Point of View

McCrory’s plan would ruin an enviable health care program

April 24, 2013 

As one of the newest doctors in North Carolina, I’m concerned about the potential plans to outsource the state’s Medicaid program as proposed by the governor’s administration.

Just one year ago, I was completing my medical school training in Philadelphia and looking for family medicine residencies in states that supported primary care and had forward-thinking approaches to community and population health. North Carolina kept popping up in literature and discussions because of its innovative Community Care of North Carolina program, which has been gaining traction as a national model for care delivery and as a model for improved health and decreased costs.

As a student, I recall being told by a keynote speaker at a national conference in Washington to “get to North Carolina to train to be a family doctor because the things they’re doing with CCNC are unlike anywhere else in the country – you just won’t find that kind of environment or patient care anywhere else.”

Looking deeper, I found in CCNC a program truly built with patients at the heart. Even more promising, I realized that it’s run and overseen by many of the same local doctors who see patients face-to-face in community clinics. Having always dreamed of being a small-town family physician, these goals made sense to me. The more I discovered about CCNC, the more I was convinced that it is the kind of program that promotes the vision of the traditional community-oriented family physician I grew up idolizing.

And yet CCNC accomplishes even more through the lens of next-generation models of care delivery with an adaptable and innovative mentality, which is both improving care and saving money. It became clear that the goals of North Carolina were to put patients, families and communities first. I saw how doctors here were able to provide better care, get better outcomes and help control costs.

I wanted to be a part of that. So I chose to move to North Carolina and complete my training as a family doctor.

I appreciate the governor’s desire to control Medicaid spending. I know few physicians who would argue against reining in medical costs or making improvements. But the governor’s proposal runs counter to what North Carolina has been doing with its award-winning approach to Medicaid.

The national Kaiser Family Foundation even recently reported that North Carolina had the lowest rate of growth in Medicaid spending in the nation.

So why change direction now? And why use private managed care companies that have been shown to be more costly and less effective in many cases?

A truly sustainable plan would protect and build upon the good that North Carolina already has in place, while seeking to eliminate distracting or destructive components. Such a plan would identify the elements of the Medicaid system that are working, such as CCNC, and bolster them. Anything less would be to ignore the hard work, savings and advancement that our state has witnessed.

It would be good to underscore a program that attracts primary-care physicians to our state, that is looked to nationally as a model for savings and is one that our patients and residents genuinely trust and rely upon.

That is the kind of true sustainability and innovation that makes me want to settle down as a small-town family doctor in North Carolina. That’s how we can build the future of health care in our state: North Carolina’s physicians, hospitals and patients all working together to improve care and lower costs.

I hope the governor will reconsider and build upon the success of CCNC rather than outsource Medicaid to out-of-state HMOs.

Aaron George, D.O., lives in Durham.

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