk adverse drug events, and the resulting treatment costs would soar if the patient's primary community pharmacist is traded for envelopes and 1-800 numbers," the statement said.

Pharmacist Jim Byington, co-owner of the Village Pharmacy and Ada Hillside Pharmacy, said customer interaction is key.

"Especially with a lot of our seniors, it's a big part of being able to keep track of how they're doing," he said.

Byington listed several examples where familiarity with the customer flagged important issues with their medication, including a new prescription from a specialist clashing with current medication ordered by a previous doctor.

"And when one of our patients is admitted to the hospital, if there are questions related to the medication they take, they call us," he said. "There's not a day that goes by that I don't get a call from one of our three hospitals."

Mike Rose, pharmacist and co-owner of Parkwood Pharmacy, 1106 Burton St. SW in Wyoming, said it is another marketing ploy, and customers must do some research for the best deal.

Wal-Mart and other large chains may offer cheap or free medications, "but they are overpriced on some of the other items not on their hot list," he said. "That sometimes offsets the free medication. The total still may be more than at their normal pharmacy."

He also said the number of people without prescription drug insurance is shrinking thanks to Medicare Part D and other programs.

"Less than 10 percent of our prescription sales are cash sales," he said. "Everything else runs through insurance."

So Walmart just release a new ad saying, " At Walmart we’re proud to report that 94% of our full time and part time associates have some type of health coverage, but we won’t be 100% satisfied until every American has quality affordable health coverage." Here's our official statement on the ad:

IMMEDIATE RELEASE May 4, 2009

WALMARTS NEW AD ON HEALTH CARE: ALL TALK, NO ACTION

WakeUpWalmart.com Calls On Americas Largest Private Employer To Start By Offering Its 1.4 Million Workers Quality Care They Can Afford

Today Walmart released a new ad about health coverage. "At Walmart were proud to report that 94% of our full time and part time associates have some type of health coverage," the ad begins, "but we wont be 100% satisfied until every American has quality affordable health coverage."

Walmart is right -- every American should have access to quality, affordable health coverage, and that includes Walmarts 1.4 million U.S. workers, said Meghan Scott, Director of WakeUpWalMart.com. Walmart should start by offering their own employees quality, affordable health coverage instead of forcing so many on to public assistance.

Walmart claims that 94 percent of their employees have some type of health coverage. Of course they dont say that only 52 percent of employees get it through Walmart - which falls far short of the industry average of 65 percent. Walmart fails to cover nearly 675,000 of its employees, leaving many workers to enroll in state-sponsored plans like Medicaid or the State Childrens Health Insurance Program (SCHIP)."

In 2005, Lee Scott, Walmarts former CEO, admitted that, "In some of our states, the public program may actually be a better value -- with relatively high income limits to qualify, and low premiums."

###

You can see the ad after the jump.

Over at the Software Advice blog, they've got a post arguing that Walmart's recent move in to the e-Medical Records (EMR) business was a well intentioned, but strange move that ultimately won't reduce the overall costs of e-systems like the one Walmart is selling. Author Don Fornes argues that Walmart's intent is to, "simplify a traditionally complex and expensive purchase by distributing through a low-cost distribution channel." While we agree with Software Advice's general analysis of why this is an odd pairing, we disagree with Walmart's intent. We think Walmart's motives for jumping in to the e-Medical Records business can be summed up by two little letters: PR.

When this campaign first started, one of the biggest criticisms of Walmart was (and still is) that they didn't offer their employees adequate health insurance. Not only was their insurance hard to get and prohibitively expensive, many of Walmart's employees were paid so little that they qualified for state sponsored health care and were encouraged by their employer to go on such programs. By doing this, Walmart was passing on health care costs it should have been covering to you, the tax payer.

Walmart realized that they were getting bad press over this issue and set out to turn the tide using their expensive PR firms instead of making any real change. They released a "new" health insurance plan that made little difference to the average Walmart employee but sounded slightly better, talked about how great it was, and made sure the push it hard to the press.

Walmart selling e-Medical Record software is just the next phase of their PR program to ensure that when the average American thinks "Walmart" and "Health care" they think about what Walmart sells, and not about how Walmart is shirking their responsibility to its 1.4 million employees.

