The state got a good, unexpected Carnival throw last week from the Louisiana House of Representatives when it failed to muster a majority to allow funding for any aspect of a new Louisiana State University hospital in New Orleans.
Constructing a replacement for the ravaged existing facility got caught in the crossfire of three issues. First, the mail balloting of this ensued when the Legislature’s Joint Legislative Committee on the Budget overrode a Louisiana Recovery Authority decision to send forward only $74 million to plan and buy land for it, instead approving $300 million that could have started the building of it. Second, given the surplus of hospital beds in the metropolitan New Orleans area, there is great questioning whether such a facility on the scale it has been conceptualized is needed. Third, supporting the grandiose version was seen as validating the present indigent care system while refusing to redesign health care in any meaningful way in the state, holding onto the inferior money-given-to-the-institution rather than money-follows-the-person concept.
The 50-37 defeat provides an interesting window on the political scene because it was unexpected. First, it shows the GOP really is getting organized, as most of the votes against the plan came from near-unanimity on its members’ parts, rebelling against the committee comprised almost totally of Democrats (indeed, of the few Republicans on it of over 20 members, only state Rep. Steve Scalise can be considered taxpayer-friendly).
Second, it lays bare the politicized nature of higher education governance in the state, since those shocked at the failure of it to pass including Gov. Kathleen Blanco blamed the Louisiana State University system, represented by its Board of Supervisors, for not “lobbying enough” for the measure to pass. A very unfortunate fact of life in Louisiana is academic institutions, because of a political culture that overemphasizes special interests and underemphasizes merit, are unusually influenced by political decisions, in this case because the indigent care system in the state largely was put into the hands of the LSU system.
Third, it demonstrates the weakened nature of Blanco and the politics of post-hurricane recovery. She easily could have tried to cajole some people to vote in support – in fact, it was really no-shows that prevented passage who with a simple gubernatorial reminder well might have had the motion carry. However, the LRA largely is her tool, so she had disincentive to lobby for a decision that countered its. But also, during this election year with the stakes so high and her political capital running so low, she will want to save her efforts for matters that have a wider and/or more visible impact on a large portion of the Louisiana population.
However it happened, it constitutes an entirely welcome development and buys more time for sharper thinkers and public concern to build to engineer true health care redesign.
15.2.07
Melancon plays game with complaints that ring hollow
You don’t win a couple of terms in Congress without being a good politician, and Rep. Charlie Melancon is proving he is by his recent “attacks” on U.S. House leadership.
Democrat Melancon has expressed irritation at his party’s majority leadership, saying that it has not followed through on promises to do “more” for the state in wake on the 2005 hurricane disasters, It’s hard to know what more could be done with about $60 billion thrown at the state in the past 18 months by the federal government, but that’s Melancon’s argument as he says there needs to be additional loan forgiveness and brokering of disputes concerning distribution of federal money.
Even so, Democrat leaders say they will try to address such concerns. But, being realistic, nothing is going to happen here. Simply, Democrat representatives from the rest of the country are not going to give away money to Louisiana unless, liberals as they are, they see a political payoff. They survey the situation in the state, where a Democrat governor stands little chance of winning reelection and will drag the party’s statewide fortunes down with her, and see there is not much to be gained from trying to boost Democrat fortunes in the state. They might tinker at the margins, but because there is no national political payoff from transferring money from American taxpayers (money they can use for their own purposes) to Louisiana, they won’t do it.
Melancon realizes this, and thus must make it appear that he is “fighting” for state interests, hence the source of his complaints. It’s a game where symbolism trumps substance and one that he knows and the Washington Democrats know must be played to try to build an image that he does not, as is the actual case, have beliefs that run counter to the majority in his district, so they play it. He must in order to continue to fool Third District voters in what might be a very challenging 2008 election cycle.
While by this tactic Melancon tries to craft an image that his is a not a liberal Democrat, by no objective means isn’t he. In his first year, he managed to score a 61 on the American Conservative Union scale, slightly conservative, but on others’ scorecards, those of the Americans for Tax Reform, the Citizens Against Government Waste, and the National Taxpayers’ Union, he got a 17, 27, and 29. The liberal Americans for Democratic Action confirms, where the scale is reversed; they gave him an 80 in 2005. In that year alone, among other things, Melancon voted against cutting taxes and reducing the size of the budget, reform of the United Nations, tort reform, increasing U.S. energy independence, reducing the deficit, and more stringent border control.
But Melancon will play the game to boost his reelection chances, trying to unlink himself to the very liberal leadership of the House which he supported in its establishment only last month and whose measures in other areas he continues to support. It’s the only way he can try to obscure his liberal voting record, but it won’t fool an informed citizenry.
Democrat Melancon has expressed irritation at his party’s majority leadership, saying that it has not followed through on promises to do “more” for the state in wake on the 2005 hurricane disasters, It’s hard to know what more could be done with about $60 billion thrown at the state in the past 18 months by the federal government, but that’s Melancon’s argument as he says there needs to be additional loan forgiveness and brokering of disputes concerning distribution of federal money.
