Wednesday, May 27, 2009


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By Ezra Klein

If I were a Republican, I'd be ready to slit my wrists at the prospect of former Columbia/HCA Healthcare CEO Rick Scott heading the conservative response to Obama's health reform effort. This is like liberals getting Franklin Raines to run their economic messaging or Bush tasking Donald Rumsfeld with a comprehensive defense of his administration's legacy.

In the 90s, HCA was the largest for-profit hospital company in America. As Forbes wrote, "it bought hospitals by the bucketful and promised to squeeze blood from each one." More than any other single company, it was responsible for the cruelty that turned the public against managed care. Indeed, remember when audiences began spontaneously clapping for Helen Hunt's anti-HMO rant in As Good As It Gets? That was the sort of ruthless cost-cutting pioneered by HCA they were shouting down. If Scott didn't exist, health reformers would have to invent him.

But it turned out that HCA's wild profitability wasn't all efficiencies. A seven-year federal investigation uncovered widespread fraud. According to Forbes, HCA has "increased Medicare billings by exaggerating the seriousness of the illnesses they were treating. It also granted doctors partnerships in company hospitals as a kickback for the doctors referring patients to HCA. In addition, it gave doctors 'loans' that were never expected to be paid back, free rent, free office furniture, and free drugs from hospital pharmacies."

When all was said and done, HCA agreed to pay the government $1.7 billion. It was the largest fraud settlement in U.S. history. Richard Scott, the CEO, was forced to resign in shame.

And now, he's back.

Conservatives for Patients Rights is a multimillion dollar initiative that plans to stand athwart health reform and yell, "stop!" They've hired the same PR firm that sold the Swift Boat veterans for Truth. Their first ads will come this week on conservative talk shows and cable news. Their media blitz has already started. Today, Scott was profiled by The Politico. “If we have more government involvement we’re going to have dramatically worse health care,” he told said.

So, to recap: The first major health care group fielded in opposition to Obama's initiative comes from a for-profit hospital executive who resigned amidst the largest fraud case in United States history and means to sell an anti-government message using the same PR firm that helped the Swift Boat veterans.

There's an old saying: It is good to be lucky in your friends. But it is even better to be lucky in your enemies. Health reform, it would seem, is lucky in its enemies.

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