We think Software Advice's post backs up our point. They argue that EMR systems won't take advantage of Walmart's economy of scale advantage, and consumers will want an expert's help when buying a such a complicated system. Softwart Advice points out that this is not a natural fit for Walmart, and we agree. It wasn't some ill considered decision, or a quirky new product Walmart is trying, though, it is a PR move, pure and simple.

One of the biggest criticism we here at Wake Up Wal-Mart have always had of the world's largest retailer is that they fail to take care of their workers. Specifically, we've always found their health care criminally lacking. While Wal-Mart has made a few small steps in the right direction (due to our constant cajoling) their coverage remains pitifully inadequate. Today two items came out that prove Wal-Mart is having their PR department press hard on the message, "look how awesome we are at health care! We've totally turned things around!" The first is a Reuters article in which Wal-Mart brags that:

the number of U.S. employees who have health care coverage through its plans or another source has risen to 94.5 percent from 92.7 percent a year ago.

The world's largest retailer said more than 733,000, or 51.8 percent of its U.S. employees, were covered by its own plans as of Nov. 7, 2008, the end of its annual enrollment period.

Wal-Mart said that is up from 50.2 percent who were covered by its own plans a year earlier.

The second is a Washington Post article that claims that "the world's largest company has become an unlikely leader in the effort to provide affordable care without bankrupting employers, their workers or taxpayers in the process."

Needless to say, we see right through Wal-Mart's bragging and we disagree with the Post's assertion.

Here's the statement we put out regarding Wal-Mart's health care coverage:

IMMEDIATE RELEASE February 13, 2009

CONTACT: Meghan Scott

WAL-MART’S HEALTH COVERAGE STILL WOEFULLY INADEQUATE

Today, Wal-Mart announced that the percentage of its employees on Wal-Mart health insurance plans rose from 50.2 percent to 51.8 percent.

“While Wal-Mart likes to brag about its new and improved health care plans, the reality is that America's largest private employer is leaving thousands of its workers without insurance and forcing thousands more to depend on state aid,” said Meghan Scott, Director of WakeUpWalMart.com. “Wal-Mart’s so-called improvements also force employees to choose between high monthly rates or pray every day they don't get sick."

Nearly half of employees decide not to purchase insurance through Wal-Mart, often because they cannot afford to. The 51.8 percent of employees on Wal-Mart plans falls far below the average for large companies (those with 1,000 or more workers), which cover 65 percent of their employees. Eighty-five percent of Costco’s employees are insured through the company.”

Wal-Mart has a long history of using state health insurance programs to subsidize the employees it does not cover. Former CEO H. Lee Scott even explained that, “in some of our states, the public program may actually be a better value- with relatively high income limits to qualify, and low premiums.”

Those who do opt to purchase Wal-Mart’s health insurance also face a harsh reality. An average full-time employee who chooses the least expensive insurance plan has to spend more than 20 percent of their income. Cynthia Murray has worked for Wal-Mart for nine years and can’t afford to spend $180 on healthcare premiums every two weeks when her average paycheck is only $489.”

“The world's largest retailer refuses to offer health care its employees can afford. Wal-Mart can throw out a bunch of numbers, but as a company that made $12 billion in profit last year Wal-Mart has the ability and responsibility to do better by it’s 1.4 million employees.”

One of Wake Up Wal-Mart's major issues since its beginning has been health care. Wal-Mart's woefully inadequate coverage not only puts individuals at risk, but forces you, the tax payer, to foot the bill for their greed when Wal-Mart employees look to the state for help. Wal-Mart got a lot of credit last year when they announced they were overhauling their health coverage. We knew better though, and since then it has consistently been shown that Wal-Mart hasn't changed. As recently as this month, a report came out showing that Wal-Mart employees still rely heavily on state aid for health care.

Today, however, we learn that Wal-Mart is once again reforming their health care. This time, they're focusing on maternity care and anti-smoking programs. There is nothing wrong with this, both are important pieces of keeping a work force healthy. The problem is, it's a little like adding a shiny new mirror to a car with a broken engine and transmission. The problem with Wal-Mart's health coverage isn't that it doesn't provide for adequate maternity leave, the problem is that it's either affordable but provides close to no coverage, or far too expensive for the average Wal-Mart employee.