Even so, Democrat leaders say they will try to address such concerns. But, being realistic, nothing is going to happen here. Simply, Democrat representatives from the rest of the country are not going to give away money to Louisiana unless, liberals as they are, they see a political payoff. They survey the situation in the state, where a Democrat governor stands little chance of winning reelection and will drag the party’s statewide fortunes down with her, and see there is not much to be gained from trying to boost Democrat fortunes in the state. They might tinker at the margins, but because there is no national political payoff from transferring money from American taxpayers (money they can use for their own purposes) to Louisiana, they won’t do it.
Melancon realizes this, and thus must make it appear that he is “fighting” for state interests, hence the source of his complaints. It’s a game where symbolism trumps substance and one that he knows and the Washington Democrats know must be played to try to build an image that he does not, as is the actual case, have beliefs that run counter to the majority in his district, so they play it. He must in order to continue to fool Third District voters in what might be a very challenging 2008 election cycle.
While by this tactic Melancon tries to craft an image that his is a not a liberal Democrat, by no objective means isn’t he. In his first year, he managed to score a 61 on the American Conservative Union scale, slightly conservative, but on others’ scorecards, those of the Americans for Tax Reform, the Citizens Against Government Waste, and the National Taxpayers’ Union, he got a 17, 27, and 29. The liberal Americans for Democratic Action confirms, where the scale is reversed; they gave him an 80 in 2005. In that year alone, among other things, Melancon voted against cutting taxes and reducing the size of the budget, reform of the United Nations, tort reform, increasing U.S. energy independence, reducing the deficit, and more stringent border control.
But Melancon will play the game to boost his reelection chances, trying to unlink himself to the very liberal leadership of the House which he supported in its establishment only last month and whose measures in other areas he continues to support. It’s the only way he can try to obscure his liberal voting record, but it won’t fool an informed citizenry.
14.2.07
Jindal insurance bill needs additional strengthening
A luxury opinion columnists have but politicians don’t is, not to be flippant, they do not have to adopt ideas contradictory to their basic ideological principles to get elected. We can advance our ideas in the purity of intellectual contemplation, without worrying how well they go down with voters. By contrast, electoral appeal may cause politicians to promote things with more of an eye to getting elected rather than to the principle of the idea.
That may be the situation that Rep. Bobby Jindal finds himself with his proposed Multiple Peril Insurance Act which would expand coverage of the National Flood Insurance Program. The bill would add wind coverage to existing coverage, add payment of living expenses due to displacement, and raise coverage limits.
Unfortunately, the concept of the NFIP has been problematic from the start. Essentially, it encourages building in high-risk areas and discourages the private sector from entering this business. But until the hurricane disasters of 2005, it had not been a problem to the U.S. taxpayer because premiums going into the program had paid for claims.
13.2.07
Realities to create long Saints goodbye
It’s debatable the odds of which occurring are worse: Gov. Kathleen Blanco getting herself reelected or the New Orleans Saints sticking around after the team’s subsidy from the state runs out after 2010. Blanco apparently is willing to bite the bullet, despite meaning the state will fork over nearly $90 million to the team, even after she has criticized the deal, and not exercise the state’s option to get out of paying all but $20 million of that after the upcoming season.
Until Hurricane Katrina blew through area and out some levees, the big sticking point in negotiations was infrastructure. Owner Tom Benson has argued facilities disallowed realization of a greater revenue stream for the team, but the state was reluctant to meet his main demand, a new stadium which he argued would allow for more revenue-generating amenities like luxury boxes.
But after the disaster, the dynamic has changed from infrastructure to whether the market has enough capacity to make the team profitable enough not to relocate to greener pastures, or even to be profitable. The cold, hard facts are when the 2006 census estimates come out, the New Orleans-Metairie MSA’s population will fall to about a million, below that of Buffalo’s and Jacksonville’s to make it the second-smallest National Football League market, ahead only of Green Bay – and practically it will be the smallest, since the Packers already play some home games in Milwaukee.
With over a dozen MSAs with larger populations without a team, it’s hard to argue that New Orleans presents the best deal for the Saints – especially without subsidies that pay for Drew Brees’ contract. With all the most updated facilities around, there simply may be no way to keep the time in a market that, if anything, will shrink and is disproportionately poorer in terms of business entertainment dollars than even its size would indicate.
After the team’s magnificent run to the National Football Conference championship game this year, the pressure will intensify for the state to offer incentives for the team to stay. This must be resisted because in the post-disaster environment, both natural and man-made by the ravages of liberal populism, every dollar will count and the state must spend wisely. Enjoy Saints football the next few seasons because, barring radical economic changes (or NFL insistence on their staying put), it’s not likely Louisianans will enjoy their presence much longer.
