"Imagine waking up one day and all your medical decisions made by a central national board. Bureaucrats decide the treatments you receive, the drugs you take, even the doctors you see," the narrator reads, derisively likening the scenario to the health systems of England and Canada, where "waiting lists reign supreme. That's what some in Washington mean by reform. Let's have real reform by putting patients first."
That ought to start tongues a wagging.
The name and voice are familiar to many who've been around the hospital industry for 20 years. But Rick Scott, the non-profit organization's founder, soon hopes the organization's reputation and cause will grow as well.
Mr. Scott has been deified and demonized by various admirers and opponents as both the savior and the Anti-Christ of healthcare, a hard-driving executive who took his Columbia Hospital Corp. (now HCA) from two El Paso hospitals in 1988 to the nation's largest investor-owned hospital chain and the world's largest healthcare company, with 340 hospitals and 135 surgery centers. At its peak, the company, now privately held, employed 285,000 and was the seventh largest U.S. employer.
The attorney and entrepreneur revitalized the investor-owned hospital industry and terrified the tax-exempt sector of it by applying his aggressive cost-cutting techniques and take-no-prisoners business and acquisition practices. He was named one of America's most admired executives. He consolidated hospitals, improved efficiency and quality in his hospitals and cut costs. Columbia merged with HCA in 1995, and Mr. Scott was forced out in a management shuffle in 1997.
Then he disappeared.
He didn't vanish, of course, but did keep a lower public profile in the wake of the leadership changes and government investigations into HCA. The company eventually paid more than $1.7 billion in civil and criminal charges, but Mr. Scott was never charged with anything and continued to invest in healthcare. He purchased a controlling interest in America's Health Network, which later became Discovery Health. The former hospital industry titan launched his Solantic Corp. chain of 24 urgent care centers in Florida in 2001. Mr. Scott also chairs Solantic.
Now he has created CPR, the tax-exempt educational organization he hopes will influence the national debate over healthcare reform and steer it from a government dominated healthcare system.
Pushing for change
Mr. Scott says he is passionate about healthcare and is disturbed with what he's hearing from Washington. And he's committed $5 million of his own money to fund a new campaign, Conservatives for Patients Rights, which advocates a market-driven healthcare system that protects the physician-patient relationship.
He says he's bothered by the prospect of America's health system turning into a 'nanny state,' government-led program with government bureaus making decisions, rather than one led by an individual's freedom to choose.
"What I'm concerned about is that we seem to be going down a path saying that American healthcare today is bad when it's not," he says. "The biggest problem is the high cost of healthcare has made it unaffordable to millions of Americans. I personally believe in what's best for patients. The more we can focus on the four pillars of patient rights — choice, competition, accountability and personal responsibility — the more healthcare costs will drop."
He recalls that one year after starting Columbia in1989, healthcare inflation was at 18 percent. By 1996 the annual rate of healthcare inflation had dropped to less than 1 percent.
"We (Columbia/HCA) had an impact on the industry," he says.
Mr. Scott elaborates on his four pillars concept, saying patients should have the right to choose their own doctors and health plan. "Each of us knows what we need and we ought to be able to shop around and compare prices and quality. We ought to know what everything costs and the healthcare organization's results. Consumers should have all the facts about those results. That will drive down costs tremendously," he predicts.
He says 45 percent of the uninsured are between jobs and have insurance within four months of losing their jobs. "If you purchase your health insurance individually, you should get the same deduction an employer gets," Mr. Scott says. " People need to be rewarded for taking care of themselves. That by itself would have the biggest impact: if people stopped smoking and started exercising. If you're doing the right things, your healthcare costs ought to be lower. There is a direct correlation between body mass index and a person's healthcare costs."
Mr. Scott says he believes America now has an historic opportunity. "We have a president, Congress and public ready and willing to improve healthcare," he says. "My goal is to help educate Americans as we go through debate about how this will impact healthcare.
"I believe in this stuff and I think if you believe in something you should put your money where your mouth is," he says.
Taking a proactive approach
Early in 2009, Mr. Scott got started by hiring a small crew and launched an organization, and March 2 started a Web site: cprights.org. The Web site dissects details of 16 health plans being offered, explains Mr. Scott's concept of the four pillars of healthcare reform and includes legislative alerts and updates.
"We have a lot of people trying to help us, and starting in the next few weeks, the Web site will allow us to accept money," he says. "The goal is to be a grassroots organization to go after the average American who also believes in the four pillars."
He says there's no plan coming from Washington, but is worried about the potential harm of the proposed federal Council on Comparative Effectiveness. "The concept makes all the sense in the world," he concedes of the plan to test which drugs, tests, devices and treatments work best and then publicizes those. "But if you look at what happens down the road, the organization could be issuing that information in the form of guidelines it expects providers to comply with. There's a danger that some of those guidelines will be driven by cost and that the government won't pay for certain treatments because they're too expensive."
He says rationing healthcare could end up denying many patients needed treatments if the government runs short of money. "Americans don't want a federal agency to dictate how to practice medicine."
Mr. Scott says America's hospitals try to take care of as many uninsured as they can, but says hospitals and emergency rooms aren't always the best places to receive healthcare.
"It always comes down to affordability. In the end Americans want the best healthcare we can get. The question is: What is the best way of getting the greatest amount of appropriate care to the greatest number of people possible? We should have a great safety net based on income. We need that. But building that shouldn't require changing our entire system in a way that would not give us the choices of health plans, doctors and competition."
That's why he is pushing the four pillars of patient rights as a launching point for a national debate.
"Whatever happens is unlikely to be a perfect system, but we have to create a solid patient safety net system," he says, citing food stamps as a successful method of feeding the nation's poor. "We can move to a means-tested voucher program, kind of like food stamps, using a personal healthcare credit card. The other way is to find providers who are good at taking care of this population and want to serve them, like Medicaid HMOs, which are generally doing a good job of taking care of this population."
Mr. Scott says right now he's not enlisted any congressional leaders to take up his cause.
"We will continue to educate Americans on what's going on and respond to bills coming out of Congress and the White House," he says. "Instead of getting diluted by making this a big group of people, I just said this is what we believe. I've met with politicians. But what we're seeing now is more people talking about the four pillars and that's a good thing."
Contact Mark Taylor at mark@beckersasc.com.