Once again Wal-Mart is showing that they'd rather put out a press release than keep their employees healthy. Sure, they'll get some good PR out of this, but their employees are suffering because of it.

Here's the story from Reuters:

Wal-Mart expands worker health benefits

ATLANTA (Reuters) - Retail leader Wal-Mart Stores Inc said on Tuesday that it was expanding health benefits for workers, including offering a 2009 program that provides pre-pregnancy and child development services.

The company said a "Life With Baby" program in next year's benefits package would provide workers counseling with registered nurses through all phases of maternity.

It said that plan also includes expanded benefits such as periodontal cleanings to help prevent gum disease in mother and child, and a new program designed to stop smoking.

In a statement, the retailer said about 15,000 of its workers have babies each year.

Wal-Mart also said its 2009 health plan offerings would provide added preventive coverage such as mammograms, colonoscopies and flu vaccinations to workers.

Earlier this year, Wal-Mart said 92.7 percent of its employees have health-care coverage, including 50.2 percent who are covered by the retailer's plan. Wal-Mart has 1.4 million U.S. workers.

Last year, facing tons of pressure for the public, consumers, and the media, Wal-Mart announced it was overhauling its health care plan. It was a crass PR move (followed by more PR moves) in order to silence critics, and it did little to help its employees stay healthy.

A new study by Policy Matters Ohio shows that Wal-Mart's Health Care PR stunt was, well, a PR stunt. It has made no demonstrable difference in the number of their employees enrolled in state medicare, despite what their press releases say. Indeed, Wal-Mart is responsible for more workers on state Medicare than any other company. It is a true shame that Wal-Mart refuses to live up to its responsibility of providing affordable and decent health care to its employees. Instead Wal-Mart forces its workers to rely on the government, and you, the tax payer, foot the bill for them.

Check out the new report from Policy Matters Ohio titled PUBLIC BENEFITS SUBSIDIZE MAJOR OHIO EMPLOYERS: A 2008 UPDATE.

Marred with a bad rap on Health Care, Wal-Mart launched an aggressive PR campaign meant to change the perception that Wal-Mart offered terrible health insurance and relied on the Government to subsidize health care for its employees. They unleashed a 'new' insurance plan which still left a large percentage of employees uninsured or on government insurance, and they opened in store health clinics and heralded them as the savior to the health care problem. In May, it seemed that those clinics were ill-fated. They weren't making much money, and one of the largest companies running such clinics shut quite a few down. Now it seems that more of Wal-Mart's clinics have shut down. With no warning, and with no reason given, 15 clinics shut down in Colorado.

Once again, we wonder about these clinics. Are they really a solution to our problems? Wouldn't it make more sense to just have good, affordable insurance? What happens to the working families, including Wal-Mart employees, who, for a short period of time, depended on these clinics because they didn't have insurance now that they are closed? Instead of doing the responsible thing and offering quality, affordable health insurance to its employees, Wal-Mart has attempted to turn health care in to something they can make money off of. We think that is a shame.

Here's the full article from the Rocky Mountain News:

SmartCare closes 15 Wal-Mart med clinics

SmartCare Family Medical Centers on Friday unexpectedly shut its 15 in-store health clinics located in Wal-Mart stores throughout Colorado.

Wal-Mart had no prior notice, company spokesman William Wertz said.

SmartCare's public relations agency issued a statement confirming the closures and referred questions to the company's Texas headquarters, which didn't return a call.

The in-store clinics treated common medical problems like strep throat and ear infections for a $65 flat fee. The clinics, staffed with nurse practitioners, were open from early morning to late evening seven days a week for walk-in appointments.

Several other operators of in-store health care clinics, including New York-based CheckUps, have closed sites amid high operating costs. Last month, CVS/Caremark, the parent of MinuteClinic, said it was curbing growth plans and might shutter some locations.

Wal-Mart contracts with a number of clinic operators nationwide and remains committed to the idea, Wertz said.

It's too soon to tell what Wal-Mart will do with the SmartCare clinic locations, he said, but the store might consider a partnership with local medical centers or other providers.

