Conrad L. Flick, a Cary doctor and former director of the American Academy of Family Physicians, writes in a letter too long for print of Community Care of NC:
I read with interest the announcement recently of the proposed changes to our Medicaid system, primarily Community Care of North Carolina. I have a unique perspective on our system and on opening it up to for profit outside entities.
I am a family physician and small-business owner in Wake County for over 20 years. Recently I served three years on the American Academy of Family Physicians Board of Directors, having the privilege of representing over 100,000 family physicians from every state and community type imaginable. As part of my responsibilities, I gave presentations around the nation on many subjects, but being from North Carolina, I was often asked to talk about CCNC – how did N.C. put it together and provide such quality and do so efficiently. States wanted to emulate CCNC, they wanted to know how they could build a similar system, often after theirs had been fragmented by managed-care entities brought in to control costs and provide budget predictability.
At a recent meeting I attended, those same family physicians across the country were shocked over the recent proposal and how it came about and why it would even be considered as an option as they talked about the problems with managed care in their own states and communities.
I see patients daily and know our current healthcare system’s struggles and failures to be fair and equitable to its citizens. I also know at least in our Medicaid population, N.C.’s most vulnerable, we do it better and more innovative than anyone. Why then open it up to outsiders and significant change?
We all know, including in CCNC, that there is room for improvement. Identify those areas and improve a good system and make it great rather than creating a system-wide change that could have long-lasting negative effects. The new direction is not innovative; it has been tried in other states with very mixed results. It may provide budget predictability, but usually only for several years, but it does not provide better healthcare.
If the new plan fails, we cannot go back. Once fragmented, the system cannot easily be put back together. As a physician who is a small-business owner, I know the many difficulties of dealing with insurance companies and for-profit entities versus a trusted homegrown organization that puts patients first and helps providers do so better and with the right resources.
I believe we can build on CCNC and make it better, not replace it, so that it and North Carolina remain the envy of the rest of the nation due to leadership, quality, efficiency and innovation.
Conrad L. Flick, M.D.
The length limit was waived to permit a fuller response.