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General Hospital, sued the state when it granted permission for HCA to open its six new trauma centers. They have shown the court how difficult it is to recruit and maintain the specialists needed for a Level 1 facility and how adding competitive Level 2 centers only a few miles away can make that task much more difficult … and expensive. So far the courts have been siding more with the three nonprofit hospitals, and HCA has been looking to other avenues for relief in its efforts to protect this new "cash cow." State Rep. Jason Brodeur, R-Sanford, has spon- sored a bill in the House of Representatives that effectively would shield the six HCA hospitals from the current litigation. The leg- islation, if passed and signed by the governor, would allow all existing Level 1 and Level 2 trauma centers in the state to continue oper- ating, provided they comply with routine oversight and other operating regulations. A similar bill is pending in the Senate. When one looks back a few years, the cur- rent cozy relationship HCA has with both the Florida Department of Health, which autho- rizes new trauma centers, and its obsequious allies in the Legislature makes more sense. In the 1990s, the company — then known as HCA/Columbia, and helmed by none other than Rick Scott — was embroiled in a legal tussle with the federal government over gouging Medicare for unnecessary tests and treatments. Eventually, the company paid a record fine of almost $2 billion to settle all criminal and civil charges, including 14 felo- nies. Rick Scott left the company as part of the deal, having to admit to no complicity in the scam. He was showered with a sev- erance package worth hundreds of millions of dollars. Now Rick Scott is governor of Florida, thanks in large part to the tens of millions of dollars, received from HCA, that he spent on his elec- tion campaign. And HCA has set its sights on making Florida a major part of its campaign for huge profits from trauma centers. If allowed to keep its current six trauma centers — and the bills in the Legislature are designed to do just that, despite what the courts might conclude — and open the four additional centers it has planned, HCA's impact on health care costs for Floridians will be staggering. Already, the six HCA trauma facilities charge more in fees and billed services than all of the other trauma centers in the state. Their patients got an average bill of $124,806, which is more than $40,000 higher than the average bill of other trauma centers. But beyond the costs to patients is the ques- tion of quality care. Despite sycophantic posturing in the Legislature, the courts also have been taking a hard look at how well patients are cared for in Level 2 versus Level 1 trauma centers, and the Level 1 trauma cen- ters have been winning. OPINION Sarasota News Leader March 21, 2014 Page 94