Wal-Mart is trying to brand itself a leader in health care. They've rolled out cheap prescriptions, changed their employee coverage (as paltry and sad a change as it was), and opened in store clinics. CEO Lee Scott even chastised business leaders for not weighing in on health care policy (we won't harp on the obvious irony). But this latest news from the Wall Street Journal is likely to throw a wrench in Wal-Mart's PR plan. It seems that Walk In Clinics are hard to manage, and they're hard to make money with. What with Wal-Mart's obsession with making gobs and gobs of money, it'll be interesting to see how long Wal-Mart's clinics will last. Wal-Mart had long touted these clinics as a cost effective solution to health care. It would eliminate doctors visits and safe people money, they said. It was, in essence, Wal-Mart's scheme to fix our health care crisis. Instead, we think Wal-Mart should offer affordable, quality health care to its workers, and legitimate policies on sick days. They can't make a ton of money off of it, but I'm pretty sure it'll work better than walk in clinics at keeping people healthy.

Here's the story from the Wall Street Journal:

Health Clinics Inside Stores Likely to Slow Their Growth

The boom in walk-in health clinics located inside pharmacies, supermarkets and big-box retailers is showing signs of slowing.

Hailed as an inexpensive option for treating minor health ailments like sore throats and rashes, the retail clinics have grown in
number to 963 as of May 1 from just 125 three years ago. The clinics typically feature nurse practitioners who can prescribe basic drugs, and the price for a visit ranges from $50 to $75.

But in recent months, retail health-clinic operators based in New York, Nevada, Indiana and Alabama have closed their doors, shuttering 69 clinics in 15 states, including ones operating inside outlets of Shopko Stores, Meijer Inc., Bi-Lo LLC, Wal-Mart Stores Inc. and the Medicine Shoppe unit of Cardinal Health Inc.

Now, the biggest retail-clinic operator, CVS Caremark Corp., says it is scaling back expansion plans for its Minute Clinic brand.

"We have seen fallout in this industry, on a smaller scale, that is not unlike the dot-com bubble," says Tom Charland, the owner of industry consultant Merchant Medicine LLC and a former vice president for strategy at Minute Clinic. "The big mistake was for people to think they could reach break-even in six months," he says. "People are learning this is an 18-to-24-month process to get to break-even."

Mr. Charland says the venture capitalists and private-equity firms that backed many of the retail clinic operators failed to appreciate how complicated and expensive the clinics are to operate. Research shows that patients are enthusiastic about the clinics' convenience and quality of care, but acceptance has been slow.

CVS, which operates more than 500 Minute Clinic facilities, says its plan to scale back expansion is part of a change in strategy. David Rickard, chief financial officer, told analysts last week that the company expects to add 100 clinics this year, down from a prior estimate of 200 openings. He said the company may also close some Minute Clinic locations that aren't in CVS outlets. He said that CVS will focus on "enriching" services at Minute Clinic facilities rather than expansion, and that the company believes Minute Clinic will be a "terrific, successful little business."

Some operators are finding that the clinics are complex to manage. Earlier this year, Check Ups, a clinic operator based in New York, abruptly closed 23 clinics that it operated inside Wal-Marts in Florida, Mississippi, Alabama and Louisiana. It was stretched thin by operations in multiple states, says company spokesman William Armstrong.

"You have to have a critical mass of stores seeing a high number of patients to get somewhere," he says. He adds that new clinics need to spend a lot of money on marketing to build public awareness and that the clinics become expensive quickly. "We ran out of operating funds," he says.

Not everyone is trimming sails. Walgreen Co. says it still plans to more than double the number of its Take Care health clinics this year by adding about 240 locations between now and the end of the year, bringing it closer to the number operated by rival CVS. The expansion will cause a drag on earnings in fiscal 2008 of five cents a share, the company says.

Tina Galasso, an analyst who follows the retail clinic industry for Verispan LLC, says the cost of setting up an in-store clinic runs about $500,000. That is one reason why much of the future growth in walk-in health centers is expected to come from big companies with deep pockets and from hospital systems that are already well-known within a community and don't have to spend so much on marketing.

In a strategy that combines both elements, Wal-Mart plans to partner with hospital systems to open as many as 400 co-branded store clinics by the end of 2010, up from about 50 sites in operation now. That approach is a departure from an earlier strategy under which Wal-Mart leased space to operators like Check Ups that weren't associated with hospital systems.

