No Bull, No Fluff, No Smudges
Your news source for
Flagler, Florida and Beyond

Floridians, Start Your Orwells: Rick Scott’s Buzzword-Assault on State Health Care

| December 27, 2010

Jim Saunders
Health News Florida

State employees had better develop an “entrepreneurial spirit” and a “start-up company philosophy.” And they’d better get ready to see jobs “privatized.”

That message echoes through a report that Gov.-elect Rick Scott’s transition team released this week about the state’s health and human-service agencies.

County health departments? They should be a “last resort” for providing primary care to residents.

Public hospitals? Maybe not needed.

Three state mental hospitals? Private companies can do better.

Scott made a fortune running the Columbia/HCA hospital company and then founded a chain of walk-in clinics. Bottom line, he’s no stranger to the private health-care industry.

Now, judging from the 68-page transition team report, he could move state health services more in that direction. While the details of such ideas always get sticky, Scott appears to have a willing audience among business-friendly Republican legislative leaders who are worried about a gaping budget shortfall.

“Government shouldn’t be competing with private industry,” House Health Care Appropriations Chairman Matt Hudson, R-Naples, said this week as he discussed the report.

But lobbyist Karen Woodall, who has long worked on health and human-services issues, worries that a privatization push could focus more on saving money than on better delivery of services. The state already relies heavily on non-profit groups to provide services, she said, and she is particularly concerned about attempts to shift work to for-profit companies.

“My overarching concern is that saving money shouldn’t be the driving factor,” Woodall said.

One potentially far-reaching recommendation in the report is to “get the Department of Health and the county health departments out of the business of primary-care delivery.”

The transition team said an increase in providing primary care at county health departments contributes to “mission creep” — a view that public-health agencies have expanded their duties beyond what was originally intended.

The recommendation also appears to have support among legislative leaders, who have increasingly talked about relying on non-profit federally qualified health centers — instead of county health departments — to meet patient needs. Other options mentioned in the report include increased use of teaching hospitals and private providers to care for patients.

“I do not believe DOH should be providing primary care services in a county where an FQHC or free primary clinics exists,” House Appropriations Chairwoman Denise Grimsley, R-Sebring, said in an e-mail this week.

But Dr. Leslie Beitsch, associate dean for health affairs at the Florida State University Medical School, said moving away from primary care at health departments needs to be looked at county by county. He said, for example, that might work in places such as Miami-Dade County, but not in rural counties that don’t have alternative providers.

“In DeSoto County, you’re going to need the health department,” said Beitsch, who has teamed with other public-health advocates to make a series of recommendations about the future of the Department of Health.

To a large extent, however, the transition team’s recommendations are aimed at squeezing government and making it more business-like. Even the wording is akin to something out a business seminar.

One part calls for the Department of Health leadership “to reflect an entrepreneurial spirit and passion for excellence.” It also says the department should “institutionalize a start-up company philosophy” and “create measurable outcomes and reward those who are entrepreneurial in achieving those outcomes.”

Beyond the philosophy and lingo, some ideas aren’t new. For example, the team calls for closing the state’s A.G. Holley tuberculosis hospital in Palm Beach County and moving patients to other facilities — an idea that has rattled around the Legislature for years.

The report says “significant savings can be realized by reduction in facility-related overhead and sale of the hospital and its large campus.”

The president of the Florida Hospital Association, however, said recently it would be a mistake to close A.G. Holley and scatter TB patients to other hospitals throughout the state. Bruce Rueben told Health News Florida that caring for the patients is the “quintessential public-health responsibility.”

Another warmed-up idea would privatize mental hospitals in Macclenny, Gainesville and Chattahoochee. The report says the move could save $38 million to $58 million for the state — and lead to better care.

“Examples of the successful privatization of former state hospitals have proven to provide better care to patients,” the report said.

But if Scott moves forward with the idea, he likely will slam into some political realities. The Macclenny hospital, for instance, is a major employer in rural Baker County, and community leaders have lobbied heavily against past privatization efforts.

Some ideas in the report are more novel. One potentially explosive recommendation calls for a panel to study the role that taxpayer-funded public hospitals — like Jackson Memorial and the North and South Broward systems — should play in the future.

The report points to some urban areas, such as Tampa and Orlando, that provide health services to low-income people without needing “government-run hospitals.”

“What is unclear is whether government should be in the business of operating a competitive enterprise using tax dollars as a subsidy without a thorough review of whether this model is the most-beneficial and cost-effective way to use the tax revenue,” the report says.

Jim Saunders can be reached at 850-228-0963 or by e-mail here.

