Courtesy of a Democrat-led Legislature and governor, Louisiana is frittering away its opportunity to accomplish meaningful indigent health care reform that will increase quality at decreased costs to taxpayers. Once again, the federal government may have to step in to prevent this foolishness from happening.
It isn’t so much the vague SB 1, which will make its way to the House floor later this week, that is compelling the state to retain its antiquated money-goes-to-the-institution indigent health care system, as that bill is written to allow but not mandate the continuance of a system that no other state in the Union thinks is good. Sure, it’s a bad bill because it gives the appearance of reform where there is none and because it’s a vessel to discourage moves towards a more efficient money-follows-the-person system that produced better quality care. But worse is how it is designed to be combined with other bad decisions to keep putting vested interests ahead of those of the indigent and of taxpayers.
It’s worse what the House did with SCR 76 which authorizes the building of a palatial new “Big Charity” hospital in New Orleans, an edifice which would far exceed the needs of that of a hospital whose mission primarily is to educate. Many supporters say a consultant study required to determine the size showing a larger hospital, one at $1.5 billion that may cost double what was first envisioned, justifies the grandiose version.
But the study they cite was commissioned by the Gov. Kathleen Blanco Administration which all along has plumped for a big hospital in order to justify continuance of the charity hospital system, as a state-run indigent care system provides more avenues for patronage and increases the size of government and its power – specifically the Louisiana State University system which runs it. Further, it based that conclusion on the assumption that the charity hospital system would continue; otherwise, the complex will be much too large and wasteful.
This gets more convoluted and ludicrous: with a large hospital as a “sunk” cost, the state will argue that it will be too expensive to forgo its two-tiered system, justifying its continuance. The two concepts work hand-in-hand: the larger hospital only can be justified under the current system, but then continuance of the current system is justified by saying such a large hospital would make changing that system more costly.
Most (but not all, those mostly being the usual liberal and RINO) Republicans saw through this nonsense and voted against SCR 76 (mirroring somewhat the previous Senate outcome). They joined with Democrat Treasurer John Kennedy in noting that system reform should come first, and then a hospital built to fit that. Waiting even a year would not be a big deal for, as Kennedy as noted, quick renovation of parts of the old Big Charity could keep adequate care going for years (especially given the reduced population being served in the area). Nor would this imperil any deal with the U.S. Department of Veterans Affairs to build the new facility next to a new VA hospital where some parts would be shared; decisions on land acquisition and the joint operations can continue as the size question is answered.
But that would reduce the power and privilege enjoyed by government, especially of the LSU system and the hospitals in the system, and so the Democrats could not have that. Passage of both chambers means this kind of legislative instrument goes into effect, but there are two chances for the federal government to step in and essentially negate this wasteful decision. First, the VA may select a site that would not work for this health care castle, and already has given indications that it might do that. Secondly and more crucially, since federal recovery funds would be used in the building of it, the U.S. Department of Health and Human Services would have to give its permission for their expenditure on this – and accordingly to Republican Sen. David Vitter, an opponent of the larger version, that agency doesn’t look too kindly on this notion.
So it may be that the federal government once again may have to rescue Louisiana from its own follies. Let’s hope it does.
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