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26.11.08

New Big Charity coming, but likely in delayed fashion

Yesterday I referred to the final site selection for the new Medical Center of Louisiana – New Orleans as a “minor victory” for the state, because while it had gotten a commitment from the federal government to provide the money-saving option of intertwining it with a new Veterans’ Administration hospital, controversial work remains to be done that could delay the opening of the advertised state-of-the-art facility past its scheduled opening date of 2013 – perhaps way past then.

First, there’s the matter of the historical structures located in the district, bordered by Canal, S. Claiborne, Tulane, and S. Rocheblave. Only as an extreme last resort could these be molested, so either they must be incorporated into the new facilities and/or campus, or moved. But there are nearly 200 such structures and only $400,000 budgeted for removal, at just $20,000 each. If preservationists and owners are successful in getting, by government acquiescence or judicial fiat, more money to move more things, costs could skyrocket and slow the building down tremendously.

(As practical matters go, the Deutsches Haus should be built around and allowed to operate unmolested, even subsidized, as long as the medical staff frequent it only on their off hours and well before their next shift begins. Better than sending them across the way to the unpredictability of a reconstituted Nick’s Bar, where, if the campus is planned right, parking might actually improve. Most importantly, if done right, parking for the Canal Street parades could improve as well and the city could make a little money from those tired of driving all around Mid-City hours before a parade to find a parking spot leaving an inch of space on both end and a 1 percent chance either it’ll get sideswiped or washed by desperate paradegoers).


Second, there’s a question of state financing because, even with a somewhat downsized version of the Big Charity hospital component, the state is expecting a good portion of its funding allotment to come from reimbursement for damage to Big Charity by the 2005 hurricane disasters that would approximately halve the cost of the state facility for Louisiana. But the federal government – not unreasonably – has asserted that Big Charity’s condition was so run down by the state’s neglect that storm damage did little to deliver the coup de grace and has to date offered a figure about 5 percent of the state’s request. That seems to have been sextupled in informal negotiations but still would leave the state searching for nearly $350 million more in very tight budgetary times – and all of this will delay things.

Third, Sen. David Vitter is displeased with the size of the facility arguing it is too big. He does make a very good point – as Louisiana reforms its indigent medical care system which should cut demand on the facility and with a smaller metropolitan area as a result of storm displacement, even the scaled-down version now on the boards may be too much. With Vitter perhaps the key person in working out a dispute over money on the related matter of indigent health care reform, some kind of tradeoff may occur. The way these things work, for projects like this where a federal agency and money is involved, a senator can wield a virtual veto power, once again slowing down matters if he sticks to his guns.

So it’s going to be awhile before all parties are satisfied, therefore the 5-year away figure might turn out to be considerably optimistic. Still, at least there’s movement and hopefully in a direction compatible with quality, efficient medical care

1 comment:

James Sanders said...

All in all one of the greater cluster jobs involving our esteemed state governemnt. What happens when a category 4 or 5 storm hits New Orleans as one or more surely will? We'll once again relocate the medical school, transfer the VA patient care, and lose other incidental little things like the Bureau of Vital Statistics. The way nagin and riley are running things, the 82nd Airborne will be needed to provide security at the VA half and LSP and National Guard the charity half. The politicos who condemn us to pay these boondogles should be condemned to receive their own medical care there.