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This column publishes usually every Sunday through Thursday after noon (sometimes even before; maybe even after sundown on busy days) U.S. Central Time except whenever a significant national holiday falls on the Monday through Friday associated with the otherwise-usual publication on the previous day (unless it is Independence Day or Christmas or New Year's when it is the day on which the holiday is observed by the U.S. government). In my opinion, there are six of these: New Year's Day, Memorial Day, Independence Day, Veterans' Day, Thanksgiving Day, and Christmas (Easter always being on a Sunday).
With Thursday, Dec. 25 being Christmas Day, I invite you to explore this link.
Posted by Jeff Sadow at 12:00
Politics continues to drive the issue of financing Louisiana’s transition from state-run to state-overseen hospital care for the indigent, leaving it uncertain whether the state will be forced to pay back some money to the federal government.
The U.S. Department of Health and Human Services finally approved the state’s deals for the majority of its state-owned hospitals that turn over management to nongovernment concerns. Through the first year of operation by doing so the state has saved $52 million and expanded services. But HHS also alleged that part of the financing arrangement violated regulations in that it relied upon front-loading lease payments by the operators. It essence, it claimed that early delivery of these provided additional money for the state to use to obtain reimbursement of Disproportionate Share Hospital claims (the federal government typically pays about three-fifths of these), to the tune of $190 million. Regulations forbid anything that is not a payment for service, so if this interpretation were to be accepted, the state would have to pay that back.
Logically speaking, HHS’s never has been a convincing argument. A lease payment is a lease payment regardless of its timing and does not turn into a “donation” just because it’s early. And it makes perfect sense for these kinds of early payments as an inducement for the operators to stay on the job; in fact, amendments forced upon the state in this review process made it easier for operators to bail out earlier, magnifying the value of this tactic. If an operator shows good faith to see through the length of the contract by paying more of it up front, then it is likelier not to terminate the contract early if it know its payments are going to go lower in future years. Making all lease payments equal only encourages instability in the program.
Posted by Jeff Sadow at 11:00
Undoubtedly spendthrift Democrats looking to back up certain special interests and media mavens with pretensions of moral superiority will jawbone legislators and Gov. Bobby Jindal to accept expansion of Medicaid starting next fiscal year in this upcoming spring’s legislative session. They will do so only by ignoring the mounting evidence that, in any form, it proves a bad deal for Louisianans.
Expansion would provide free insurance to those making 25-100 percent of the federal poverty income limit; currently, these people obtain medical care by appearing at a health care facility where they must be treated or referred at no cost to put them out of medical danger. The state estimates that through 2023 expansion would have cost the state at least hundreds of millions of dollars. In the most likely scenario, by 2030 the cost to taxpayers would end up about $1 billion extra under expansion than under the current regime. Under the least optimistic scenario, costs would have been over $2 billion extra through 2023.
Jindal has pointed to the Medicaid program’s structure as a major reason for the considerable costs, and proposed his own federal overhaul to make it more efficient. Those ideas translated to the state level were passed into law this year, but would need those federal changes to implement. With that unlikely to happen until election of a reform-minded president in 2016, some supporters have tried to grasp onto other states’ efforts that don’t ask for major federal reform but with tweaks.
Posted by Jeff Sadow at 10:30
The first round went against the inhabitants of Fortress St. Tammany. Likely, every round will. But, in the end, part of their inconsistent ideology may end up winning the fight for them.
Last week, Louisiana’s Department of Natural Resources’ Office of Conservation ruled that Helis Oil & Gas should receive a permit to drill a vertical well in a tract in the parish. It’s not like this is unprecedented: dozens of wells dot the parish. That the company could come back several months later from doing such and then petition to drill horizontally is what has gotten the attention of the parish’s resident Luddites.
St. Tammany, if going by voter registrations and records, is perhaps the most conservative parish in the state. By way of example, on Nov. 4 for the U.S. Senate it graced (short-time) hometown boy Republican Rob Maness with 19 percent of the vote where he only got 14 percent statewide, and on that day Republican Rep. Bill Cassidy got 52 percent of the parish vote as opposed to his 41 percent statewide. Then on Nov. 6, Cassidy galloped into the Senate with 56 percent of the vote statewide, but hauled in a whopping 72 percent in the parish.
Posted by Jeff Sadow at 09:45
Last week, Bossier City lawmakers shot down a pay raise for employees, where having no such hikes has become the norm over the past few years. Maybe if the city hadn't played venture capitalist in the name of economic development, this would not have happened.
This comes from about a dozen years existence of what’s now called the CenturyLink Center. Flush with cash with the introduction of riverboat casinos in the 1990s and with the familiar gnaw of Shreveport envy tugging, the city’s elected officials (with councilors Jeff Darby and Bubba Williams still with us from then, and current Mayor Lo Walker having ascended from being the city’s chief administrative officer) decided to build the mid-sized multipurpose arena on the taxpayer dime. Of course, had a market existed for this, the private sector would have obliged, but politicians charged on, telling the public it could be done for under $40 million but which ended up costing half again more.
That and controversy over its siting (which drew big opposition from residents in the areas around the Jimmie Davis Bridge) cost some city council members their elective careers in 2001. It’s just plain cost taxpayers since, with a total deficit running into the millions of dollars since its opening in 2000, as reflected by the fact that in all of those years operating revenues exceeded operating costs except for two, meaning the city has transferred in through 2013 approaching $5 million that could have been spent on other city operations.
Posted by Jeff Sadow at 10:00