everybody. In my book … the biggest difference between the US and the other rich democracies — Britain, Canada, Japan, Germany — they’re like us but those countries all said, ‘We’re a rich country we’re going to supply healthcare for everybody who’s sick.’ And the US has never done that.” Some might argue that Reid’s plan sounds like socialized medicine. “In Germany, everybody is on private insurance; the docs are private, the hospitals are private. There’s no Medicare, in Germany. It’s all private. There’s no Medicaid, that’s for poor people. It’s all private. In America, you know 49 million Americans are on Medicare, that’s a government-run insurance plan, although people on Medicare, some of them don’t know that. Many countries have less government involvement than the US but they cover every-insurance. we took care of everybody that walked in our front door,” says retired surgeon Dr. Ellis Tinsley We were able to keep our overheads down and practice; we were able to charge the fee that was not cut,” Tinsley says. “Half of my practice now would be Medicare. The government sets that fee. It doesn’t matter what you charge. You can charge anything you want, but Medicare is going to charge you so much. Plus the fact, Medicare passed a law saying you can’t do what we were doing. You can’t give free care to a Medicare patient. When I go to the doctor now, I pay just like everybody else. We used to never charge medical people.” “The person who didn’t have anything, we took care of them and didn’t charge them.” Tinsley attributes the shift from patient care to the profitability of healthcare to a variety of factors. “Medical care got on the New York Stock Exchange,” Tinsley says. “You can buy stock in United Health Care. United Health Care comes down and commiserates with the doctors, and gets some of their money, gets some of the hospital’s money. Everybody says, ‘Buy United Health Care, they’re really making the money this year.’ That’s money that doesn’t go into patient care it goes to New York. The CEO makes $160 million a year,” Tinsley says. “We’re a long way from a patient, a doctor and a nurse,” he adds. “I think medical care dollars should all be directed toward the patient.” Dr. Tinsley was not acquainted with the Grand Junction model documented by T.R. Reid in “US Health Care: The Good News,” but says it would not be possible for a doctor led healthcare pro-gram to operate in New Hanover County. “It’s in the hands of the government now,” Tinsley says. “They’re pretty much setting the rules. I don’t know where it’s going to go but it’s really worrisome. The government is now sell-ing people policies at higher prices with big deductibles that they don’t need.” “They’re one-size-fits-all. Some states you have a choice but if you don’t need maternity care why do you have to buy a policy that covers that? If you don’t need pediatric care, why do you have to buy that? If you’re a lady, why do you have to buy coverage for prostate surgery? It’s just crazy what they’ve done. It’s because the doctors had very little to say what was put in the law. The various lobbies, all these insurance companies that are going to sell these policies, I think in large part … even though they talk a good game and say it’s all patient directed, that we’re going to take care of the 30,000, 40,000 that don’t have health insurance, that’s good, but they could have accomplished a lot of those things without doing what they’ve done.” Tinsley recalls a time when his practice, Wilmington Surgical Associates, approached a big consumer, General Electric. “When things were changing, we actually went to General Electric and said, ‘Here’re our prices. We will reduce them. If we do your work, which means more volume, we’ll reduce our prices, help everybody reduce the cost, but then that’s about the time other health insurance things came in. It’s just hard to keep it all organized.” When Blue Cross/Blue Shield was established in North Carolina, Tinsley says the board was primarily made up of medical profesionals. “The board up in Raleigh … they decided they shouldn’t have all medical people because they’re just going to take care of them-selves when the whole profession is dedicated toward taking care of the patient. So they had other people put on the board and then you had other insurance companies come in and you had competi-tion there.” “It’s a real mess. That’s not to say it doesn’t need to be changed and reorganized but what’s best for the patient should be the bot-tom principle more than anything else and I’m not so sure that’s what the deal is.” “That’s why I say, I hope from the standpoint of the person who takes care of you when you get sick, I hope all this busi-ness stuff doesn’t detract from the advances, the technology and the fun of taking care of you and get-ting you well and I’m afraid it’s going to.” — Dr. 51 www.wrightsvillebeachmagazine.com WBM
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