Until Hurricane Katrina blew through area and out some levees, the big sticking point in negotiations was infrastructure. Owner Tom Benson has argued facilities disallowed realization of a greater revenue stream for the team, but the state was reluctant to meet his main demand, a new stadium which he argued would allow for more revenue-generating amenities like luxury boxes.
But after the disaster, the dynamic has changed from infrastructure to whether the market has enough capacity to make the team profitable enough not to relocate to greener pastures, or even to be profitable. The cold, hard facts are when the 2006 census estimates come out, the New Orleans-Metairie MSA’s population will fall to about a million, below that of Buffalo’s and Jacksonville’s to make it the second-smallest National Football League market, ahead only of Green Bay – and practically it will be the smallest, since the Packers already play some home games in Milwaukee.
With over a dozen MSAs with larger populations without a team, it’s hard to argue that New Orleans presents the best deal for the Saints – especially without subsidies that pay for Drew Brees’ contract. With all the most updated facilities around, there simply may be no way to keep the time in a market that, if anything, will shrink and is disproportionately poorer in terms of business entertainment dollars than even its size would indicate.
After the team’s magnificent run to the National Football Conference championship game this year, the pressure will intensify for the state to offer incentives for the team to stay. This must be resisted because in the post-disaster environment, both natural and man-made by the ravages of liberal populism, every dollar will count and the state must spend wisely. Enjoy Saints football the next few seasons because, barring radical economic changes (or NFL insistence on their staying put), it’s not likely Louisianans will enjoy their presence much longer.
12.2.07
Overpaying Bossier, Caddo Parishes need to watch expenses
It seems that Caddo Parish recently hired Susie Morgan to be the first lobbyist at the federal level for the parish, following the lead of Bossier Parish which did so three years ago. According to her employer the Bossier Police Jury, they seem pleased at her performance. Whether this translated into a wise use of taxpayer dollars is a wholly different story.
In 2004, Bossier Parish started off Morgan, then a lawyer with a Shreveport firm, at $40,000 a year. In 2006, it reports paying her $60,000 annually. Caddo Parish plans on giving her $4,000 a month up to $55,000 a year (including expenses).
(Although she is reported to live in Washington, her actual employer, as of July, 2005, is a New Orleans firm, Phelps Dunbar, and campaign contribution records give her residence as being in New Orleans. A past supporter of Lt. Gov. Mitch Landrieu’s, $3,500 of hers found its way into Landrieu’s campaign fund for New Orleans mayor; safe to say Morgan will not be representing the city of New Orleans any time soon after incumbent Ray Nagin was reelected.)
11.2.07
"Shortchange" complaint properly analyzed has little merit
A favorite sport of Louisiana politicians these days is complaining how the state has been allegedly “shortchanged” by the federal government in terms of disaster relief funds. A review of the facts makes this a tenuous argument at best, and any minor disparity can be explained by these and legitimate concerns about the state’s fitness to make wise spending decisions.
One point of contention has been in the majority of cases over the past couple of decades, the federal government has waived the 25 percent state match requirement on federal disaster monies going into a state. While Pres. George W. Bush waived 15 percent of that, the fact that 10 percent still is asked for has raised eyebrows particularly as it concerns the most expensive natural disaster ever.
But what observers forget is that because it is by far the state that ever has had the most federal money pumped into it for this cause (subtracting out federal insurance payouts, the figure is around $42 billion presently; contrast that with the second-most expensive, Hurricane Andrew and Florida in 1992, where subtracting out insurance proceeds the amount came to only $11 billion). At present (because only a small portion of this figure is subject to the state match) the state estimates the reduced requirement is costing the state $400 million.
Well, at present the state is sitting on a huge budget surplus – precisely because of all the federal money pouring into the state. In other words, so much money is coming in that the state is taking in more, probably much more, than $400 million in taxes and excises due to the economic activity of rebuilding the federal money has spurred (after all, Louisiana is balking about paying less than one percent of the total federal money it has received). Yet state politicians, receiving an incredible gift both in terms of rebuilding funds and in fattening state coffers, still moan.
Another grievance has developed around the fact that only 54 percent of community development block grant funds, a major portion of the total funds remitted for disaster response, has gone to Louisiana where by the number of structures damaged the state suffered three-quarters of the total. But there’s nothing that could be done about that because that is a legal requirement. (Sen. Mary Landrieu is authoring legislation to change that.)
Any other disparity in funding can be explained by an unfortunate fact of life, but one that Louisiana politicians refuse to mention precisely because it reflects poorly on them. Simply, of all the states affected by the 2005 hurricane disasters, by far Louisiana traditionally has shown itself to be the most irresponsible in fiscal matters. In the past decade, Alabama, Mississippi, and Texas have elected conservative reformists who have done a far better job of making proper priorities and steering spending more towards their states’ peoples’ benefit and away from taking care of special interests first. Louisiana, by contrast, has remained stuck on stupid by electing majorities who prefer to grow big government and shower rewards on favored constituencies.
