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28.2.13

Promising college funding plan may lack effectiveness

Increasing bang for the buck in higher education has become a mission for many in the Louisiana Legislature in the past few years, and the latest idea to do so holds both promise and peril to accomplish it.



State Sen. Conrad Appel and state Rep. Steve Carter, heads of their respective chambers’ committee on education, have given notice they plan to file legislation to tie some funding to higher education to performance of schools. Institutions would be divided into five tiers depending on mission, then evaluated and compared to regional peer institutions on a metric such as graduation rate, with funding decisions based upon relative performance. Carter asserts the necessity of this addition due to the GRAD Act standards, which are a series of institution-set goals that must be met to allow an increase of up to 10 percent in tuition without legislative approval, are too easy manipulable by colleges.



To increase flexibility and incentives, the proposed legislation would remove that necessity of Legislative tuition increase approval. Louisiana is the only state where its legislature must otherwise give approval for tuition increases, and by a two-thirds vote of the body no less. This and other restrictions on tuition autonomy exercised by universities have created some perverse incentives to dampen efficiency efforts, but the thinking to date has been against giving universities free hand with tuition without assurances of accountability. The intent behind this legislation signals with this additional accountability measure that there is legislator comfort with giving up its stranglehold.

27.2.13

Misinformed Landrieu bullies to serve party, save job

The remarks were as much about Sen. Mary Landrieu trying to save her job as it was her being a knight in the service of evisceration.



Louisiana’s only Democrat officeholder elected statewide accused Republican Gov. Bobby Jindal of deciding not to commit the state to expansion of Medicaid, the cornerstone of the Patient Protection and Critical Care Act (“Obamacare”) for which Landrieu cast the decisive vote, because it would detract from his credentials to win a putative GOP nomination for president in 2016. A majority of Republican governors have like Jindal refused to go along with this or have remained noncommittal.



And for good reason, for the medical economics of the situation continue to demonstrate in general this was a lose-lose proposition for the state – it would result in poorer outcomes with the state picking up proportionately more of the tab. This is because those who would qualify already with private insurance would bail out of that for cheaper Medicaid, Louisiana would have to pay for administrative expenses to increase program capacity, and in a few years will have to pick up 10 percent of the tab with the possibility that proportion will increase over time.

26.2.13

Alternative hospital plan expands govt, not care dollars

Journalists’ knowledge about public policy typically is like farm land during the Dust Bowl era – acres in coverage area but not even an inch deep. So it comes as no surprise when a gaggle of them showed up to hear state Rep. Stephen Ortego pitch an alternative, government-centric plan for provision of indigent and uninsured health care to that outlined in Gov. Bobby Jindal’s recently-submitted budget that they seemed unable to probe deeper to uncover the practical and theoretical problems with it that make it a poor substitute.



Ortego addressed the Baton Rouge Press Club, claiming the budget assumptions are untenable. Jindal’s plan, already implemented with negotiations among providers, is to contract out management of eight of the 10 state-owned charity hospitals to nongovernment providers, who make lease payments. They submit to the state for regular Medicaid reimbursement those people covered under it. The state, using its own money (about a third under the current formulaic calculation) and a federal government match (the remaining two-thirds or so), reimburses at a set rate. But since the rate is low, in order not to discourage providers from servicing this clientele, money up to a cap provided by the higher Medicare rate additionally can be provided through a different program known as the Upper Payment Limit where a similar matching strategy occurs. The lease payments will be used as the state match. The Jindal Administration calculates that this arrangement will save money as opposed to the current system which shovels the UPL money directly to charity hospitals without the benefit of a managed care approach that avoids reliance upon the open-ended fee-for-service model.



Instead, Ortego’s idea would be to fold the ten institutions into existing hospital service districts, which would run them independently. This would expand their present duties of coordinating regional psychiatric care. They may also acquire a portion of tax revenue streams, such as from the proposed increased tobacco tax. This could be integrating into providing money to the state, which by law must provide at least 40 percent of the match, to get UPL funds.

25.2.13

Shreveport, Caddo show risks of govt-managed development


Government as economic developer is a risky tool – just look at the fiscal disasters Bossier City has heaped upon its citizenry with its footing for a money-losing high-tech office building known as the Cyber Innovation Center (culpability here also including Bossier Parish), a parking garage for the busted Louisiana Boardwalk, and the CenturyLink Arena which can’t hold an anchor tenant or make money. Or Shreveport’s Red River Entertainment District, which has sucked millions from the city in unwise loan backing. But in circumscribed doses it might prove helpful, and the Caddo Parish demonstrates the limits of this.

Shreveport is trying to get it together again with a new plan for the RRED, with the latest plan getting it donated from its past owner El Dorado and its management contracted out. With space of 14 properties, only two commercial ones occupy it now, local establishments in a departure from the chain-heavy emphasis that began the RRED’s life a decade ago (not that a few local operations haven’t failed there as well.)

Then, nightlife, food, and entertainment were featured. This was a workable formula, given the nearby presence of other such establishments and the casinos. But it was executed poorly. Parking was a problem with little in the way of non-casino-controlled spaces but this did not discourage youths who preferred hanging out more than engaging in commerce from congregating there on weekend nights, for awhile making the area look like a confined cruising version of the intersection of Greenwood Rd. and Jewella Ave.