Fought the Prescription Drug Database
At first, Scott seemed determined to allow Florida's deadly pill-mill addiction to flourish. In February, he proposed repealing the law that created a prescription drug database designed to track the sale of narcotics. He argued that the database, intended to help spot patients who are "doctor-shopping," was an invasion of privacy. His backers in the Legislature also argued that the database didn't solve the problem because doctors weren't required to check it before dispensing drugs.
Still, in a state where seven deaths a day are blamed on prescription drug abuse, Scott's opposition to the database seemed bizarre. Lawmakers and police officials around the country — particularly in states like Kentucky, whose OxyContin drug trade is fueled by Florida's pill mills — bellowed in protest. Even Scott's fellow Republican Attorney General Pam Bondi fought to keep the database. Finally, Scott reversed course and agreed. In June, he signed a law that strengthens criminal penalties for overprescribing drugs, requires pain clinics to register with the state, and prohibits most doctors from dispensing narcotics.
In Broward County, doctors and patients have been participating in an experiment with privatizing Medicaid since 2006, when then-Gov. Bush enacted reforms he said would control skyrocketing costs and improve care through competition. The pilot program hit many pitfalls, but that didn't stop Scott from signing a law to expand it statewide. Now 3 million of Florida's poorest citizens, including kids, pregnant women, and elderly residents of nursing homes, will learn the joys of dealing with HMOs.
Currently, Medicaid patients either enroll in a state-contracted HMO or visit doctors who accept Medicaid's fee for the services they perform. Under the new plan — proposed by Scott's transition team and sponsored by Sen. Joe Negron (R-Stuart) — patients must enroll in private HMO plans. The HMOs will have more power to change the "scope, duration, and level of benefits," says Laura Goodhue, executive director of the community health advocacy group Florida CHAIN. She fears the HMOs will limit services and deny claims.
In the pilot program that has been operating in Broward and four other counties since 2006, the results have been troubling. According to a 2008 Georgetown University review of the program, a majority of doctors complained that their patients were having a harder time getting care because of the maze of paperwork and limited benefits.
"The complexity of the program has grown, causing confusion and increased administrative burdens for consumers and providers," the report says. "Access to needed services appears to be worsening, according to both physicians and beneficiaries."
"The only way to save money is to delay and deny care," Goodhue says. "People are getting the runaround."
A state-funded study by University of Florida researchers shows that Medicaid expenditures decreased in Broward and Duval counties during the first two years of the pilot program but cautioned, "It is not known whether these savings are sustainable over time."
The saving grace may be that before it can be implemented statewide, the reform plan must be approved by federal officials, because more than half of Medicaid's funding comes from the federal government, Goodhue says.
Acted Sketchy About Solantic
Let's say you're a multimillionaire who amassed his wealth running a health-care company and then decided to run for governor. Immediately after taking office, you start proposing and supporting legislation regarding health-care issues: privatizing Medicaid, requiring drug tests for state workers and welfare recipients, opposing a database that would track the sale of addictive prescription drugs. Unfortunately, the citizens of Florida are not total morons, and they realize that you, as governor, might actually profit from some of these proposals.
Turns out you still own a chain of urgent-care clinics that happen to offer $35 drug tests! Technically the $62 million investment in Solantic is in your wife's name. You moved it to the Frances Annette Scott Revocable Trust a few days before taking office. But it's tough to believe you're not still raking in the dough.
So do you apologize? Do you stage a public mea culpa and admit your conflict of interest? Not if you're Rick Scott. Instead, you wait for the media and the public to get so angry that someone files an ethics complaint against you. Then you rush to sell off your shares in the company. That's not suspicious at all.
Axed Funding for People With Disabilities
Need to trim your budget? There's no swifter solution than taking money from people who are physically incapable of fighting back.
The state Agency for Persons With Disabilities was running a $170 million deficit this spring when Scott decided to start slicing. Tasked with supporting 30,000 people with developmental disabilities, the agency had never been good at living within its means. Since 2005, it has shifted 5,000 clients from its waiting list to its roster but has never sufficiently increased its budget, says Kimberley Thompson, director of community relations for Sunrise Community, a Miami-based nonprofit agency that serves the disabled. Scott insisted he was rescuing the agency by forcing it to tighten its belt.