Still no day at the beach

What Rick Scott brought to health­care, he’d likely bring to the Sun­shine State

Modern Healthcare - - Opinions Editorials -

Some things never change.

The car­toon be­low was pub­lished in Mod­ern Health­care in 1993. It cap­tures the essence of Rick Scott’s take-no-pris­on­ers busi­ness style as chief of Columbia/HCA Health­care Corp. Last week, Scott em­ployed the same tac­tics in the po­lit­i­cal realm, se­cur­ing the Repub­li­can nom­i­na­tion for gover­nor of Florida. Scott waged a spend­ing blitzkrieg, pump­ing some $50 mil­lion—most of it his own money—into ad­ver­tis­ing and other cam­paign ac­tiv­i­ties. Lo­cal news ac­counts de­scribe the ex­pen­di­tures as un­prece­dented. One story quotes a GOP of­fi­cial as wor­ry­ing about a can­di­date with galaxy-size funds at his dis­posal and lit­tle need of party sup­port.

Most of the me­dia ac­counts from Florida also rely on first-ref­er­ence de­scrip­tions of Scott as a health­care ex­ec­u­tive or busi­ness­man. This is like call­ing the con­quis­ta­dors ex­plor­ers. The tepid terms leave out a whole di­men­sion of distin­guish­ing be­hav­ior.

Dur­ing the Florida cam­paign, Scott re­peat­edly por­trayed him­self as a cham­pion of free mar­kets. The truth, like the short­hand de­scrip­tions, is more com­plex. Scott loved un­re­stricted eco­nomic free­dom but was not so fond of com­pe­ti­tion. The com­pany he helped found gob­bled up hos­pi­tals (of­ten not-for-prof­its) in tar­geted mar­kets and sought to dom­i­nate those ar­eas. Scott be­lieved in shut­ting down hos­pi­tals and fa­cil­i­ties that drew busi­ness away from Columbia prop­er­ties.

He led his bonus-driven com­pany into an eth­i­cal and le­gal morass. (See re­lated Com­men­tary, Dec. 7, 2009, p. 24.) The wreck­age of his ten­ure in­cluded a then-record $1.7 bil­lion set­tle­ment with the fed­eral govern­ment over a va­ri­ety of dif­fer­ent forms of fraud. Scott was never charged in­di­vid­u­ally, but here is what he says on his own cam­paign web­site:

“I’ve made mis­takes in my life. And mis­takes were cer­tainly made at Columbia/HCA. I was the CEO of the com­pany, and as CEO I ac­cept re­spon­si­bil­ity for what hap­pened on my watch. I learned very hard lessons from what hap­pened, and those lessons have helped me be­come a bet­ter busi­ness­man and leader.”

That last as­ser­tion is ques­tion­able. Scott, who de­parted Columbia with more than $300 mil­lion, moved on to other en­ter­prises, in­clud­ing Solan­tic, a chain of ur­gent­care clin­ics he co-founded. Not sur­pris­ingly, it has been hit by a se­ries of law­suits, al­leg­ing em­ploy­ment dis­crim­i­na­tion, wrong­ful death and a fraud­u­lent mis­use of a med­i­cal li­cense. Set­tle­ments were reached in at least some of those cases. Just be­fore the elec­tion, ac­cord­ing to lo­cal re­ports, a fired physi­cian lodged an un­proven al­le­ga­tion of Medi­care fraud against Solan­tic, which the com­pany de­nies.

Through­out his ca­reer, Scott has demon­strated con­tempt for any force, pub­lic or pri­vate, that op­poses his vi­sion of the way things should be and his prof­its. His mul­timil­liondol­lar, air­wave-sat­u­rat­ing cam­paign against health­care re­form (Scott spent about $15 mil­lion of his own money on the ef­fort) un­der the ban­ner of Con­ser­va­tives for Pa­tient Rights is a good ex­am­ple.

Dur­ing the gu­ber­na­to­rial cam­paign, Scott re­peat­edly told vot­ers that, if elected, he would run state govern­ment like a busi­ness. Given Scott’s his­tory, that is ex­actly what Florid­i­ans should fear.


Man­ag­ing Edi­tor

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