It's shocking, but this is the second time in just a short while that we've agreed with something Lee Scott has said. First it was his "Wal-Mart is not green" comment, and now Lee Scott is criticizing business leaders for not stepping up and taking a stand on the health care crisis. In a Financial Times interview the CEO said, "I think government is going to be engaged after this election regardless of who wins, and I think business should be more involved in the discussion." We agree! although it is odd that of all the CEOs of all the companies in the US, Lee Scott is criticizing other business leaders. It is odd because Wal-Mart isn't exactly known for top-notch insurance, or expansive coverage.

Unfortunately, we don't think Lee Scott means that businesses should start trying to figure out how to cover more of their employees with better insurance programs because health and happy employees are more productive. Rather, we think he probably means that businesses might want to start combating plans that may cost companies some money now, before the politicians force them into it. I guess we don't agree that much.

Here's the article:

The chief executive of Wal-Mart has criticised US business for not taking a lead in the debate on the future of US healthcare ahead of the presidential elections in November.

Lee Scott said in a Financial Times interview that he was "not particularly encouraged" by the public debate on the issues.

"I think business has been absent in this debate on healthcare. I'm not sure why," he said.

"I think government is going to be engaged after this election regardless of who wins, and I think business should be more involved in the discussion. I think it has long-term ramifications for our global competitiveness."

Mr Scott said Wal-Mart, which has more than 1.3m US employees, had not taken "a firm stand" on what a national healthcare system might look like.

The retailer has in the past argued that reforms should focus on reducing costs rather than increasing employer funding of the system.

Some US corporate leaders say they have kept a low profile on healthcare for fear of being dragged into a political debate that could end up harming their companies' image and finances.

One chief executive of a large US company said recently: "Healthcare is a minefield of problems. We don't know yet how the debate will shape up and until then we don't want to make our positions known."

Mr Scott said some business leaders might hesitate to take on the burden of entering a debate that they were not required to be in. But "in our case we were already in the debate", he said.

Union-led critics have repeatedly attacked Wal-Mart during the past three years over the level of healthcare provision for its low-wage workforce.

Its healthcare spending is below unionised competitors - principally the three leading supermarket groups - while being broadly in line with other retail competitors.

Mr Scott expressed satisfaction that in spite of the union campaign, Wal-Mart's record had not become an issue in the Democratic primaries. Hillary Clinton served on Wal-Mart's board from 1986 to 1992 when her husband was governor of Arkansas, the retailer's home state.

Both Democratic presidential hopefuls say they want employers to either provide health insurance or to contribute towards costs, with Barack Obama saying he would set a percentage of payroll costs for health coverage.

For those of you who aren't on our e-mail list, here's a letter we sent out about Wal-Mart deciding (or being pressured) to do the right thing. Finally.

Occasionally others help us step back and look at a situation in a different way. This is one of those times. --Pat Curran, Executive Vice President, People. Wal-Mart Stores, U. S.

Dear Wake Up Wal-Mart Supporters,

Over the past few weeks, the Debbie Shank case gave us a tremendous opportunity to teach Wal-Mart a lesson about corporate responsibility.

Check out the Wal-Mart workers' petition to Lee Scott and Shank case overview

Today, the backlash against Wal-Mart's lawsuit finally drove the company to drop its claim on her settlement winnings. Consider this concrete proof that Wal-Mart must change when supporters like you take action.

After years of being dragged through the courts, the Shanks can finally begin to piece their lives back together. We couldn't be happier for Debbie and her family. But, we still can't forget the other Wal-Mart associates who have been treated unfairly by Wal-Mart.

Let's not forget Olga Sanchez, who lost her job because Wal-Mart wouldn't let her see her son before he was deployed to Iraq; or Sean Thornton, who lost his job while he was on active duty. We can't let Wal-Mart forget the 1.6 million women involved in the largest certified gender discrimination lawsuit in history.

We can change America's largest retailer just by raising our voices. That's an amazing thing. If we all remember this day, we'll see better things to come for Wal-Mart's associates.

Thanks for all that you do,

The Team,
WakeUpWalMart.com

Here's an article from the Wall Street Journal about Wal-Mart finally dropping it's claim to the money Debbie Shank won in a suit against the trucking company that hit her car, leaving her permanently brain damaged.