Certainly, liberal Democrats are not going to admit this about themselves, and even conservative Republican politicians for the most part shy away from pointing this out because of a desire for comity and in case they engage in some future big spending themselves which could get this turned against them (one of the few who does not hesitate is Rep. Tom Tancredo, now running for president). But anybody who has eyes, ears, and a brain can figure out the big government lovers who haunt Louisiana are going to do a poorer job of disaster relief (Gov. Kathleen Blanco’s Road Home, anyone?) than more responsible politicians in other states.
Which is why the federal response that Louisiana should spend the money it has first, such as the tremendous backlog sitting in the Road Home program, before asking for more is entirely appropriate. Like it or not, reality is the inferior liberal ideology pursued by Democrat Blanco and a Democrat-controlled legislature make them bad bets on which to loosen the reins in this situation. Until Louisiana demonstrates a more responsible attitude and competent ability towards use of the people’s money, common sense and prudence dictates close monitoring such as this is necessary.
One point of contention has been in the majority of cases over the past couple of decades, the federal government has waived the 25 percent state match requirement on federal disaster monies going into a state. While Pres. George W. Bush waived 15 percent of that, the fact that 10 percent still is asked for has raised eyebrows particularly as it concerns the most expensive natural disaster ever.
But what observers forget is that because it is by far the state that ever has had the most federal money pumped into it for this cause (subtracting out federal insurance payouts, the figure is around $42 billion presently; contrast that with the second-most expensive, Hurricane Andrew and Florida in 1992, where subtracting out insurance proceeds the amount came to only $11 billion). At present (because only a small portion of this figure is subject to the state match) the state estimates the reduced requirement is costing the state $400 million.
Well, at present the state is sitting on a huge budget surplus – precisely because of all the federal money pouring into the state. In other words, so much money is coming in that the state is taking in more, probably much more, than $400 million in taxes and excises due to the economic activity of rebuilding the federal money has spurred (after all, Louisiana is balking about paying less than one percent of the total federal money it has received). Yet state politicians, receiving an incredible gift both in terms of rebuilding funds and in fattening state coffers, still moan.
Another grievance has developed around the fact that only 54 percent of community development block grant funds, a major portion of the total funds remitted for disaster response, has gone to Louisiana where by the number of structures damaged the state suffered three-quarters of the total. But there’s nothing that could be done about that because that is a legal requirement. (Sen. Mary Landrieu is authoring legislation to change that.)
Any other disparity in funding can be explained by an unfortunate fact of life, but one that Louisiana politicians refuse to mention precisely because it reflects poorly on them. Simply, of all the states affected by the 2005 hurricane disasters, by far Louisiana traditionally has shown itself to be the most irresponsible in fiscal matters. In the past decade, Alabama, Mississippi, and Texas have elected conservative reformists who have done a far better job of making proper priorities and steering spending more towards their states’ peoples’ benefit and away from taking care of special interests first. Louisiana, by contrast, has remained stuck on stupid by electing majorities who prefer to grow big government and shower rewards on favored constituencies.
Certainly, liberal Democrats are not going to admit this about themselves, and even conservative Republican politicians for the most part shy away from pointing this out because of a desire for comity and in case they engage in some future big spending themselves which could get this turned against them (one of the few who does not hesitate is Rep. Tom Tancredo, now running for president). But anybody who has eyes, ears, and a brain can figure out the big government lovers who haunt Louisiana are going to do a poorer job of disaster relief (Gov. Kathleen Blanco’s Road Home, anyone?) than more responsible politicians in other states.
Which is why the federal response that Louisiana should spend the money it has first, such as the tremendous backlog sitting in the Road Home program, before asking for more is entirely appropriate. Like it or not, reality is the inferior liberal ideology pursued by Democrat Blanco and a Democrat-controlled legislature make them bad bets on which to loosen the reins in this situation. Until Louisiana demonstrates a more responsible attitude and competent ability towards use of the people’s money, common sense and prudence dictates close monitoring such as this is necessary.
8.2.07
Vitter pushes Blanco to do right for taxpayers, indigent
Thus, it takes another push from the federal government to make Louisiana do the right thing when it comes to indigent health care. Sen. David Vitter, who said his message merely echoes the sentiments of Housing and Urban Development Secretary Alphonso Jackson, argued in a letter to Gov. Kathleen Blanco and Jackson that the federal government should not pitch in $300 million to build a new state-owned hospital in New Orleans unless it also revamped its indigent health care system away from its institutional bias to a money-follows-the-person regime.
With the widespread damage from the 2005 hurricane disaster brought to the existing Medical Center of Louisiana New Orleans facilities (better known as “Big” Charity Hospital), the state decided it should build a whole new complex around downtown rather than renovate permanently the existing one. That’s not a bad idea, but the state rolled out an extremely ambitious, much expanded plan but which depends upon being attached to a Department of Veterans Affairs veterans’ hospital. The federal contribution to this would be $300 million.
