The Corner

Righting Health Care

Later today, the Obama administration will hold a White House Forum on Health Reform. Richard Scott has long been at work in on the topic. Scott is former chairman and CEO of Columbia/HCA, named one of the 50 Best Performing Companies of the S&P 500 in 1997. He is also co-founder and chairman of Solantic Corporation, a Florida chain of 23 urgent-care centers that proudly features its prices on the Internet and on a “Starbucks style” menu board. Most recently, Scott is founder of Conservatives For Patients’ Rights, which seeks to advance some conservative principles in health-care policymaking while working with those who aren’t so conservative.


In light of the summit and an “open letter to the president” ad he has in the Washington Post today, NRO asked Scott a few questions about what he has in mind.


Kathryn Jean Lopez: Why are you stepping up to the health-care plate now?


Richard L. Scott: America is ready to improve health care. I believe there needs to be a strong advocate for patients’ rights, someone who has worked in the health-care industry. I hope my experiences focusing on reducing costs and improving outcomes can help ensure that any health-care proposals that are implemented focus on choice, competition, accountability, and personal responsibility.

Lopez: You’ve been here before, haven’t you?


Scott: During the time I was the chairman and CEO of Columbia/HCA, President Clinton proposed a significant change in how health care was provided in this country. In my position then, I worked to educate our 285,000 employees, our patients, and Congress on the ramifications of the Clinton health-care bill.


Lopez: What are the similarities between Obama’s health-care proposal and HillaryCare of old?


Scott: At this point, we do not know what Obama will propose. After President Obama’s summit this week, I hope we will see a proposal. What concerns me is that it appears we are heading down a road toward government-run health care, similar to what the Clinton health bill attempted. Such a program would increase costs and lead to rationed care. 


Lopez: Are there positive differences — progress, perhaps? Are there dangerous features?


Scott: President Obama has stated that he would like to retain the employer-sponsored insurance most people are covered by today. The stimulus bill that just passed establishes an ominous-sounding Federal Coordinating Council. My concern is that the end result will be the government dictating to your physician what treatments or drugs you will be entitled to in an effort to control costs.


Lopez: Who are Conservatives For Patients’ Rights? Aren’t all conservatives for patients’ rights? Though, now that I’m asking . . . what are patients’ rights?


Scott: Patients have a right to choose their own physician and the right to choose the insurance plan that fits their needs, not a plan dictated by some bureaucrats. Patients have the right to shop and compare for health-care providers based on price, outcomes, and service. Patients have the right to the same tax deduction for purchasing health insurance as employers have. Patients are entitled to standard insurance forms. Patients have a right to be rewarded for taking care of themselves and leading a healthy lifestyle such as eating properly, exercising, and not smoking. 


Lopez: What’s conservative about that?


Scott: Conservatives believe in individual freedom and the right to make choices and the obligation to do the right things. We believe in free-market solutions to health care through innovation and competition, not government bureaucrats who could not possibly make the best health-care decisions for any of us. Government-run health care is an attack on our freedom as Americans. I would hope folks who are believers in the free market and who oppose government-run health care will visit us at, and sign up to be a part of our grassroots effort. 


Lopez: Was George W. Bush conservative on health care?


Scott: President Bush believed individuals should be entitled to the same tax breaks for purchasing insurance that employers receive. Under President Bush, Medicare has been working to reimburse hospitals based on outcomes. 


Lopez: What is the most common Republican mistake on health care?


Scott: I believe Republicans should lead by proposing changes in health-care policy that promote choice, competition, accountability, and personal responsibility. We should be bullish to talk about health care. After all, it is free-market principles that have lead to life-changing solutions in health care and the reason many Canadians and British come to America for life-saving treatments. 


Lopez: Can Democrats and Republicans actually work together on this issue and ultimately come out with something remotely conservative?


Scott: Yes, both Democrats and Republicans must improve health care based on what is good for patients. I believe Americans want health-care costs to come down. By following our four pillars of choice, competition, accountability, and personal responsibility, Democrats and Republicans can reduce health-care costs and improve outcomes. If the goal is to reduce the cost, which we all agree is too high, then cost cannot be reduced by more government. In fact, costs goes up when government encroaches while quality of service goes down. 


Lopez: What can we — must we — learn from England and Canada?


Scott: Both England and Canada have discovered that the government’s controlling health-care costs through wait times and restricting access to life-saving drugs is not acceptable to citizens. While citizens like the thought of a single-payer system, they do not like the consequences.. Both countries are now looking to work the free market into their systems. 


Lopez: Can health care learn from Fannie Mae and Freddie Mac?


Scott: Yes; if we are not careful, we will have Fannie Med. Both Fannie and Freddie believed the government could help low- and middle-income homeowners reduce the cost of homeownership. The end result was that the very people the government targeted to help were the ones most hurt when they lost their down payments and equity in their homes when Fannie and Freddie failed. There is no such thing as a free lunch. Government involvement usually means higher, not lower, costs. Centralized planning has never worked anywhere in the world long-term. Government actions always seems to hurt the very people they were intended to help.


Lopez: You started a hospital company in 1987, the day the market dropped 500 points. Does that give you a different perspective than many policymakers?


Scott: Having the opportunity to build companies that succeeded in reducing costs while improving outcomes and patient satisfaction gives me the confidence to know that we can drive health-care costs down and improve outcomes as well as the experience for patients. 


Lopez: You established a health system in Bunyala, Kenya. How did you wind up there? How does one do that? And are there any lessons there for us?


Scott: My wife and I were looking for a health-care project in Africa to become involved in. We knew an individual at World Vision, and he told about a project they wanted to pursue in Bunyala, where the average income is something like $100 per year. We were focused on ways to improve their health.


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