Don King is infamous for his catchphrase, "Only in America!" The much-derided boxing promoter usually delivers that line while grinning ear-to-ear and holding at least one tiny American flag. Many people of goodwill cringe when they see it, and roll their eyes. It's insincere, unctuous, tasteless, and it's probably true. Only in America can a small-time hood become a multimillionaire boxing promoter who's hated by many, if not most, of his former boxers, and who's accused of stealing his way to the top. Yet nothing sticks. He's the true Teflon Don. And he's a leader.
What do Don King and boxing have to do with healthcare? Well, while you were paying attention to more important things, the guy who led one of the largest hospital companies in America to the biggest Medicare fraud payment in history is on track to become Florida's next governor. In case you don't remember the particulars, Columbia/HCA, under Rick Scott's watch, pled guilty as a company to a variety of fraud charges in relation to a number of government programs, including Medicare. At the time, according to Forbes magazine, it was the biggest fraud settlement in U.S. history. Yes, Rick Scott, the former Columbia/HCA head, will be the Republican nominee for the governor's race in that state this November, after beating career politician and Florida Attorney General Bill McCollum. Now, only Democrat Alex Sink and independent Lawton Chiles stand in his way.
Though Scott was never personally charged or convicted with a crime in relation HCA's admission of fraud, he was forced out by the board shortly after the company's plea, as co-founder Dr. Thomas Frist Jr., took over to right the ship. Scott, wealthy from his HCA stint and his successive business ventures, campaigned on an anti-incumbent, anti-illegal immigrant platform. He cast himself as an outsider. He's clearly that. The Republican party—and lobbyists—overwhelmingly supported McCollum and ran negative attack ads in the last weeks running up to the primary. Voters bought Scott's side of the story—by a 3% margin. Scott paid handsomely to be the eventual Republican nominee; he spent $50 million of his own cash on his primary campaign. It apparently was money well spent. In a climate where voters seem to want anybody but the incumbent, often for good reason, they got "anybody."
One of Scott's biggest campaign promises is that he will do all he can to repeal the Patient Protection and Affordable Care Act. Ironic isn't it, given that Medicare was Columbia/HCA's victim? But hypocrisy is par for the course in politics. Whether you are a fan of the law or not, a repeal would cause huge upheaval in healthcare even at this early date, as institutions around the country are transforming their organizations to deal with its myriad likely ramifications for their businesses.
And don't think it can't happen. Though repeal seems a long shot, there is some precedent. The 1988 Medicare Catastrophic Coverage Act, which enjoyed much greater public support than PPACA, was repealed only a year after it passed when it became clear that seniors hated what it did to their pocketbooks and freedom of choice. A lot of people hate what they derisively call ObamaCare, even if they're not exactly sure why they hate it. They vote, and if many more people with Rick Scott's political opinions get elected, I'd say repeal is a possibility.
Did I mention that Scott is still very active in healthcare? He's a major investor in a chain of walk-in clinics across North Florida.
We praise true leadership in this country. It's a rare enough talent that it's extremely prized, even if that leadership could be ethically flawed. It's also well-compensated.
Say this for Scott. He's a leader.
Philip Betbeze is the senior leadership editor at HealthLeaders.