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3.2.07

Boasso set to run for governor, but with odds against him

So it looks like another heavyweight is entering Louisiana’s Governor’s race, and it’s somebody who could win. But whether that happens is an entirely different matter.

State Sen. Walter Boasso has been a success in the business world and in just three years in the state Senate has compiled a high-profile record. In fact, at this stage in the endeavor he is better known and positioned to win than another wealthy state senator who had served two terms more inconspicuously but who then went on to grab two terms in the Governor’s Mansion – former Gov. Mike Foster.

However, besides both being Republicans the Boasso-to-Foster comparison has little room for stretching because of the differences in dynamics between the 1995 and 2007 contests. Foster waded into a field of lesser names, including former Gov. Buddy Roemer whose aura was tarnished by his managing to come in third to the likes of former- and then-Gov. Edwin Edwards and David Duke. Foster cannily switched his affiliation to the GOP as too many of that party saw previously-switched Roemer as damaged goods and no other Republican looked to emerge. Democrats split up their vote among several candidates but blacks stayed mostly loyal to state Sen. Cleo Fields, putting him in the general election runoff with Foster, enabling Foster to win.

The 2007 contest looks to be totally different. The literal elephant in the field is Rep. Bobby Jindal who already has corralled extensive Republican and statewide support, if polls are accurate. Only two serious Democrats seem set to compete, current Gov. Kathleen Blanco and Public Service Commissioner Foster Campbell so that increases the odds that one, probably Blanco, will corral the hardcore Democrats meaning Boasso’s chances of being able to muscle his way into a runoff are reduced. (And if Blanco defers running in favor of somebody like former Democrat Rep. Chris John, that makes Boasso’s task even harder.)

With Jindal already monopolzing such support, and Democrats ready to rally around any candidate they see as competitive, this makes it difficult for Boasso outpoll either one of them. Against either in the general election he could be very competitive, likely the favorite against Blanco, but getting there will be difficult.

Foster spent millions of his own money to get himself elected in 1995. Boasso may be willing to part with a like amount, but the dynamics of the 2007 are such that it’s likely to be money wasted – if this race doesn’t also serve a secondary purpose as warmup for him for other higher offices in 2008?

1.2.07

LA officials talking irresponsibly about health care reform

As might be expected, the health care redesign for Louisiana suggested by the federal government (which pays for much of it) was not well received by state officials – who, of course, have a vested interest in maintaining the present inefficient, ineffective system.

The federal government wishes the state to move to a money-follows-the-person regime for indigent health care, highlighted by state subsidies of private health insurance. Unique among the states, Louisiana presently has a money-given-to-the-institution system of charity hospitals that lack flexibility in choice for patients and has few incentives to operate efficiently. This paradigm shift is to facilitate universal health insurance coverage, with the federal government promising some assistance in the transition period in moving from the current system to their desired one.

But the institutions getting health care money presently don’t wish this system to change, and their chief apologist is the state’s Secretary of Health and Hospitals Fred Cerise. The state’s media don’t seem to press him on two issues that cast serious doubt on any defense of the current system. (If he reads this, maybe he’ll drop a comment to make such an attempt.)

First, if the charity hospital model is so right for the state, why doesn’t any other state employ it – and practically all of them have better health outcomes than Louisiana? Second, why would the redesigned model not work in Louisiana as well as it has in all other states – even in those that are “poor” like Louisiana?

What comments he has had on this issue, in defending the current system and disparaging the federal plan, ultimately ring hollow. For one, he claims that outcomes in the charity system as good as they are in the private sector in the state. But this claim charitably is misleading, and technically just flat wrong on what measurements of hospital quality exist. While the primarily teaching institutions in the LSU system (which runs the charity system as a whole) hold their own, or maybe a little worse against comparable private institutions, the several in the system that are not primarily teaching fare worse against the non-government sector institutions.

