With the New York Times openly speculating about the possibility that President-Elect Donald Trump might tap Florida Governor Rick Scott to run Health and Human Services, it’s time to take a look at how Rick Scott himself might view the possibility. Scott has said he isn’t interested in the job, but what else is he supposed to say at this early stage?
Here are three reasons Donald Trump might offer the job to Rick Scott:
Trump knows Rick Scott really hates ObamaCare – In 2009, a year before anyone in Florida had ever heard of him, Rick Scott launched “Conservatives for Patients’ Rights” (CPR), a campaign in which he spent somewhere north of $6 million of his own personal weatlh to oppose the passage of government-run health care. In the end, Scott claimed victory when he led the charge against the so-called “public option,” a government-run health insurance organization that would compete with private insurers. Running HHS, and the repeal and replacement of ObamaCare, would be poetic justice for Rick Scott.
Nobody understands healthcare like Rick Scott – In terms of sheer budget size, four programs, Medicare, Medicaid, Children’s Health Insurance Program (CHIP) and of course, ObamaCare itself, gobble up more than 25% of the entire federal budget. If Rick Scott believes he can help “make America great again,” HHS would be the place to start. Rick Scott is a numbers guy, first and foremost. He has an uncanny knack for looking at spreadsheets, profit and loss reports, or other financial documents and quickly picking out the most crucial data. He built his hospital empire, Columbia/HCA, in large part because he was one of the first to realize that occupancy rates at hospitals – the ratio of empty beds to filled beds – could determine whether a hospital had the potential to be profitable. And he often bought hospitals just to close them down. While some criticisized the tactic, it helped make the remaining hospitals in a given market more efficient, lowering health care costs for his company. At HHS, it wouldn’t take long for Scott to determine where the federal government is wasting its money, and where it would get the most bang for every taxpayer dollar.
Trump knows Rick Scott really hates federal regulations – In 1997, some believe that the Clinton Administration, through the Department of Health and Human Services, unfairly singled out one of the largest health care companies in the world: Rick Scott’s Columbia/HCA. It remains the biggest knock against Scott: the federal government fined Columbia/HCA about $1.7 billion for allegedly overcharing Medicare and failing to comply with Medicare regulations. Scott has long acknowledged that “mistakes were made” on his watch. But it’s also fair to point out that Medicare regulations were inconsistent and nearly impossible to make sense of. In fact, dozens of companies were similarly fined during the same period in which Scott’s company was singled out – his just happened to be the biggest health care provider in the world at the time. Taking over HHS would provide Scott with an opportunity to simplify the federal regulations that govern one of the largest cost-centers in the entire federal budget. To a numbers guy with Scott’s background, that challenge might be incredibly appealing, and it would represent sweet justice for him to take over control of the federal agency that nearly destroyed his career.
With that said, I’d be surprised if Scott is actually interested in the job. Already, the president-elect is signaling moderation, especially on ObamaCare. While Scott is already talking up the dismantling of ObamaCare, there are a couple of roadblocks that would stand in his way: the first is Trump himself, who told 60 Minutes that he’s open to keeping the certain parts of the program in place, including a provision to cover those with preexisting conditions, which Trump says is one of the “strongest aspects” of Obamacare.
The second roadblock is Congress, and the notion that you can’t just get rid of Obamacare without replacing it with something. Just what kind of something that ends up being is for Congress to sort out – which is not something Rick Scott has the patience for. He’s a chief executive at heart, used to being in charge and making decisions without having to say “pretty please.” At HHS, not only would Scott have to contend with Trump, he’d also have to answer to Congress. And knowing the man like I do, I can’t see him relishing the idea of going to Capitol Hill with hat-in-hand and testifying before bipartisan congressional committees, where Democrats will have a chance to rub his nose in a lot of old but very nasty press clips, just for the sport of it.
My money is on Scott staying put right here in Tallahassee, working with the Trump administration to secure a Medicaid waiver and block grant for Florida, which would give him the leeway he needs to save the state a small fortune in health care costs during his final two years in office. Just in time for this.