The world\u2019s wealthiest woman has a blunt diagnosis of the sickness she has set out to cure. \u201cHealth care is going to break and bankrupt American companies, and America itself, if we don\u2019t change it,\u201d Alice Walton says in a forceful Southern drawl.<\/p>\n
The 75-year-old daughter of Sam Walton, the late Walmart founder who turned a five-and-dime store in rural Arkansas into the world\u2019s largest company by revenue, thinks the US is very close to that breaking point. \u201cWe are at the crisis,\u201d she says.<\/p>\n
The disconnect between the country\u2019s outsized spending on health care and its struggles to stem the tide of chronic disease and preventable deaths has consumed policymakers, business leaders, and patients for years, preceding the Trump administration\u2019s Make America Healthy Again agenda or Democrats\u2019 efforts to pass the Affordable Care Act in 2010. Now \u201ceverybody\u2019s feeling the pain,\u201d Walton says, citing recent reports that health insurers in her state have been pushing companies for a one-third increase in premiums.<\/p>\n
Walton, a former investment banker with an estimated wealth exceeding $100 billion, has no executive role at Walmart, but she has picked its hometown of Bentonville, in the Ozark Mountains, as \u201cthe perfect playground\u201d from which to test the combination of policy, commercial, and educational reforms that she believes are needed across the country.<\/p>\n
Walmart\u2019s growth, coupled with investments from Walton and her family, has turned this former backwater into a heartland hotspot, known for mountain biking trails, a thriving art scene, and one of the country\u2019s fastest-growing populations. In 2011, Walton opened Crystal Bridges, a lauded museum anchored by her collection of American masterworks, including paintings by Georgia O\u2019Keeffe and Norman Rockwell\u2019s Rosie the Riveter.<\/p>\n
But she saw a critical missing piece in the region\u2019s revival: Arkansas has four counties without a doctor, and another eight with just one doctor and no hospital, she says, pointing to such \u201chealth care deserts\u201d as a leading cause of the country\u2019s grim medical statistics. \u201cThere is no health care in rural America,\u201d she says.<\/p>\n
A \u2018whole health\u2019 rethink of medical school<\/p>\n
There are several remedies in Walton\u2019s prescription, including the Heartland Whole Health Institute, which she launched in 2019 to manage the research and policy side of her campaign. The latest opened in July, when Walton welcomed the first 48 students (out of 2,000 applicants) to the Alice L. Walton School of Medicine, or AWSOM, a gleaming building on a plant-filled campus from which she intends to reimagine medical education.<\/p>\n
The Ozarks-inspired structure was designed by the Arkansan architecture studio Polk Stanley Wilcox, and features walls hung with art, a \u201chealing garden,\u201d and a two-acre rooftop park alongside its state-of-the-art examination rooms and operating theater.<\/p>\n
Walton seems less interested in the building than the curriculum, which she designed with the school\u2019s dean and CEO, Dr. Sharmila Makhija, an oncologist who previously ran the obstetrics department at New York\u2019s Montefiore Health System.<\/p>\n
Alongside a conventional medical curriculum, AWSOM\u2019s course features exposure to art and nature, an emphasis on self-care, and direct clinical experience from the very start of students\u2019 studies. Walton and Makhija hope not just to provide a \u201csupport system\u201d to ease the stresses of med school, but to train a new generation of doctors in preventive, patient-focused \u201cwhole health\u201d principles. Makhija defines these as looking not only at a person\u2019s illness, but at their broader needs and circumstances \u2014 and at the health outcomes they want from treatment.<\/p>\n
\u201cYou still have to know how to take care of the kidney,\u201d she says, but mainstream medical education has become too narrow, leaving young doctors lacking empathy or ill-equipped to deliver bad news. \u201cWhen you\u2019re talking to another human being and telling them that they\u2019re not going to make it, there is an art to that. There\u2019s a compassion and an empathy, and that\u2019s not taught,\u201d Makhija adds.<\/p>\n
Tim Hursley\/Courtesy of AWSOM<\/p>\n
12 years, 30 surgeries, and one book club<\/p>\n
Walton is a commanding and lively presence, brightly dressed and wearing large, luminous emerald earrings on a quiet summer Thursday morning. But AWSOM\u2019s focus on the softer skills of medical care stems from her own traumatic experiences of medical treatment.<\/p>\n
A car crash in 1983 led to her having 30 surgeries over 12 years. \u201cI know the health care system way too well,\u201d she says drily. \u201cThe first thing I learned is that anybody with a chronic disease is going to have mental health issues of some type \u2026 but the health care industry doesn\u2019t even recognize that. There\u2019s no support system, and I learned that firsthand.\u201d<\/p>\n
Walton took up meditation and yoga in those years. But painting was her main \u201cweapon against anxiety, against depression, against \u2026 all sorts of negative thoughts,\u201d she says. That\u2019s why AWSOM sits on the same campus as Crystal Bridges, why the museum has a director of arts and medicine, and why \u201ccollisions\u201d between students and curators are part of AWSOM\u2019s curriculum. Exposure to art and nature, she says, were \u201cmy personal way to get through 12 years of not much fun.\u201d<\/p>\n
Many wealthy individuals have fallen ill and subsequently endowed medical facilities. Education and health care have been the biggest recipients<\/a> of billionaire philanthropy over the past decades. But Makhija says Walton stands apart for her effort to learn the intricacies of America\u2019s health care industry. \u201cAlice can do anything she wants, and she\u2019s taking on a very complicated sector,\u201d she says. \u201cI think a lot of big changes happen when you have someone outside the system who tries to understand it, not just try to apply different measures, but to really make those changes.\u201d<\/p>\n \u201cAll I\u2019ve been doing is reading health care books now for four years,\u201d says Walton, adding with a laugh that it is not a book club she would recommend.<\/p>\n How to change a system with a prototype<\/p>\n