Beware Rick Scott's Brave New Healthcare Fix
The hospital CEO turned US senator is a fraud superstar at working the system.
When Rick Scott came to town, every one of us who worked at Columbia Hospital Corporation’s Victoria Hospital in Miami, Florida stood at attention. The young, dashing CEO had come to make sure staff bloat was reduced and profits were maximized. After leaving my position in Denver and moving my whole family to Florida just five months prior to being the hospital’s billing manager, I was just learning how to do my job within all the rules and regulations. And Rick Scott in our facility meant I needed to at least be pleasant to the big boss. And, indeed, I was.
As the day of Scott’s visit wore on, staff members who were about to be laid off just six weeks before the holiday season in 1989 were called to the admin offices via the hospital’s public announcement system. The extension named “3200” was the call to ride the elevator up several floors to be dismissed by the hospital CEO and his CFO. The day never left my memory as one during which good, kind, and dedicated colleagues, including the boss who brought me to the position, were riffed. On her way out the door, she reminded me to stay alert and be careful. I didn’t know what to do. I cried a lot that night at home, yet I didn’t know what was still to come in Scott’s new vision of profitability.
Within weeks, I noticed a change in our workflow. I was pushed hard to generate collection letters for all the Medicare patients who had been admitted to Columbia’s Victoria Hospital who had not paid their Medicare deductibles before discharge. But then I was instructed to put those generated collection letters in the patient files but never to mail them to the patients. That, I was told, would create a paper trail for due diligence in collection efforts as required before the hospital could submit to have those unpaid (and now unbilled) deductibles reimbursed by the federal Medicare program.
Filing letters in patient files without sending them out seemed wrong and it seemed fraudulent to me, and since I was new to it all I thought maybe if this was standard practice for the hospital, it could have been some loophole I didn’t know about. I dove into the Medicare rules, and I found this troubling line, “If you knew or should have known,” a certain action was fraud, you are complicit and could be charged with a crime. When I questioned the CFO about it, he snapped at me and said that if I wouldn’t do my job, I might need to rethink working there.
Universal coverage via improved and expanded Medicare for all of us would end Rick Scott’s grift.
In mid-December 1989, with my husband suffering heart problems and desperately in need of insurance coverage, I loaded all my personal items in a box and left the hospital. I quit my job. I wrote a letter to my former US Sen. Tim Wirth of Colorado about the situation, and I never heard directly back about what happened to that letter as I asked him to be cautious about disclosing my name or location. I was already terrified of these people. They collected hundreds of thousands of dollars quarterly from the scheme I was asked to be part of, and Rick Scott’s Columbia Hospital Corporation was building a portfolio that included an awful lot of hospitals. Scott was a rising star, after all, and making the first few hospitals he owned profitable was critical to keep that star on its trajectory.
After the Department of Justice started investigating Columbia’s hospitals in the mid to late 1990s, the hospital industry giant paid a record $1.7 billion settlement around defrauding the US government programs, Medicare, Medicaid, and TriCare. It turns out the schemes to enrich profits were widespread and involved much more than patient collection letters. Yet, even after Rick Scott was forced to resign and take responsibility for the fraud committed, he took a severance package of $10 million and stock options totaling nearly $300 million. Wow, that was a generous, golden, gilded, and glorious send off, eh? Up next for Scott?
To see this man ascend the political ranks to be thought of as an appropriate US Senate architect of a new health industry scheme to replace the Affordable Care Act-Obamacare subsidies is a tragic turn of events. We will not get anything close to a humane system under a Rick Scott plan.
The health industry is likely celebrating a return to laissez-faire, anything-goes-if-it’s-profitable model Rick Scott was an expert at designing and operating for Columbia Hospital Corporation. Patients will be the revenue stream upon which his fortune grows larger, and until we wake up and finally move to a model that puts patient health and well-being at the forefront of the design, we will see the health industry enrich itself beyond its wildest dreams while the architect of Medicare and Medicaid fraud, Sen. Rick Scott, takes yet another victory lap on taxpayer money. He and his health industry allies really love being on the dole, despite any claims to the contrary. They just call it profit.
Universal coverage via improved and expanded Medicare for all of us would end Rick Scott’s grift. Perhaps now the truth becomes even more clear. Ending the stranglehold of hospital corporations like the behemoth HCA Healthcare that also includes all of the hospitals previously owned by Columbia Hospital Corporation. On the corporate website, HCA Healthcare writes, “HCA Healthcare, Inc. owns and operates 186 hospitals and approximately 2,400 ambulatory sites of care, including surgery centers, free standing emergency rooms, urgent care centers, and physician clinics in 20 states and the United Kingdom.”
The profits are dear—not the patients, my friends.
a camera monitor is used in patient rooms on August 2025 at HCA/Healthcare. (Photo by Donna Smith)