Cape Gazette

My medical calling will become a trade

By Chris Casscells, M.D. | Jul 29, 2013

For too many people, Santa Claus is coming early for Christmas to bring us unlimited free health care that "someone else" will pay for. For medical providers, all services will be paid for by the government, and paperwork responsibilities will lighten.

Health insurance companies have been promised an increased base of business because everyone will be in the pool. And of course, the government will run things more efficiently than the free market and save trillions.

For over 60 years my family (I am a third-generation doctor) has offered free medical services to a clinic with the Wilmington Hospital to provide free care for those who cannot afford medical services. My family did this because we wanted to - we did not get paid and we received no other reward for doing so.
I also deal with my own patients on a case by case basis.

For example, one of my patients, a poor peach farmer from Kent County, could not afford to pay the bill in full. So he paid the only way he could - with a basket of big, fresh, delicious peaches from his orchard when he came in for his yearly exam.

But now because of ACA, that is no longer necessary. The law allows for medical providers to be paid for charity work. A lot of doctors like the idea of getting paid by the government for people who in the past we treated for free because we were good people. These payments will add to the budget deficit and most doctors will see more patients.

Due to the increased workload of doctors, in many cases you may not even see one; you might see a nurse's aide or a physician's assistant instead.

Business-savvy doctors may succeed, but a large number of old-fashioned doctors like me will step aside because I can't see too many patients too quickly and feel like I'm being a doctor. But then again, maybe I'm too stubborn.

Finally, ACA law gives too much power to bureaucrats, most of whom have no medical background, to make decisions on healthcare for patients. This will destroy the doctor-patient relationship which has existed since long before Hippocrates became famous for his Hippocratic Oath.

One-quarter of general practioners in America are over the age of 60. Many who do not like the direction medicine is going in will either retire or refuse to take any private insurance, Medicare, or Medicaid. You will have to pay a flat fee for services. The wealthy will be able to afford a good doctor, but everyone else will have to wait in line, and even then you might not see a real doctor.

We as humans are hardwired to care for our kin. But as the bureaucracy grows, aided by Obamacare, the patient-doctor relationship will give way to bureaucrats making decisions solely based on cost.

Charity healthcare will disappear.
My calling will become a trade.

Chris Casscells, M.D.
Director, Center for Healthcare Policy
Caesar Rodney Institute

Comments (1)
Posted by: Thomas Adams | Jul 29, 2013 16:03

Nationwide, fewer physicians provide free or discounted fees (charity care) to uninsured patients.  Not only that, the physicians who do provide charity care have cut back on the number of hours they offer.   These declines started decades ago and have become progressively worse over time.   They did not start with the passage of Obamacare in 2010.


It was heartwarming to read Dr Casscells’ account of the farmer who could not pay cash for his yearly medical exam and so he paid in peaches.  It’s a good thing the farmer’s exam occurred during peach season and that he apparently did not need treatment for a serious (read expensive) medical condition such as a hip replacement—one of Dr Casscells’ areas of specialization.  The average cost of a hip replacement in this country is over $40,000!   The same surgery costs $10,000 or less in Switzerland, Spain, and France.  I have to wonder what Dr Cassells would do with $40,000 worth of peaches.


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