ANALYSIS: Romney and Scott in Wonderland

Introduction

On the campaign trail in Iowa last week, former corporate executive and Republican governor of Massachusetts Mitt Romney shot back at hecklers who were challenging his stance that it would unfair and unwise to raise taxes on wealthy individuals and corporations to reduce the deficit.

“Corporations are people, my friend,” Romney said. “Everything corporations earn ultimately goes to the people. Where do you think it goes? Whose pockets? People’s pockets! Human beings, my friend.”

Democrats were quick to pounce. Rep. Debbie Wasserman Schultz of Florida, chairwoman of the Democratic National Committee, said of Romney’s remarks: “It is a shocking admission from a candidate—and a party—that shamelessly puts forward policies to help large corporations and the wealthiest Americans at the expense of the middle class, seniors and students.”

It’s fair to say that not everyone in Florida shares Wasserman Schultz’s point of view, certainly not her Republican governor, Rick Scott, and the folks who work for him at the state’s Department of Management Services (DMS).

Last week I wrote that DMS, on orders from Scott, planned to eliminate state workers’ choice of HMOs from two or three to just one. By doing so, DMS says the state will save $400 million over two years.

The irony—or hypocrisy, if you will—of this decision is that Scott was one of the most vocal opponents of federal health care reform. The front group he set up and funded, Conservatives for Patients’ Rights, claimed in TV ads that the legislation favored by Democrats would effectively end “choice and competition” in health care, resulting in people losing the ability to choose their own doctors and health plans.

The folks at DMS were not happy with the way I characterized their decision to effectively end choice and competition in health care for Florida state workers.

John P. (Jack) Miles, who, like me, used to be a CIGNA executive, sent me a terse note via LinkedIn accusing me of engaging in “disappointing spin.”

He wrote: “The statements you made and the latitude you took on the HMO procurement outcome in the State of Florida might make interesting reading but is inaccurate and does not represent the facts; very unfortunate.”

What was my sin? How had I erred?

Well, as it turns out, I apparently was confused about who the real consumer is in Florida. Not only are corporations people, as Romney asserts, the State of Florida is a person, according to the DMS PR guy. To be precise, the word he used was “consumer.” I had foolishly thought that state workers and their dependents, the people who actually need and occasionally use health care services, were the consumers.

I stand corrected.

“As I said in our phone conversation,” Kristopher Purcell, the DMS director of communications wrote me in an email, “the State of Florida is the consumer.”

As for the elimination of competition, Purcell noted that competition had once existed and had served a useful purpose for said consumer (the State of Florida), but was no longer necessary. Here’s how he described it: “It was the robust and open competition between HMO bidders that was a major factor in achieving cost savings in the State.”

Purcell also said I was inaccurate when I wrote that the four HMOs selected by DMS to serve state workers would not compete with each other in any single county in Florida. I should have written, he said, that the four companies had competed for the real consumer, the State of Florida, and the State of Florida had decided that one HMO per county was quite enough.

“The 4 companies already have competed with each other for state employees in the same county,” he wrote. “And the winner, if you will, from the competition was awarded the contract for a given county.”

Purcell also said that no state employee who wants to stay in an HMO will see any changes in his or her benefits. I had not said there would be changes in benefits, only that the employees might have to find a new doctor if their current doctor was not in the network of the HMO that DMS has chosen for them. Purcell did not dispute that.

“The only difference for an employee who moves to a new HMO carrier is the provider network,” he wrote.

Of course, that is a very big difference in my book. Remember, it was Scott who warned us that federal reform would lead to Americans losing their ability to choose their own doctors. Starting in January, thousands of Florida state workers and their dependents will face the possibility that the doctors they have been seeing for years will not be available to them because the HMO the State of Florida has chosen for them might not have those doctors in its provider network.

Purcell told me he believes the chosen HMOs will expand their provider networks to include more doctors, but where’s the guarantee that will happen? There isn’t one.

Oh well. At least we have all learned something important over the past few days. In the eyes of Republicans candidates, governors and their bureaucrats, corporations are people, just like you and me, and so are our state governments. That is important to remember. Now, and in November 2012.