Yet another reason has emerged to reevaluate again the size of the new
Medical Center of Louisiana – New Orleans, or “Big Charity.” Scheduled for
completion in 2015 but with no building of it having begun, just site
preparation, there’s still time to take into account the changing policy
landscape that reinforces
the need to scale back on the facility.
After the hurricane disasters of 2005 damaged the aging former
facility, then Gov. Kathleen
Blanco came up with a grandiose replacement version firmly wedded to the
idea that Louisiana should stay in the business of direct health care provision
to the indigent. Even though the actual needs of the state as far as medical
training and usage suggested that the old structure could be rehabilitated for
much less than a price tag well over $1 billion, Blanco started forging ahead.
When Gov. Bobby
Jindal came on the scene, after review wisely he scaled back the size, but
still kept a facility larger than what the demographics suggested despite that his
policy direction argued for a smaller facility still. The original Blanco plan
was to increase the non-state-paid use of it (unrealistically in an over-bedded
market) and Jindal throughout his terms has worked to increase private
provision.
Now another Jindal policy decision will affect the actual demand for
health care paid for by the state on behalf of the indigent. Deservedly
he opted the state out of mandated by without penalty increases in Medicaid
coverage, but as it turns out the final version his administration accepted to
build Big Charity was based upon the higher state-paid volumes coming from
accepting the increased coverage. Because it was too large, already the state
was on the hook for as much as over $100 million annually in subsidization, and
it’s possible this may rise with a smaller amount of demand probably made on
its facilities.
This strengthens the utility of an alternative
plan put forward by current officeholders Sen. David
Vitter and Treas. John
Kennedy, which would provide for more beds (but more geographically spread
out) for about 70 percent of the cost. Even some adjustments to that, such as a
new but smaller Big Charity, could keep as many or more beds than the 454
currently envisioned among all facilities and at a lower cost that reduces
dramatically the subsidization.
1 comment:
Not many comments lately, huh?
Let me help you.
It is pleasing to see you, and perhaps others of your disposition, catching up with John Kennedy and David Vitter.
Let's hope Gov. Jindal does, on one of his stops back in Louisiana.
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