Cerise also claims that siphoning funding out of the charity system would reduce preventive care functions which an increased reliance on is one reason the federal model will produce better outcomes at reduced cost, defeating its purpose, he argued. That is a red herring: money could be removed from other aspects of the existing system, such as ridding the teaching infrastructure of waste by halting duplication and consolidating functions and programs.

But this attempt also misses the entire point of why the federal model will be better. Because the federal model introduces more competition since reimbursements will be based upon number of patients processed which in part reflects the quality of the institution, this dynamic spurs improved performance. But the funding for the charity hospitals largely is lump-sum; each gets substantially a fixed amount no matter how much business they attract or discourage.

The whole present scheme exists somewhat at the sufferance of the federal government – and that may the key to get Louisiana officials ultimately to do the right thing by going along with the federal plan. U.S. Health and Human Services Secretary Mike Leavitt indicated those dollars may not be forthcoming in the future. Cerise and company better listen or the coming health care funding crisis in this state, as costs of indigent care under the current system continue to balloon, will make the present and past ones look benign by comparison. (Eve former U.S. Sen. John Breaux, who never lifted a finger to implement this as a senator, now gets this -- scary!)

31.1.07

LA needs to take advantage of federal health care generosity

What more does U.S. Sec. of Health and Human Services Mike Leavitt have to do to get Louisiana to do the right thing? For months, the federal government has been working on getting the state to scrap its inefficient, low-outcome charity hospital system of indigent health care (which no other state does, and since their health outcome indicators almost all are better, should tell us something) in favor of a money-follows-the-person regime of subsidized insurance that allows patients choice and flexibility in care, rather than in directing money to institutions

It’s a plan that is working everywhere else that it’s been tried, and makes perfect sense: people in the marketplace will spend their health care dollars much more efficiently than institutions billing the state. But because of vested interests in the old system, primarily institutions, this simple, clear, and workable idea continues to meet resistance.

The previous objection had been that costs would go up for the state under this plan. They would temporarily, because of the increase in quality of health care delivery while still maintaining the cumbersome charity system. But as the transition period moved along, as people shifted into the new system with its greater efficiency, in the long run costs would go down with better outcomes comparable to the charity system.

Leavitt now has promised the state that the federal government will pick up initially 40 percent of the estimated additional costs. Still, that would leave Louisiana on the hook for $300 million in the first year. That has led shills for the institutions such as state Sen. Joe McPherson (owner of health care institutions) to disparage the plan. Worse, among others McPherson plans during the upcoming legislative session to try to get legislation passed that would more securely lock in the existing wasteful, underperforming system.

If Gov. Kathleen Blanco is smart, she will recognize the long-term benefits of systemic change and the generous offer of the federal government to ease the transition. To that end, Blanco could take a good chunk of the predicted revenue surplus of the state for this fiscal year, say $1 billion (most of it), and get the Legislature to create a fund to that would be used to supplement this Medicaid plan Leavitt has offered. This is possible because Leavitt can waive requirements to allow the state to pursue the new plan with extra federal dollars.

Chances are that the state fund would sustain the program as the transition occurred until first there was no need for it as a supplement, and then no need for a federal supplement. The federal government would be pleased to see the state wants to help itself get out of the mess it created and therefore may be quite willing to subsidize the program beyond its entitled federal dollars for several years as a result.

This is an opportunity the state cannot afford to miss. And if the state does pass on it, Leavitt needs to yank any additional funds the state could have gotten. After all, there’s no sense in throwing good money after bad, especially since its taxpayers’ dollars. Meaning once again Louisiana will have missed a chance to put people ahead of politics.

30.1.07

Surplus gives Blanco a chance to do it right for once

This afternoon, the Revenue Estimating Conference for Louisiana formally certified what had been put in front of it almost two months ago, that the state has $827 million to spend on nonrecurring items. Regardless of the motivations that delayed recognition of this money, it has met the legal requirements and now is available to be spent.

