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Panel opens up Pandora's box for Jindal hospital plans

You pay your money and you take your chances, a sentiment reaffirmed to the Gov. Bobby Jindal Administration when the Commission on Streamlining Government brought up the contentious issue of whether to build a new hospital complex for the Medical Center of Louisiana-New Orleans.

The Administration’s main purpose in having the Commission, as noted, is to use it as a vehicle to build political support for its redesign of government which has as part of it some controversial matters that challenge existing power structures within state government. Having the Commission endorse Jindal’s views would make some of his desires politically possible in the face of entrenched opposition.

But the shoe got put on the foot when the Commission dove into the matter of rebuilding “Big Charity,” the public hospital now run by the Louisiana State University System that was rendered inoperable in the aftermath of Hurricane Katrina in 2005. Original plans by former Gov. Kathleen Blanco set to create a palatial new facility, even as the area had excess hospital capacity that was only going to increase through depopulation. Jindal scaled back those plans somewhat.

However, ignored by the state was the realistic alternative of taking the old building structure and remodeling it. A study paid for by historic preservationists showed this to be a considerably cheaper option, although a study by the LSU System claimed a new building would be more cost effective. Heretofore, the state has accepted the LSU line.

Looking for ways to save the state money as forecasted budget deficits could be in the $2-3 billion range in the next two fiscal years, the Commission advocated what normally is an idea that merely puts off hard decisions, delays matters, and costs more money – do another study. Yet in this instance such a position is justified. Members were right to note that no study unconnected to advocates of one choice or the other has been completed and, if the preservationists’ numbers are the most accurate, around a quarter of billion dollars are at stake and could be saved. For that amount of money, a little more time and expense is cost effective.

Perhaps even more controversially, the motion passing that addressed this issue included review of the LSU System business plan for operating the new facility. At the time it was produced, many (including the Jindal Administration in its conclusion to build a smaller facility) questioned the assumptions behind it that appeared to justify the presence of a larger facility. If a review of the plan showed even at its reduced level too many beds would exist to serve the market and operate it without large losses, this might argue in favor of renovation – although it also could become justification for a new but even smaller Big Charity that might make that plan more cost effective relative to renovation.

After the Commission reports by Dec. 15, then it’s up to the Joint Legislative Committee on the Budget to carve out the relatively small amount of money in short order as the recommendation wants the study completed by the beginning of the next regular legislative session in late March. Whether that happens will indicate how much power the Jindal Administration is able or willing to exercise on the matter if it truly is closed-minded about ramming through a hospital of questionably-needed size in this era of tight budgets.

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