However, Vitter signaled that the state should not get disbursement of that money unless it also agreed to scrap any vestige of the money-given-to-the institution charity hospital system of indigent care. That system (found only in Louisiana) is less efficient and produces poorer outcomes with fewer services than the model the state is being urged to adopt by the federal government, but Blanco and other state officials have put up strong resistance to genuine system reform because it would reduce a reduction of scope, size, and authority of government, and would steer money away from the special interests backing these politicians.
(While it’s true that Vitter is a Republican and virtually all the opponents of reform are Democrats, it’s not really a partisan issue. No less than Democrat stalwart and former Sen. John Breaux has come out in favor of real reform. Rather, battle lines have been drawn between big government practitioners of politics as usual who have run Louisiana for decades and those who wish to transfer power from government to the people, in this case clients of indigent health care. For her part, Blanco showed how inflexible and lacking in creative thinking she is with her reaction to Vitter’s letter: “I simply have a hard time believing that Secretary Jackson, who deeply cares about the low-income population, would go along with such a plan to inflict so much potential harm.”)
The two issues relate: much of the justification for an expansion of Big Charity rests on its continued use as the processing warehouse for indigent care; give the indigent their own insurance they can use at a variety of places rather than giving them a location at which to appear when needing care and traffic at Big Charity will go down. The fact that the greater New Orleans area also will be down at least a couple of hundred thousand people perhaps for the foreseeable future in a market with too many beds prior to Hurricane Katrina does not seem to have made an impression of those who want more beds in the new facility.
Blanco, the good old boys around her, and the special interests benefiting from the current system are like junkies who need their crack removed to start their recovery – in this instance, with denial of the federal funds for the grandiose Big Charity. Instead, the federal government could pledge to give that amount to the state for transition costs (which would require some redirection of funds between HUD and the Department of Health and Human Services which might have to involve Congress) while the state scales back on its idea for the new complex that would not require that federal money. Add to that no possibility of federal waivers to redirect those dollars going into the state’s Medicaid program and no additional transition dollars unless the state junks any element of its current system in any redesign.
Vitter deserves applause for standing up for Louisiana and American taxpayers and for those who need indigent health care in the state; hopefully his tough love and the support of Jackson will get Blanco and her cronies to put people ahead of politics on both of these issues.
With the widespread damage from the 2005 hurricane disaster brought to the existing Medical Center of Louisiana New Orleans facilities (better known as “Big” Charity Hospital), the state decided it should build a whole new complex around downtown rather than renovate permanently the existing one. That’s not a bad idea, but the state rolled out an extremely ambitious, much expanded plan but which depends upon being attached to a Department of Veterans Affairs veterans’ hospital. The federal contribution to this would be $300 million.
However, Vitter signaled that the state should not get disbursement of that money unless it also agreed to scrap any vestige of the money-given-to-the institution charity hospital system of indigent care. That system (found only in Louisiana) is less efficient and produces poorer outcomes with fewer services than the model the state is being urged to adopt by the federal government, but Blanco and other state officials have put up strong resistance to genuine system reform because it would reduce a reduction of scope, size, and authority of government, and would steer money away from the special interests backing these politicians.
(While it’s true that Vitter is a Republican and virtually all the opponents of reform are Democrats, it’s not really a partisan issue. No less than Democrat stalwart and former Sen. John Breaux has come out in favor of real reform. Rather, battle lines have been drawn between big government practitioners of politics as usual who have run Louisiana for decades and those who wish to transfer power from government to the people, in this case clients of indigent health care. For her part, Blanco showed how inflexible and lacking in creative thinking she is with her reaction to Vitter’s letter: “I simply have a hard time believing that Secretary Jackson, who deeply cares about the low-income population, would go along with such a plan to inflict so much potential harm.”)
The two issues relate: much of the justification for an expansion of Big Charity rests on its continued use as the processing warehouse for indigent care; give the indigent their own insurance they can use at a variety of places rather than giving them a location at which to appear when needing care and traffic at Big Charity will go down. The fact that the greater New Orleans area also will be down at least a couple of hundred thousand people perhaps for the foreseeable future in a market with too many beds prior to Hurricane Katrina does not seem to have made an impression of those who want more beds in the new facility.
Blanco, the good old boys around her, and the special interests benefiting from the current system are like junkies who need their crack removed to start their recovery – in this instance, with denial of the federal funds for the grandiose Big Charity. Instead, the federal government could pledge to give that amount to the state for transition costs (which would require some redirection of funds between HUD and the Department of Health and Human Services which might have to involve Congress) while the state scales back on its idea for the new complex that would not require that federal money. Add to that no possibility of federal waivers to redirect those dollars going into the state’s Medicaid program and no additional transition dollars unless the state junks any element of its current system in any redesign.
Vitter deserves applause for standing up for Louisiana and American taxpayers and for those who need indigent health care in the state; hopefully his tough love and the support of Jackson will get Blanco and her cronies to put people ahead of politics on both of these issues.