That acknowledged, the next step is for the Legislature to authorize a lifting of the constitutional cap on spending for this purpose. The state’s constitution prohibits spending beyond a level determined by the amount of economic growth in Louisiana’s private sector. Since so much federal money has been poured into the state for recovery efforts, being money that did not come from tax revenues courtesy of actual economic growth in the state which has lagged government spending growth by far, the ceiling is about $658 million below the $827 million extra now recognized.

Gov. Kathleen Blanco has pledged this money will go to road construction and repayment of retirement debt – the former faces a tremendous backlog and the latter is unfunded to a tune of roughly $11.45 billion. If she is serious about using this money – again, constitutionally it can be used only for one-time expenditures like these – she will ask the Legislature to send these funds only to pay off the unfunded accrued liability (UAL) present in the retirement accounts and only what is known as the TIMED program.

Such actions would denote a responsible approach to using the surplus because they would not be used for overtly political purposes, in focusing on real needs. No one politician can use funding the UAL as a tool to get reelected because shoring these up targets disproportionately favorably no legislator’s district. Similarly, by plowing other funds into TIMED, a set of (16 then, with six completed now 10) infrastructure projects agreed upon 18 years ago, again political opportunism and favoritism to specific legislators would be minimized.

By contrast, if Blanco were to send most of the newly-minted funds into the capital outlay process that would result in funding for roads being the whim of whatever legislator had the most pull and most intensely backed Blanco’s other plans, this would indicate a lack of seriousness in terms of sensible priorities for spending. As has been the hallmark of Blanco’s term in office, politics rather than priority would triumph in this scenario.

With Blanco running for reelection, chances actually are decent that she will depart from her past and actually agitate for sensible use of these funds.

29.1.07

Stuck on stupid XXI: Blanco blame game neglects herself

Blame gets thrown all around to explain why there seems to be such a slow pace concerning the (as it was once called before negative publicity about it took off, Gov. Kathleen Blanco’s) Road Home Program for Louisiana residents to get compensation for storm ravaged homes and rental property losses. In the final analysis, it rests squarely at the feet of Democrat Blanco.

For her part, the governor has been attempting to shift it to ICF International, the contractor the state’s Louisiana Recovery Authority hired. That board, of course, serves as an extension of Blanco as she appointed all its members so, in a sense, when she criticizes ICF, she criticizes her own judgment. Making the fact worse is her designees on the LRA failed to include in the contract the firm won some performance incentives that theoretically could speed up the process.

However, on many measures, ICF is not doing that bad of a job. The latest statistics do show very few grants awarded since it all began in August, 2006, but a steadily accumulating total mainly bottlenecked at the decision stage – when homeowners must decide what they will do with their money which the company can’t control. While Louisiana demonstrably is behind Mississippi with its similar but not identical program, because its program got started later than the Magnolia State’s, in a comparative perspective it’s not as far behind as it may seem at first glance.

But the main reason it fell behind came through inaction and poor decisions on Blanco’s part. Mississippi got cracking in Oct., 2005 with planning for this in a special legislative session. A month later, Blanco cobbled together a special session which did nothing to address the home rebuilding issue. After it, she seized upon and placed all her marbles in a plan from Republican Rep. Richard Baker that ultimately and rightly was seen as unworkable by the U.S. Congress. So, when rejected, Blanco was left with nothing in hand, just in time for another special session during which, again, nothing was done to set up the structure to create a program. This made Congress hesitant to make any promises regarding sums of money to be made available, until during the 2006 regular sessions finally Blanco came up with what is now her Road Home Program.

Clearly, Blanco’s dithering and inability to lead, either emanating directly from her or in terms of lighting a fire under the Legislature to do something, delayed the beginning of the program, making Louisiana look much farther behind. And, some of the delay when it has gotten going has accumulated at the insistence of the state, such as in time it takes to check for fraud, for which Blanco seems to be blaming the contractor.

