Establishment Candidates, Insurgents Both Score in Tuesday's Primaries

First, Congratulations to Rick Scott of Florida! Now, I'm not a big fan of Columbia/HCA or Rick Scott, and I don't even live in Florida, but to be fair, some of the reported details about Scott need to be corrected. Scott started Columbia, but he did not start HCA; years later Columbia bought HCA to become Columbia/HCA. Most of the alleged fraud at issue was regarding coding and billing for hospital services by HCA before Scott and Columbia purchased it. With Medicare, Medicaid and other hospital insurers, it doesn't matter what the hospital might charge for its services, all insurers have a fixed amount that they pay. For example, if hospital A charges $500 a day and hospital B charges $1500 a day, Medicare will still pay $200 a day, and no more, to either hospital. Predictably, the goal of all payors, especially Medicare and Medicaid, is to pay out as little as possible. During the 1990's there was a great amount of frantic activity among investigators and prosecutors to find and prosecute healthcare fraud, even where none existed, in an attempt to "claw-back" money where they could. They also sought to intimidate healthcare providers to bill for a lower level of care than they delivered. Less intensive care is billed with a lower level code and receives a lower payment. It is apparent that Rick Scott and Columbia/HCA was unfortunate enough to be caught up in this frenzied witch hunt. Clearly, the majority of alleged fraud that actually involved Scott was not really fraud. Hospital records and other evidence supporting the charges of fraud were lacking. Still, the government clung to an arbitrary, self-serving belief that hospitals were billing for a higher intensity of care than they had actually provided. With the government threatening to prosecute Columbia/HCA, Scott, who was the company CEO, wanted to fight the government, believing the company was innocent. But the Board of Directors did not have any real grasp of the business of coding and billing for healthcare services, was completely intimidated by prosecutors, and insisted on settling out of court. Because of the Board's capitulation, Scott resigned in protest. Columbia/HCA gave Scott a generous severance and bought out his interest in the company. Scott was not forced out of his job, and while Columbia/HCA did settle with the government, it was never found guilty or "liable" by any court of law. In addition, if there had been the slightest shred of evidence against Scott in this regard, the relentless government wolves would have devoured him. Instead, no charges were ever brought against Scott in the Columbia/HCA case.