In his victory speech last night, Rick Scott, the 57 year old former health care executive and founder of the health care attack group Conservatives For Patients Rights, assured Republicans that the âparty will come togetherâ after a particularly bruising primary challenge against Florida Attorney General Bill McCollum. Scott entered the race in April and proceeded to spend approximately $50 million of his estimated $218 million fortune on a negative campaign that sought to deflect attention from his past business controversies and smear McCollum as a product of the establishment. That outlandish sum, however, is not nearly as shocking as how Scott came to acquire it â as the chief executive of one of the largest and most controversial for-profit hospital chains in the country, Columbia/HCA. In 1987, Scott, a mergers and acquisitions lawyer who âhad cut his teen on deals involving radio stations, fast food businesses, and oil and gas companies before focusing in on the money to be made by acquiring hospitals,â didnât enter the health care business for the sake of improving the quality of care, but rather wanted to âdo for hospitalsâ¦what McDonaldâs has done in the food businessâ and âwhat Wal-Mart has done in the retailing business.â The goal, as Maggie Mahar explains in Money Driven Medicine, âwas to combine volume with low cost.â This quote is demonstrative: âDo we have an obligation to provide health care for everybody? Where do we draw the line? Is any fast-food restaurant obligated to feed everyone who shows up?â he asked. Indeed, through an aggressive strategy of rapid acquisitions and consolidation, Scott turned Columbia/HCA into one of the largest health care companies in the world. Forbes magazine noted Scott ruthlessly bought âhospitals by the bucketful and promised to squeeze blood from each one.â HCA/Columbia executives saw health care as any other commodity. âThis industryâs not any different than an airline industry or a ball bearing industry,â said David T. Vandewater, Columbiaâs chief operating officer. âYou run at 40 percent of capacity or at 60 percent of capacity youâre not getting the maximum value out of your assets.â Under Scottâs leadership, Columbia/HCA pled guilty to an massive array of fraud charges â which resulted in a fraud settlement of $1.7 billion dollars, the largest in U.S history. Columbia/HCA systematically defrauded taxpayers, charging Medicare $15,000 for Tiffany pitchers and other luxury goods, âexaggerating the seriousness of the illnesses they were treating,â and engineering a program where doctors were granted partnerships in hospitals as a kickback for referring patients. In 1997, âdisaster struck in the form of an FBI raid.â In July of that year, âfederal agents swarmed Columbia/HCA hospitlas and offices in five states. Within weeks, three executives were indicted on charges of Medicare fraud, and the board had ousted Scott.â Scott left in disgrace, but not before walking away with âa $9.88 million severance package, along with 10 million shares of stock worth up to $300 million at the time.â During Scottâs tenure at Columbia/HCA, his cost cutting methods threatened patient care and safety: â Susan Marks, a technician at one of Scottâs hospitals, was forced to monitor 72 heart monitors by herself. Marks explained, âI have to. Iâve been told you either do it, or thereâs the door.â [ABC News, 9/26/97] â Scott downsized nursing staffs, created conditions where âbabies were attended as infrequently as every three hours. Once, the only nurse caring for seven ill infants was so busy she failed to hear an alarm when a baby stopped breathing. A parent dashed to the baby and stimulated breathing, the state report said.â [New York Times, 5/11/97] â Hospital workers in Florida complained, âgloves come in only one size, and rip easily.â In addition, California employees protested âfilthy conditions,â and being âstretched to the limitâ as Scottâs company slashed âthe ratio of nurses to patients.â [Money Driven Medicine, pg. 119] In 2001, Scott would return to health care and the âMcDonalds model,â with a chain of urgent care clinics all over Florida. And as Tristam Korten explained in this two part series for Salon, it quickly replicated many of Columbia/HCAâs favorite business practices. http://www.forbes.com/2000/12/15/1215disaster.html http://www.usdoj.gov/opa/pr/2002/December/02_civ_731.htm http://www.salon.com/news/feature/2009/09/30/rick_scott_one http://query.nytimes.com/gst/fullpa...6C0A961958260&sec=health&spon=&pagewanted=all http://thinkprogress.org/2010/08/25/scott-mcdonalds/