Wal-Mart Stores Inc. is dropping a controversial effort to collect over $400,000 in health-care reimbursement from a former employee who is confined to a southeast Missouri nursing home since she suffered brain damage in a traffic accident.

The world's largest retailer said Tuesday in a letter to the family of Deborah Shank it will not seek to collect money the Shanks won in an injury lawsuit against a trucking company for the accident.

Wal-Mart's top executive for human resources, Pat Curran, wrote that Ms. Shank's extraordinary situation had made the company re-examine its stance. Wal-Mart has been roundly criticized in newspaper editorials, on cable news shows and by its union foes for its claim to the funds, which it made in a lawsuit upheld by a federal appeals court.

Insurance experts say it is increasingly common for health plans to seek reimbursement for the medical expenses they paid for someone's treatment if the person also collects damages in an injury suit. The practice, called "subrogation," has increased since a 2006 Supreme Court ruling that eased it.

Wal-Mart's Ms. Curran said the retailer was required by the rules of its plan to seek reimbursement from the Shank's settlement. But she said the case has made Wal-Mart revise those rules to allow for flexibility in individual cases. "Occasionally others help us step back and look at a situation in a different way. This is one of those times," Ms. Curran wrote in the letter.

Ms. Shank, 52, lost much of her memory and ability to communicate or walk in a crash between her minivan and a tractor trailer in May 2000. Her family sued the trucking company and won $700,000. Court records show that after attorney's fees and costs, the remaining $417,477 from the settlement went into a trust to care for Ms. Shank. The fund now has about $270,000, the family said.

Ms. Shanks' health insurance was through Wal-Mart, where she worked nights stocking shelves. After the Shanks won their lawsuit, Wal-Mart sued the Shank family to recover medical costs totaling about $470,000.

Wal-Mart won its case and subsequent appeals by the Shanks that went as far as the Supreme Court, which closed legal avenues this month by declining to hear the case.

The case put a spotlight on the growing use of reimbursement claims by health plans, experts say. Roger Baron, professor of law at the University of South Dakota and a specialist in health-plan law, said health plans have become "very aggressive" about subrogation since the 2006 Supreme Court decision.

"It's free money. They want the free money," Mr. Baron said.

Lynn Dudley, vice president for policy at the American Benefits Council in Washington, D.C., said the negative publicity around the case was beginning to draw the attention of lawmakers who might want legislation to stop or limit subrogation.

Mr. Baron said Wal-Mart's size -- it is the nation's largest nongovernment employer, with over 1.3 million workers -- means that its willingness to compromise in an individual case may have a wider impact on reimbursement practices by other health plans. "I'm so pleased to see an element of reason because so much of this subrogation has been about just blindly going after the money," Mr. Baron said.

Here's a little video we put together of Wal-Mart CEOs and execs talking about Wal-Mart doing the right thing, and the importance of the individual and the associate. We totally agree with these statements, and it would be great if Wal-Mart acted the way it was talking. But instead of doing the right thing, and caring for its associates, Wal-Mart sued Debbie Shank for nearly half a million dollars. I guess to Wal-Mart suing a former employee who is permanently brain damaged for the money she was going to use for long term care is 'doing the right thing.'

Wal-Mart workers in Essex County, NY are "living better" after a recent court decision. Wal-Mart has been ordered by a U.S. District Court to provide health care for workers' stepchildren. The decision comes after one woman on Wal-Mart's health care plan was refused coverage for her stepson.

Sadly, Wal-Mart requires a court order before acting like a responsible employer.

In an Aug. 22 decision, the U.S. District Court for the Northern District of New York ruled that Wal-Mart Stores Inc. must extend health insurance benefits to the stepson of a Wal-Mart employee living in Essex County. The Essex County Department of Social Services sought to obtain medical support from a Wal-Mart employee on behalf of her stepson.

Essex County had obtained a Family Court order establishing the employee’s obligation to provide available health insurance for her non-custodial stepson, who had been receiving coverage through Medicaid. The Essex Department of Social Services’ Child Support Collection Unit issued a notice to Wal-Mart, the stepmother’s employer, but the company refused to enroll the boy in its health plan.

The case was moved to federal court, which ordered Wal-Mart to comply with the Family Court order and provide coverage for the stepchild, even though such coverage was beyond the coverage ordinarily provided by the company’s plan.

The entire press release is here.