7.2.07
Stuck on stupid XXII: Saving big government rather than money
If an idea makes sense, you can bet the good-old-boys (and girls) that comprise a majority of elected officials in Louisiana are going to reject it. Gov. Kathleen Blanco in this regard didn’t disappoint when she said a universal health care plan whose early indications in other states are positive that would replace Louisiana’s solitary, inefficient, and low-performing charity hospital-based plan “seems to be an insult to our intelligence.”
Blanco and her minions continue to insist that the plan pushed by the federal government, which states across the country are adopting, is not for Louisiana. Alone among analysts of the plan, which would steer federal health care dollars away from institutions and into the hands of presently-uninsured health care clients, they actually think, when all the evidence is against them, that only a system something like what the state presently has will produce cost-effective and acceptable patient outcomes.
One reason Blanco has taken this line is that the federal government has not offered to pay for all of the transition costs into the better system. There will be some because for awhile two systems, the recommended money-follows-the-person and the existing money-given-to-the-institution, will run simultaneously. As time passes and the former, efficient system gains usage at the expense of the latter, inefficient one, costs per uninsured will decrease.
As usual, Louisiana wants somebody else to pay for its mistakes, even as the state sits on potentially more than a billion dollars in surplus that could pay for any transition dollars the federal government does not provide – which would provide savings in the future. But the state’s contention itself rings hollow that the costs will be so high. Both the federal government and those outside government repeatedly have questioned this state’s figures, saying they are very much exaggerated.
Even if the state’s claim wasn’t so dubious, the fact remains many savings could be made in Louisiana health care spending with simple legal and procedural changes. Just to name one, the state’s own auditors concluded that nearly $100 million a year alone could be saved by changes in how nursing homes are reimbursed.
Another indicator of the state’s inherent inefficiency in providing care is in its per capita expenses for uninsured care. In Massachusetts (which recently reformed its system along the lines Louisiana should), that state spent about $1.3 billion last year for a population of almost 6.5 million, or an average of $202 per person, while Louisiana spent $935 million for a population of just over 4.25 million for an average cost of $218 per person – and Massachusetts covers more services and more expensive ones than does Louisiana. A money follows-the-person system would force more efficiency into spending as private entities who must compete against each other take a bigger share of total dollars spent.
The smokescreen about costs gets circulated because the Blanco Administration needs political cover for its real motive in rejecting needed change: protecting the large state government structure of charity hospitals and other institutions, and interests of other institutions outside of government who have become junkies dependent upon state money in this policy area. Tossing money around to certain constituencies brought these people to power, and it’s the only thing they know.
It’s the old unwelcome love of big government exhibited by Blanco and many of her predecessors and fellow state politicians who do not really understand the way the world really works and who put more faith in government than in people to solve problems. And thus she and defenders of the present ailing system, like state Sen. and nursing home operator Joe McPherson, on this issue remain stuck on stupid.
Blanco and her minions continue to insist that the plan pushed by the federal government, which states across the country are adopting, is not for Louisiana. Alone among analysts of the plan, which would steer federal health care dollars away from institutions and into the hands of presently-uninsured health care clients, they actually think, when all the evidence is against them, that only a system something like what the state presently has will produce cost-effective and acceptable patient outcomes.
One reason Blanco has taken this line is that the federal government has not offered to pay for all of the transition costs into the better system. There will be some because for awhile two systems, the recommended money-follows-the-person and the existing money-given-to-the-institution, will run simultaneously. As time passes and the former, efficient system gains usage at the expense of the latter, inefficient one, costs per uninsured will decrease.
As usual, Louisiana wants somebody else to pay for its mistakes, even as the state sits on potentially more than a billion dollars in surplus that could pay for any transition dollars the federal government does not provide – which would provide savings in the future. But the state’s contention itself rings hollow that the costs will be so high. Both the federal government and those outside government repeatedly have questioned this state’s figures, saying they are very much exaggerated.
Even if the state’s claim wasn’t so dubious, the fact remains many savings could be made in Louisiana health care spending with simple legal and procedural changes. Just to name one, the state’s own auditors concluded that nearly $100 million a year alone could be saved by changes in how nursing homes are reimbursed.
Another indicator of the state’s inherent inefficiency in providing care is in its per capita expenses for uninsured care. In Massachusetts (which recently reformed its system along the lines Louisiana should), that state spent about $1.3 billion last year for a population of almost 6.5 million, or an average of $202 per person, while Louisiana spent $935 million for a population of just over 4.25 million for an average cost of $218 per person – and Massachusetts covers more services and more expensive ones than does Louisiana. A money follows-the-person system would force more efficiency into spending as private entities who must compete against each other take a bigger share of total dollars spent.
