Medicine man: Salick Health Care founder Dr. Bernard Salick takes pains to make profits.

He grew up on New York City's Lower East Side, but his daughters emulate the manners of the landed gentry -- they ride top-flight jumping equines purchased in Germany, and compete in what the horsey set calls "dressage."

When asked about this juxtaposition, the doting father rails, "My daughters know they must make a contribution to society -- they are given strict allowances, and don't spend a lot in stores."

Meet Dr. Bernard Salick, a walking contradiction of a man who holds the Hippocratic oath dear, but wants to make big bucks in health care for himself and his shareholders.

And make money he has -- as evidenced by his 93-acre ranch in Hidden Valley, where 100 horses leap and prance amidst 350 fruit trees and more than 4,000 other planted trees. "I spend four days a week on the ranch," relates Salick. "It is my hobby. I am probably the largest individual buyer of trees on the West Coast."

Salick, 53, never a wallflower, named his company Salick Health Care Inc., which he founded in 1983 and took public in 1985. He is the major shareholder, with a 27.9 percent stake in the company, a holding worth about $32.6 million at recent market prices. Because some Salick Health Care stock has diluted voting rights, Salick himself actually controls more than 40 percent of the stock vote.

In fiscal 1992, Salick Health Care reported profits of $6.9 million on revenues of $95.1 million. Salick is chairman and chief executive of a company that provides specialized care to outpatient cancer victims and renal dialysis

(blood cleaning) for people with bad kidneys.

Renal dialysis is a steady business -- generally, patients need treatment three times a week, at $126 a pop. The number of patients nationwide is increasing at about 7 percent a year, and treatment is funded through the federal Medicare program.

According to Salick literature, due to capital costs and regulatory hurdles, the renal dialysis trade has "barriers to entry" -- in English, it's a tough business to break into.

Salick sees no conflict between the profit system and health care. "It is only the for-profit system that will devise ways to provide quality health care at the lowest cost," he asserts with the certainty of a mathematician proving a theorem. "The not-for-profits just add the bills up and expect to get paid."

Indeed, it was in the field of renal dialysis, in 1972, that the federal government first paid prospectively for care -- the feds will pay $126 for a renal dialysis session, and not a penny more. It is up to the provider to clean the blood, at the prospective price, and make money -- and Salick Health Care knows how, says Salick.

But in his next verbal blast -- Salick rarely speaks below a dull roar -- the doctor avers, "We serve Medicaid (the federal program for the medically indigent) patients at our facilities, and we get only 22 cents (in compensation) for each dollar we spend on them. We don't have to (serve them), but we do."

When asked how he justifies the money-losing service to Medicaid patients to his shareholders -- Salick Health Care, after all, is in business to make money -- Salick, a bear-like man with beard and balding pate, temporarily blanches.

But he quickly gathers his thoughts and with ursine strength roars again, "We are affiliated with university hospitals; we get the best doctors in the world to work on our staffs. If we didn't serve the Medicaid patient, we would lose these affiliations."

Yet he concedes the flat-out indigent would have trouble getting care at one of Salick's nine cancer centers across the country.

Dr. Salick ensconced himself last year in new headquarters on Beverly Boulevard near the Beverly Center. The building, snazzily styled and full of marble and red-colored woods, has won architectural awards. It also bristles with high-tech security -- for a visitor to enter the building, a uniformed guard must use a key summoning an elevator. A badge is required.

Cameras survey everything. After the visitor rides an elevator to the top-floor receptionist, another magnetic key card is required to pass into the office area.

The offices, glass-walled, richly appointed and featuring the sort of rakish angles designers favor, are not large, however.

Why the hardcore security? "There are 200 illegal aliens out on the street in front of the building," answers Salick. "Some of the women (employees) felt unsafe."

The illegal aliens are informal day-laborers who, in small groups, seek work outside Sinclair Paints, a paint store serving contractors on Beverly Boulevard next to the Salick building.