Print Friendly, PDF & Email

15 Responses for “Floridians, Start Your Orwells: Rick Scott’s Buzzword-Assault on State Health Care”

  1. Jack says:

    Republicans are good at spending taxpayer dollars on corporate welfare. TARP was a prime example, after all it was Bush Jr.’s idea.

  2. PC MAN says:

    Whatever Rick Scott does in the future will be the same old story, a small amount of people will get very rich, a large amount of people will suffer and nothing will improve. Republicans talk a good game during elections but have no record of success.

  3. DLF says:

    Jack:: where have you been for the last two years ? The dems have done a great job of wasting our money, you can’t blame Bush for the spending habits of the “great one”

  4. DLF says:

    All I can say is we have had to live with Obama and his spending habits for the last two years, now you will need to live with Scott and his reduction in spending (maybe) At least the sun tan man is gone, thank the Lord for that.

  5. Robert says:

    I believe that private companies, as many have done, will defraud the public treasury.
    Then Rick Scott will once again feign ignorance.

  6. Bill says:

    I just cant get my head wrapped around out health system. After seeing systems like the two-tier health system in Germany work so successfully, i have such a hard time seeing why we cant implement something similar. Low income people are covered, little to no expenses. Higher income are covered, by their “private” insurance and deductibles, copays, etc etc are all covered by the government.

    People always say that Europe gives rationed healthcare, but have my family is there and lots of friends, no one has ever complained or received back service or put on back burners. Private companies still make plenty of money…

    I just have a hard time understanding that I have to pay $350 a month and if something happens I still have a $2000 deductible for tests or operations. i dont have that money available. knock on wood!

  7. Robert says:

    It is too bad that our politicians are bought off by special interests.
    And it seems that those with health care don’t want those without to have it. Something like our federal elected officials who have the best health care money can buy not wanting to see all citizens covered.

    Is there something evil about providing health care for everyone. Either way the health care industry will make money.

    The new group coming into Washington is going to make it their business to repeal the healthcare law.

    I work in the aviation industry as an IT specialist. I don’t have health care because of a pre existing condition. Now I will be able to purchase it but cannot afford it.

  8. Anonymous says:

    How is possible that 1 in every 4 kids educated in the government school system can not pass the military entrance exam and yet we want the government to run the health care system.

  9. PC MAN says:

    DLF I’m glad you refer to Mr. Obama as the “great one”. Can you guess which ex president is referred to as “the dumb one” ?

  10. Michael says:

    The Republicans continued push to privatize government programs is akin to robbing the donation pot at church, it’s corporate welfare, watch as those private companies defraud the government.

  11. DLF says:

    PC Man: thats a no brainer Jimmy Carter,who may be replaced as the worst prez in history by the great one.

  12. some guy says:

    It sucks that some can not pay for their health care BUT our Naition cant also. We can not add to our debt by having more and more Government welfair programs. If we wish to have a Country to pass on to our kids and grandkids we must get out from under this crushing debt THAT ALL POLITITIONS put on us.

  13. PC MAN says:

    What a bunch of BS “some guy says”. The amount of amnesia on the right is mind boggling. All politicians did not put us in debt, two unfunded wars and 10 years of unfunded tax cuts did. If your not man enough to admit failures from your side please go to to post your comments.
    Come on DLF we all know the W stood for WORST

  14. Livereader says:

    The Federal government is broke–out of money. So are the states–broke–they have no money. Yet we have all these social programs in place that need funding. The biggest line items in the Florida state budget are health care and education. I am NO fan of Rick Scott, but if you were trying to save a business, you have to make cuts in spending. These cuts will be unpopular, and most certainly drive up the price of services to the average citizen. I’m sure that frivolous spending in the government will continue…and tax payers will pay the price. These elected representatives are in crisis mode. Get ready for a big change my fellow Floridians!

  15. Gervais says:

    Scott is the best politician money can buy, the lesson kids is, it’s okay to be a crook, you get rewarded with a multimillion dollar golden parachute for defrauding the ‘gubmint’!

Leave a Reply

FlaglerLive's forum, as noted in our comment policy, is for debate and conversation that adds light and perspective to articles. Please be courteous, don't attack fellow-commenters or make personal attacks against individuals in stories, and try to stick to the subject. All comments are moderated.

Read FlaglerLive's Comment Policy | Subscribe to the Comment Feed rss flaglerlive comment feed rss

More stories on FlaglerLive

FlaglerLive Email Alerts

Enter your email address to get alerts.


support flaglerlive palm coast flagler county news pierre tristam
news service of florida
FlaglerLive is a non-profit 501(c)(3) organization | P.O. Box 254263, Palm Coast, FL 32135 | Contact the Editor by email | (386) 586-0257 | Sitemap | Log in