The smokescreen about costs gets circulated because the Blanco Administration needs political cover for its real motive in rejecting needed change: protecting the large state government structure of charity hospitals and other institutions, and interests of other institutions outside of government who have become junkies dependent upon state money in this policy area. Tossing money around to certain constituencies brought these people to power, and it’s the only thing they know.
It’s the old unwelcome love of big government exhibited by Blanco and many of her predecessors and fellow state politicians who do not really understand the way the world really works and who put more faith in government than in people to solve problems. And thus she and defenders of the present ailing system, like state Sen. and nursing home operator Joe McPherson, on this issue remain stuck on stupid.
6.2.07
Solid Jindal support will discourage gubernatorial aspirants
As gubernatorial candidates throw themselves in rapid fashion into Louisiana’s 2007 contest, unsurprisingly some musing has occurred regarding the meaning of it all. Those who attempt this should understand clearly what they try to analyze.
Speculation increases that Gov. Kathleen Blanco, so mortally wounded as a candidate by her missteps in office, will withdraw from the race, despite the fact that she just held a large fundraiser (if not running for reelection, what else could she possible think she could run for and win?). Blanco never has lost a race and is particularly stubborn. Further, at least through the end of the regular legislative session she will believe there is ample opportunity to salvage enough of her political fortune that she can win in October.
For her ever to change her mind, a lot has to not go right for her in the session. Unless that happens, she will remain in the race and effectively prevent any other serious Democrat other than the quixotic Public Service Commissioner Foster Campbell from running. No quality Democrat who is not after an ego boost would dare enter, knowing his upside in vote proportion in the primary likely would be less than Republican frontrunner Rep. Bobby Jindal’s and his partisan colleague competitive state Sen. Walter Boasso’s. The GOP dream would be to have another quality Democrat compete against Blanco and Campbell because that almost assuredly means Jindal and Boasso make the general election runoff.
The odds are against a Blanco deferral, but what if that happens? Only two Democrats at this time could be competitive against a Jindal-Boasso combination, Rep. Charlie Melancon and former Rep. Chris John. The latter probably would have trouble making the runoff. He was soundly dispatched by Sen. David Vitter in the 2004 Senate race, Jindal looks to be as relatively strong now if not stronger than Vitter then, and Boasso would take a decent chunk of prospective John votes away.
Melancon might be a better candidate to make a runoff against Jindal but likely still would end up failing against him. This is an unlikely scenario in any event because Melancon is extremely reluctant to run, and Boasso’s entrance into the race should make him even moreso. Simply, if Boasso doesn’t win this time out, in 2008 after a warm-up in 2007, he has two plum contests available to him. One is to run for Senate against Sen. Mary Landrieu, but the possible candidacy of state Treasurer John Kennedy if he switches parties may cause him to hesitate. The other would be a clear, unfettered shot at Melancon in a district in a presidential election year that will be reminded Melancon is a more liberal than conservative candidate of a party whose presidential candidate will be way more liberal that the Third District likes.
While some might believe Jindal and Melancon off-Congressional-year runs are equivalent, it shows they do not understand the underlying dynamics. Jindal loses nothing in an attempt at the Governor’s mansion, but Melancon could lose everything. Jindal’s House seat is absolutely safe; Melanocn’s is anything but, exacerbated by multi-millionaire Boasso’s warm-up signaling his intentions for higher office. In short, Melancon is unlikely to want to expend extra resources in an uncertain bid at the governorship when he may face a tremendous challenge in an unfavorable electoral environment a year later. Despite pressure being levied against him to get in the governor’s race, he is exceptionally unlikely to do so.
What too many analysts misunderstand about this governor’s race is that Jindal has become the mythical immovable object in the field. It is a mistake to think that Jindal’s high vote intention numbers only are a reflection of the competition he is expected to encounter. Rather, they are a sign of his attraction of voters regardless of who is in the field. No matter how many people enter this contest, he has a third of the vote regardless, and it’s almost mathematically impossible that two other candidates will exceed that. He runs and, barring some incredible circumstance, he’s in the runoff.
The question is whether who is there with him. At this point, the only two candidates with a hope of beating him there would be Boasso and Melancon (others like former state Democrat leader and businessman Jim Bernhard and GOP businessman John Georges will find gobs of money can’t make up for inexperience and, in Bernhard’s case bad publicity when he was chairman of the state Democrats especially against a field of this quality), and even they probably are not even money against him. Anybody else is highly unlikely to do beat Jindal.
This is reality and unless announced or otherwise candidates, including Jindal, recognize this and plan for it, that will greatly hamper any success they hope to have in this quest.
Speculation increases that Gov. Kathleen Blanco, so mortally wounded as a candidate by her missteps in office, will withdraw from the race, despite the fact that she just held a large fundraiser (if not running for reelection, what else could she possible think she could run for and win?). Blanco never has lost a race and is particularly stubborn. Further, at least through the end of the regular legislative session she will believe there is ample opportunity to salvage enough of her political fortune that she can win in October.