"It's a nutty world," says Salick, referring to the day-laborers' situation specifically, and urban chaos in general. "You just try to do what you can."

As Salick speaks, a Hispanic butler, quiet as a cat, uncovers a chilled plate of beautifully cut and skinned oranges, fresh from Salick's ranch. Despite tasting a bit as if they are from immature trees, the oranges are wonderful.

But Salick is now on to other matters -- like what Hillary Rodham Clinton should do to reform national health care. (The president's wife is the administration's honcho on reform plans.)

The problem of American medicine, as Salick sums it up, is this: America spends more per capita on health care than does any other industrialized nation, yet one-third of Americans lack coverage.

Perhaps not surprisingly, Salick believes that specialized centers such as those that Salick Health Care operates are part of the solution to the problem.

If duplicative services could be wrung out of the system -- not every hospital should have the same expensive equipment as the next -- then costs could be driven down.

Too, points out Salick, more than 70 percent of health care bills are generated by just 5 percent of patients. If ways can be found to treat those relatively few patients less expensively, all could benefit, reasons Salick -- and Salick Health Care knows how to efficiently treat cancer, he points out.

But Salick goes ballistic when asked if euthanasia -- recently officially sanctioned by the Netherlands -- is a good idea. (By some estimates, treatment of the terminally ill aged consumes more than half of health care dollars). "Never make value judgements," he shouts. "Never. Never. Would you want your parents not to get health care?"

Health care, Salick argues, is never a question of prudently rationing resources. "If we have enough money for B-2 bombers, to pay athletes millions, if certain entertainment industry executives make $180 million, how can we not afford health care?" challenges Salick to all comers.

Salick is asked: Should the board of directors at Walt Disney have somehow capped Chairman Michael Eisner's compensation (he's the one who took home $180 million last year)?

"No. Never put a cap on anything. Never," declares Salick. "He's done a wonderful job for the shareholders."

Salick's own salary is a bit more modest, listed at $1.31 million last year in company disclosure statements. But then, Salick shareholders have not fared as well as Disney's.

Since going public in 1985 at (adjusted for splits) a little under $10 a share, the stock has only moved up into the $13-$14 a share range -- in the midst of a historic, long-term Wall Street rally. Measured by the S&P 500, a broad indicator, the market is up more than 130 percent since 1985.

A major shareholder, Tom Revy of the Froley, Revy money management firm in Westwood, concedes his ownership of Salick "takes patience. Salick has taken longer to develop than we thought." But Revy now believes the stock is underpriced.

But Salick's board, like Disney's, is not likely to cut Salick's salary in response. The six-member board has three outside directors, one of whom, Regina Herzlinger, is a Harvard academic, and another, Thomas Mintz, is a bearded, pony-tailed local child psychiatrist.

"It's a board chosen by a man who wants to run his company and does not want to be jerked around by the directors," says money manager Revy. "You've got to trust Salick to run the company."

Salick insists his board can be tough. "They really look the company over. They really grill me," he says. Salick says he also hires "young Turks" from the best business schools, who battle mightily with him over the best way to run the company.

"Oh, we are in here (the boardroom) shouting, yelling at each other -- although in the end, someone has to make a decision, and that someone is me," says Salick.

But in the end, it is his ranch that Salick enjoys talking about most. He bought it in the 1980s, as a place for his daughters to play and ride prize-winning horses, but he quickly became absorbed in the planting of different types of avocado, citrus and apple trees, and nut orchards, as well as a vertitable forest of non-fruit trees.

"The ranch is next to David Murdock's place, past Thousands Oaks," he says, referring to the Los Angeles business mogul. "It's just a great place."

SNAPSHOT

Dr. Bernard Salick

Native of: Lower East Side, New York City 

Resident of: Thousand Oaks and West Los Angeles 

Age: 53

Education: Queens College, N.Y. B.S.; USC School of Medicine, M.D.