October 31, 2014

Future of Healthcare

Insurance: On the Offense

Solantic's Rick Scott insists that more government involvement will mean less innovation.

Mike Vogel | 5/1/2010

Rick Scott has taken a national role in the healthcare insurance debate while also backing Solantic. The company aims to provide urgent care in a retail setting: A posted menu of prices, comfortable spaces and convenience. Solantic provides physicals, shots and episodic care. Solantic can handle 70% of the cases that show up at an ER for an average cost of $111 in Jacksonville, the company says. That’s an average savings of $583, or 84% of total costs, and an average savings of 90% for uninsured patients, the company says. Unlike ERs, Solantic isn’t open 24 hours, isn’t staffed for any contingency, is in less expensive real estate and isn’t equipped with MRI machines and other equipment necessary to treat all comers.
[Photo: Eileen Escarda]

After the tumultuous finish to the years when he built Columbia/HCA into the nation’s largest healthcare company, Rick Scott came to Florida. In 2001, without much notice, he backed creation of an urgent-care company, Jacksonville-based Solantic, that has grown to 31 locations in Florida and plans to go national. The clinics promise to save money for insurers and patients by providing quality care in a Starbucks-like setting where prices for tests and other services appear on menu-like displays.

Scott’s quiet phase ended a year ago, when he made it his mission to sink Obamacare. Since, he’s advocated for healthcare insurance based on a few key principles: A safety net for the truly uninsurable, a free market and individual responsibility. As many industry players strategized to influence federal legislation to their liking, a Scott-founded organization, Conservatives for Patients’ Rights, went out front, attacking the Democratic overhaul in video ads featuring British and Canadian patients who had horrible experiences with their government health systems. “I believe you help people by helping them become more independent, not by making them more dependent,” Scott says. “I think it’s clear (people) don’t want more government.”

Scott, 57, works from an office a short walk from the beach in Naples. The lobby features an 1870 Edison ticker-tape machine, a book companion to Ken Burns’ “National Parks” series and two books supporting the 2nd Amendment. He makes his case against remaking healthcare financing with the earnestness of the Eagle Scout he is. The closer the nation moves to a Canadian or British system, the less innovation in drugs and treatments it will see, he says. Government inevitably rations care and access, providing for the “small things” needed by the majority and cutting out the rare, he says.

Scott’s opening premise: There aren’t unlimited dollars to spend on healthcare; individuals, not government, are best suited to decide how to spend them.

Scott says studies show that the number of chronically uninsured people is a manageable 8 million. The rest of the 45 million often cited as uninsured either lacked insurance only for a time while between jobs, already qualify for Medicaid but don’t know it or don’t use it, make more than $50,000 a year or are illegal aliens.

Scott’s prescription includes letting insurers sell across state lines and letting everyone, not just employers, deduct premium costs so that individuals can be responsible for choosing their coverage and care levels. When people own their policies, he says, they will keep them when changing jobs and will stay insured. Because they would stay with the same insurer, the pre-existing condition issue would fall off dramatically, he says.

Scott also would trim government mandates for coverage to essentials such as mammograms but otherwise let people buy extra coverage — for infertility or chiropractic care — as they see fit.

He says his plan would lower costs enough to put insurance in the reach of many. For those whose pre-existing conditions make them uninsurable, Scott says government should create a subsidized, high-risk pool.

Scott likes insurance analogies: Healthcare should be more like auto coverage, which covers catastrophes, not regular maintenance. Just as some consumers choose whole life and some buy term, some people might start prepaying for lifetime health coverage at 25; others will insure only for expensive episodes. Personal responsibility would be rewarded as insurers offer low-cost policies for fit non-smokers, just as life insurers charge the lowest rates to the fittest, he says.

In advocating for the private market, he offers Solantic as an exhibit. Solantic-commissioned studies indicate it saves the insured and the uninsured substantial sums — for the uninsured, 90% compared to the cost of an emergency room visit. Scott says Solantic pays its board-certified doctors competitively but is cheaper for patients because, unlike an ER, it isn’t open 24 hours and isn’t equipped with the gear and staff to handle true emergencies.

This year, Solantic began offering $5 prescriptions on 50 common medications and retail gift cards to prepay for services. It is co-branding and co-owning with Baptist Health of Northeast Florida, Shands in Gainesville and Bethesda Health Care System in Boynton Beach.

Meanwhile, supporters of Democratic bills bring up Columbia/HCA. Scott was not accused of wrongdoing but was shown the door by his board in 1997; the company later admitted to overbilling the government and had to repay $1.7 billion. A TV ad for Health Care for America proclaimed: “Rick Scott — the multimillionaire hospital CEO whose former company pleaded guilty to 14 felonies — the largest healthcare fraud settlement in history.”

Scott, after Democrats in Congress completed their overhaul, says he’ll battle on. “I don’t believe the American people will tolerate such an astounding level of arrogance from their elected representatives,” Scott said on his Conservatives for Patients’ Rights website. “This nation deserves better, and I will continue to fight to see that we get back on the right track.”

Tags: Healthcare

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