For her ever to change her mind, a lot has to not go right for her in the session. Unless that happens, she will remain in the race and effectively prevent any other serious Democrat other than the quixotic Public Service Commissioner Foster Campbell from running. No quality Democrat who is not after an ego boost would dare enter, knowing his upside in vote proportion in the primary likely would be less than Republican frontrunner Rep. Bobby Jindal’s and his partisan colleague competitive state Sen. Walter Boasso’s. The GOP dream would be to have another quality Democrat compete against Blanco and Campbell because that almost assuredly means Jindal and Boasso make the general election runoff.
The odds are against a Blanco deferral, but what if that happens? Only two Democrats at this time could be competitive against a Jindal-Boasso combination, Rep. Charlie Melancon and former Rep. Chris John. The latter probably would have trouble making the runoff. He was soundly dispatched by Sen. David Vitter in the 2004 Senate race, Jindal looks to be as relatively strong now if not stronger than Vitter then, and Boasso would take a decent chunk of prospective John votes away.
Melancon might be a better candidate to make a runoff against Jindal but likely still would end up failing against him. This is an unlikely scenario in any event because Melancon is extremely reluctant to run, and Boasso’s entrance into the race should make him even moreso. Simply, if Boasso doesn’t win this time out, in 2008 after a warm-up in 2007, he has two plum contests available to him. One is to run for Senate against Sen. Mary Landrieu, but the possible candidacy of state Treasurer John Kennedy if he switches parties may cause him to hesitate. The other would be a clear, unfettered shot at Melancon in a district in a presidential election year that will be reminded Melancon is a more liberal than conservative candidate of a party whose presidential candidate will be way more liberal that the Third District likes.
While some might believe Jindal and Melancon off-Congressional-year runs are equivalent, it shows they do not understand the underlying dynamics. Jindal loses nothing in an attempt at the Governor’s mansion, but Melancon could lose everything. Jindal’s House seat is absolutely safe; Melanocn’s is anything but, exacerbated by multi-millionaire Boasso’s warm-up signaling his intentions for higher office. In short, Melancon is unlikely to want to expend extra resources in an uncertain bid at the governorship when he may face a tremendous challenge in an unfavorable electoral environment a year later. Despite pressure being levied against him to get in the governor’s race, he is exceptionally unlikely to do so.
What too many analysts misunderstand about this governor’s race is that Jindal has become the mythical immovable object in the field. It is a mistake to think that Jindal’s high vote intention numbers only are a reflection of the competition he is expected to encounter. Rather, they are a sign of his attraction of voters regardless of who is in the field. No matter how many people enter this contest, he has a third of the vote regardless, and it’s almost mathematically impossible that two other candidates will exceed that. He runs and, barring some incredible circumstance, he’s in the runoff.
The question is whether who is there with him. At this point, the only two candidates with a hope of beating him there would be Boasso and Melancon (others like former state Democrat leader and businessman Jim Bernhard and GOP businessman John Georges will find gobs of money can’t make up for inexperience and, in Bernhard’s case bad publicity when he was chairman of the state Democrats especially against a field of this quality), and even they probably are not even money against him. Anybody else is highly unlikely to do beat Jindal.
This is reality and unless announced or otherwise candidates, including Jindal, recognize this and plan for it, that will greatly hamper any success they hope to have in this quest.
5.2.07
Barring good sense, minimum wage hike set to hurt LA
The issue of raising the national minimum wage shows again why Gov. Kathleen Blanco hasn’t a clue as far as the right policy for Louisiana, and any increase in it bodes ill for the state.
Competing bills are wending their ways through Congress that would boost it, although an effort exists to introduce tax breaks with it to try to mitigate its negative impact. There’s nothing good about raising it because it coercively takes resources from more productive users of them and transfers them to less productive users – meaning except for the small portion of the population that gets paid at that rate, the majority of whom are employed part-time and/or are not heads of households, all of society is worse off by its implementation.
Simply understood, the marketplace rewards people in proportion to their contributions to society. If a job without government mandate pays less than a minimum wage, it’s because the true value of that job to society is below that level. Not only do minimum wage laws create inefficient use of resources because of that transfer, but they also produce a ripple effect for wages near that level through upward wage pressure produced by the increase, overpricing additional wages.
Competing bills are wending their ways through Congress that would boost it, although an effort exists to introduce tax breaks with it to try to mitigate its negative impact. There’s nothing good about raising it because it coercively takes resources from more productive users of them and transfers them to less productive users – meaning except for the small portion of the population that gets paid at that rate, the majority of whom are employed part-time and/or are not heads of households, all of society is worse off by its implementation.
Simply understood, the marketplace rewards people in proportion to their contributions to society. If a job without government mandate pays less than a minimum wage, it’s because the true value of that job to society is below that level. Not only do minimum wage laws create inefficient use of resources because of that transfer, but they also produce a ripple effect for wages near that level through upward wage pressure produced by the increase, overpricing additional wages.
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