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Wal-Mart: Retailers
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None of the bills are explicitly directed at Wal-Mart, but because of its size - Wal-Mart is the largest private employer in many states - nearly all of them would require the retailer to pay more for employee health care. The Maryland bill, for example, is expected to affect only Wal-Mart.
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Worse, Wal-Mart is on a messianic mission to extend its exploitative ethos to the entire business world. More than 65,000 companies supply the retailer with the stuff on its shelves, and it constantly hammers each supplier about cutting their production costs deeper and deeper in order to get cheaper wholesale prices. Some companies have to open their books so Bentonville executives can red-pencil what CEO Scott terms "unnecessary costs."
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"Wal-Mart, a true corporate behemoth and the nation's third largest pharmacy retailer, has decided to become players in the PBM industry. They will have a dramatic affect on whether positive or negative changes occur. For example, PBMs are notorious for pushing patients to use the mail order pharmacies they actually own, which is a conflict of interest that is not to the patient's benefit. Another example of questionable PBM activities is the undue influence pharmaceutical manufacturers have in getting specific, often more expensive drugs utilized even when they are not part of the prescription plan formulary. This happens because of rebates the PBMs receive when these switches are successful. The list of dubious behavior by PBMs is extensive, but the common theme seems to be a relentless quest for profits regardless of what's in the best interest of patients.
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Wal-Mart wields its power for just one purpose: to bring the lowest possible prices to its customers. At Wal-Mart, that goal is never reached. The retailer has a clear policy for suppliers: On basic products that don't change, the price Wal-Mart will pay, and will charge shoppers, must drop year after year. But what almost no one outside the world of Wal-Mart and its 21,000 suppliers knows is the high cost of those low prices. Wal-Mart has the power to squeeze profit-killing concessions from vendors. To survive in the face of its pricing demands, makers of everything from bras to bicycles to blue jeans have had to lay off employees and close U.S. plants in favor of outsourcing products from overseas.
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"Wal-Mart, as an efficiency machine, has just done better than any other U.S. retailer, or perhaps, any other U.S. company in history," says Gary Gereffi, a professor at Duke University. He has written extensively about how mass retailers like Wal-Mart have gained leverage to reshape the global economy.
"Wal-Mart has reversed a hundred-year history that had the retailer dependent on the manufacturer," explains Nelson Lichtenstein, a professor at the University of California Santa Barbara. "Now the retailer is the center, the power, and the manufacturer becomes the serf, the vassal, the underling who has to do the bidding of the retailer. That's a new thing."
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