ST. PETERSBURG — In a spartan, contemporary downtown office with black leather chairs and glistening metal and glass tables, A.K. Desai waxed on about the entrepreneurship of Henry Ford, the latest academic book he's reading on health care reform, and where engineering fits in the future of Florida's higher-education system.
And you wonder: How does an erudite millionaire like Desai become so infatuated with a swaggering and sometimes tongue-tied Texan like Rick Perry?
Former Massachusetts Gov. Mitt Romney, whom Desai backed four years ago, came to St. Petersburg this year to court Desai for his Republican presidential campaign. Former Minnesota Gov. Tim Pawlenty, former Utah Gov. Jon Huntsman and Indiana Gov. Mitch Daniels, while he was mulling a run, also met with Desai, 53.
In the end, the health care executive who has made millions as a Medicare provider went with the Texas governor, who has argued that Medicare is unconstitutional and should be dismantled.
"I just felt Gov. Perry would be best right now when it comes to creating jobs," Desai said. "With over 16 percent underemployment and unemployment, somebody who would create jobs is what this country needs."
Florida has dozens of Republican fundraisers who bundle individual contributions to raise tens or hundreds of thousands of dollars for candidates, and this year most are helping Romney. As one of the first — and relatively few — elite Florida fundraisers to embrace Perry, Desai's political profile has risen considerably.
"I got to know Dr. Desai through the Republican Governors Association and quickly found him to be a smart, impressive health policy expert," Perry said in an e-mail. "A.K. Desai is an important part of our Florida team, providing strong support, networking and expertise to our operation."
The early Perry enthusiasm has faded fast, however. Having raised about $17 million, Perry remains a serious contender, but after shaky debate performances he has dropped in recent national polls behind Romney and businessman Herman Cain.
"There's no buyer's remorse," said Desai, who remains optimistic about Perry's chances and continues to work his contacts on Perry's behalf. On Oct. 26, he is helping host a $1,000-per-person breakfast fundraiser for Perry at the TradeWinds Island Grand Resort in St. Pete Beach.
"You cannot predict who will win," Desai said, "but you support a candidate who is going to provide good governance, and this country absolutely needs that to reclaim all the glories we had going for this great nation."
Desai practiced medicine until three years ago when he turned his attention full time to his insurance company, Universal Health Care. He cited Perry's record of restricting medical malpractice lawsuits in Texas and noted that Perry's wife is a nurse and his father-in-law is a doctor.
"They understand health care and health care issues, and understand what it takes for doctors to practice medicine and not practice unnecessary, defensive medicine, which raises costs for everybody," he said.
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Akshay Desai grew up in Surat, India, the son of two educators. After earning his medical degree, he immigrated to America in 1983 for residency at the University of Illinois. He moved to Washington to specialize in geriatrics and earn a master's in administrative medicine.
"In those days, in the '80s, it wasn't very sexy for doctors to do master's degrees and understand the business. It wasn't the norm,'' Desai said. "But I always felt that if you understand the complexity of health care, you could do better personally and professionally and contribute to society."
He'd never heard of St. Petersburg but zeroed in on it when researching communities ripe for a geriatric practice. In 1989, he joined the practice of the late Dr. Jerry Culberson, who was looking to take more time off.
Desai expanded the practice. Before long, as Medicare providers began leaving because of reduced — and later reinstated — federal reimbursement rates, Desai began thinking of his own insurance company.
He started Universal Health Care in 2002, welcoming its first member in August 2003. Today, Universal serves 116,000 members in 19 states and has annual revenue of about $1.1 billion. About 1,000 employees work out of Universal's downtown St. Petersburg headquarters.
The expansion had significant bumps. In 2007, state regulators called for liquidating the company unless it shored up reserves by more than $150 million. Universal was drawing a slew of consumer complaints for poor customer service, denial of treatment and aggressive marketing.
Desai said the problem stemmed from underestimating the popularity of one of its Medicare Advantage plans, "Any, Any, Any." The firm settled with the state after paying at least $450,000 in fines and legal fees.
Desai said those problems are long gone. The state Office of Insurance Regulation said it could not comment on whether there were any ongoing enforcement actions against Universal.
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Even amid the regulatory problems, Desai had plenty of influence in Tallahassee and Washington, thanks to his political activism. Starting in 1994, raising money for Charlie Crist's state Senate campaign and Jeb Bush's first gubernatorial campaign, Desai became a major Republican fundraiser, and another top GOP fundraiser, Zach Zachariah, became a partner in Universal.
"He's been a dear friend for a long time,'' said Crist, whom Desai stood behind even after the former governor dropped out of the Republican Party. "He's not just a great doctor and a great businessman, but a great guy as well. … He cherishes the opportunities America has provided and wants to give back."
In addition to the money Desai has bundled from other contributors, he, his wife and his corporation have donated at least $735,000 to state and federal campaign organizations, including about $480,000 to the Florida GOP and $140,000 to the Republican National Committee.
Gov. Bush appointed Desai to several state education policy boards starting in 1999, and in 2005 he tapped him for the Board of Governors, which oversees the state university system.
"A.K. is a committed reformer," Bush said last week. "He is well-read, passionate and cares deeply about the future of Florida."
Crist appointed Desai to the state Board of Education in 2007, and Gov. Rick Scott reappointed Desai this year. Desai served as a health care policy adviser on Scott's transition team.
Politically, Desai describes himself as a fiscal conservative and social moderate. Although passionate about politics, he's not one for harsh criticism of Democrats. He contributed the maximum allowed $1,000 to the 2010 gubernatorial campaign of Democrat Alex Sink, with whom he has served on a parents advisory board at Wake Forest University.
The ardent Republican declined to discuss the maximum $2,500 donation he gave to Democratic U.S. Sen. Bill Nelson in May. One likely reason: Nelson was among those leading the fight against cuts to Medicare Advantage plans, run by private companies including Desai's.
Which brings up another irony about Desai's Republican activism. Don't count him among those cheering the GOP candidates vowing to repeal the federal health care law. Except for cuts to Medicare Advantage programs, it stands to be good news for Universal's bottom line.
"More and more people will qualify for insurance," he said.
Desai lives in a modern, 9,000-square-foot home on St. Petersburg's Snell Isle, and he talks a lot about the American dream. There is no greater country in the world, he says often, and personal wealth is not nearly as fulfilling as making a difference. Raising campaign money, he said, is about much more than protecting business interests.
"I have been doing it even before there was any personal gain or loss," he said. "When you have good governance and people making the right decisions, it allows people and their entrepreneurial spirit to be unleashed. That's what America is all about. America is the land where you can do anything you want to without any barriers."
Adam C. Smith can be reached at [email protected]