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In the state of Florida, Republican governor Rick Scott and the Republican legislators are attempting to enact a far-reaching Medicaid reform bill in the state. Although newsworthy in and of itself, even more troublesome for the newly elected governor whose approval rate has been hovering at 30 percent is the serious ethical questions the proposed measure raises.
The legislation would allow HMO’s and other private health care companies’ unprecedented control over the state’s Medicaid program. One of the companies that stand to benefit from the measure would be the governor’s own company-Solantic. Solantic is a chain of urgent health care centers that provides emergency service to walk-in customers. Scott founded Solantic in 2001, shortly after resigning as CEO of Columbia/HCA during the largest Medicare fraud in history. Columbia/HCA, a large for-profit hospital chain, pled guilty to 14 felonies and paid $1.7 billion in criminal and civil fines for defrauding Medicare. Despite that, Floridians elected Scott to run their state. And bizarrely, it seems he is running the state for-profit as well. But, only for his profit.
Although Scott reports that he transferred his $62 million stake in Solantic to his wife, Ann Scott, a homemaker, many independent law experts still question the ethics of the Medicaid reform. Under a federally approved pilot program that began in 2005, some Medicaid patients in the state were allowed to start using their Medicaid at private clinics, like Solantic. Under the new sweeping Medicaid bill, the pilot privatization program would be expanded to the entire state. Solantic would stand to gain millions of customers.
“This is a conflict of interest that raises a serious ethical issue,” says Marc Rodwin, a medical ethics professor at Suffolk University Law School in Boston. “The public should be thinking and worrying about this.”
Scott’s office does not see any apparent ethics violation, although it is difficult to miss that. “The claims of a conflict of interest are incorrect and baseless,” Brian Hughes, Scott’s deputy communications director, stated without elaborating. Reporters have also questioned Scott, but he has remained firm in his defensive stance. “I believe in the principle that if you have more competition it will drive down the prices,” Scott told the St. Petersburg Times last month when asked about his wife’s shares in Solantic. “If you give more choices, it’s better for the consumer also to help drive down price…and that’s exactly what I’m going to do as governor.”
Scott also signed an executive order making drug tests required at least every three months for state employees. Although, the Supreme Court has been pretty clear about the constitutionality of that, Scott decided to go ahead and make it law of the land—for now. Again, guess who will benefit from it? Solantic also offers employee drug testing.
Florida lawmakers are working on the final Medicaid reform bill and a vote is expected in a matter of weeks. Scott’s approval continues to plunge, but he seems undaunted by it. Throwing out the first pitch at the Tampa Bay Rays opening game, Scott was met by a chorus of boos. He just smiled and waved. He will be smiling and waving all the way to the bank.