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Bill Frist's Rich, Rewarding Life
Physician, Heel Thyself

Bill Frist, senator from Tennessee and heir to resigning majority leader Trent Lott, is a Bush kind of guy. Where Lott brought little to the president's agenda, Frist is Bush's brand of compassionate conservative, a friend of Karl Rove and a key figure in the GOP's November election victory. To top it all off, he's a pivotal player in the single biggest issue facing Congress: the soaring cost of health care. It's in this arena that the president seeks to lock down his domestic support for 2004. For him, Frist is a perfect choice—business-friendly, highly connected, and blessed with a reputation as one of the good guys.

The Frist family is deeply involved in the medical business. Bill Frist's father, Dr. Thomas Frist, founded the hospital conglomerate HCA, and Tommy Frist, another son, is the former chairman and CEO and still is on the board of directors. In 1994 the business merged with Columbia, creating the nation's largest hospital network. The senator's 2001 financial disclosure form puts his Columbia/HCA shares at between $15,000 and $50,000, with $5 million to $25 million more in a blind trust whose holdings are unknown.

With Congress under pressure to regulate the cost of drugs and other medical services, we could have a new majority leader who not only hews closely to free-market principles but has been deeply enriched by them—both personally and politically. In the current election cycle, reports the Center for Responsible Politics, the senator has taken in nearly $1 million from doctors, hospitals, nursing homes, and pharmaceutical companies.

Life hasn't all been roses for the family Frist. In 1993, federal investigators swept through 19 HCA offices searching for evidence to document charges of overcharging and fraud. Among the accusations was that the network was paying kickbacks to physicians in the Medicare program. Seven years later, the company pled guilty to 14 felonies. Corporate difficulties were compounded by a suit from whistle-blowers who said they received death threats and were ostracized after going public with the allegations. Just last week the Justice Department unexpectedly announced a settlement, with the company paying $631 million.

If the whistle-blower deal is finalized, the company will have paid out $1.7 billion to settle various charges and given another $17.5 million to states claiming HCA overcharged their Medicaid programs.

Still, the matter won't end. Things could get uncomfortable for Bill Frist on Capitol Hill, where his Republican colleague Charles Grassley—new head of the Senate Finance Committee and a keen advocate for whistle-blowers—already helped derail an earlier HCA settlement and is looking into the final deal. "This settlement can't be a Christmas gift to HCA and a lump of coal for the taxpayers," he said.

In years past, Democrats have needled Frist over "shameful" conflicts of interest, with no success. When, for example, he fought hard for a patients' "bill of rights"—a measure lobbied for by Columbia/HCA—Frist declared in Bush-speak: "I see no conflict of interest as I carry out the nation's business." Frist's version of the bill provides federal protection for the right to adequate medical care, but it doesn't help pay for it. What it does do is protect the care providers from legal liability by capping damages, restricting conditions under which suits can be brought, and immunizing employers.

The anti-regulation Frist argues that lawsuits will drive the cost of health care up, pushing more and more Americans into the pool of people not covered by any kind of health insurance. He espouses Bush-style programs, including the creation of IRA-like medical savings accounts complete with tax breaks. On social issues, Frist has a spotless conservative record. He's against abortion, sex education, international family planning, emergency contraception, and fetal tissue research. He led the fight against human cloning.

Frist opposed legislation banning job discrimination on the basis of sex and said nay to a bill reserving 10 percent of highway contracts for firms owned by women or minorities. Yet inside the Beltway he is considered extremely likeable, running marathons and contributing his time as a doctor in the poor sections of Washington. When someone suffers an injury on the Capitol grounds, Frist is more than likely to be the first doctor on the scene. Politicians even speculate he could be a presidential candidate when Bush completes his second term.

Considering Frist's main competition, it's easy to see why he'd be the obvious pick. Don Nickles, the conservative business hero from Oklahoma, was the first person calling for Lott's head and among the first in line to replace him. Just behind Nickles was Rick Santorum of Pennsylvania, but he's too junior to pull off party leadership. Nickles, by contrast, has too much history. Though he called Lott's pro-segregation remarks unacceptable, Nickles himself has voted twice against the Martin Luther King holiday, backed Jesse Helms's effort to provide tax-exempt status to private schools like Bob Jones University (where interracial dating was banned), and later joined Helms in supporting the elder George Bush's veto of a Civil Rights Act amendment that would have banned workplace discrimination.

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