Blanco, running for reelection, has adopted a strategy of blaming everybody but herself for problems in her governorship. As part of this strategy, she tries to pin everything on procedural problems from the contractor. In reality, the bulk of the delay has come from a political problem, the failure of Blanco to competently discharge her duties in this matter in a timely and prudent fashion.

28.1.07

Opposing continuance of education reform hogwash

Another broad challenge Pres. George W. Bush presented to Louisiana was to continue reforms improving the quality of public education in the state. Despite the fact that some limited progress has been achieved, as typical a number of naysayers needed to vent after Bush’s State of the Union address argued for renewal of the law mandating federal standards, with some increased flexibility in targets and meeting those goals.

One group argues that the federal government doesn’t provide enough resources to enable schools to get children to higher levels of achievement. As stated by one principal, his school has to spend tens of thousands of dollars a year to hire tutors to do this.

But notice the obvious disconnect inherent in this thinking, by following the simple logic: by definition a significant number of students must need extra help either because they are too dumb or because teachers aren’t doing their jobs properly. One would assume the first instance unlikely because why should standards be written that are beyond the typical human child? Thus, schools want more money to make up for shortcomings in their performances that should be their own responsibilities to solve.

In other words, a school needs to demand more from its teachers, do a better job of hiring, or whatever to provide a long-term solution to inability to perform its function correctly, rather than engaging in short-term triage. And if the complaint is the quality of the teaching pool just isn’t out there, that’s still a state problem with its teacher education in its universities, or with inflexibility in alternative certification programs. Again, somebody isn’t doing their job well enough somewhere in the state and thereby is its responsibility, not that of the federal government. This cry for more federal money is but a smokescreen to cover up incompetency within the state’s educational establishment.

This excuse is related to another often heard, that educators in the field don’t have enough control over the process. Of course, this begs the question about the many decades before passage of reform laws where there was no process to control and so it was totally controlled by educators – and look where that got Louisiana, pretty much last in every category of quality of education. So if the state isn’t going to do a proper job, the federal government must oversee the process. (And, of course, if the state truly objects, it could opt out of meeting the requirements by refusing the federal funding that goes along with them.)

(This complaint of lack of local control is a favorite of teachers’ union because it serves to obscure their true goal – protect as many jobs gathering as high compensation as possible with the minimum of work for teachers. This is why they cannot stand the law because it opposes their “money money, less work” philosophy – never be mistaken, no teachers’ union is interested in actually educating children. Their favorite refrain is to ask for more money to be thrown at teachers, never mind that already Louisiana teachers are overpaid for the outcomes observed. The last thing they want is the only thing that would solve for the lack of teacher quality noted above – strict accountability standards that include testing as in already done in many states.)

Finally, the objection least connected to reality is that emphasis on testing causes “stress” to children. Yes, why introduce stress when their adult lives are going to be so free of it? Why stress them now, since as a result of a better education through the testing process they only will be better able to achieve as adults and thus take away stresses such as living hand to mouth, trying to get a job, overcoming bad choices, etc. Sure, keep the stress off of them now so they can have much more of it later for the rest of their lives.

Anyway, why should anybody ever be stressed over such a simple thing as a test? If you have done the best you think you can do in preparation for it, if you take the responsibility in your own hands to maximize your performance, why worry? If you know the answer, indicate it. If not, you’ve done what you could, and move on. Any anxiety coming from this must stem from thinking you’ll be missing stuff that you thought you should have known, meaning you are not preparing yourself as well as you can. If schools are doing their jobs, and are advising students to prepare on their own as well, this should never happen.

Therefore, these grievances are entirely specious. The real source of these objections are, while not a direct form of accountability, that they introduce an indirect means of requiring accountability from educators. And for too long in this state too many educators (as opposed to the more enlightened ones who have welcomed this) have not wanted the extra demands this improvement of the quality of education makes on them – and thus they try to disparage the reforms or pass off responsibility for them to others. Which is why Louisiana’s national lawmakers need to vote approval on renewing the law before it expires, to allow improvement to continue despite the motivations of others.