As the debate over health-care reform heats up on the Senate floor, with some lawmakers saying they'll pass a version of the bill by the holiday break, the national eye has again turned to New Orleans. Three of the state's top political figures -- Gov. Bobby Jindal, Sen. Mary Landrieu and Rep. Joseph Cao -- have a lot at stake in the debate, and as a result, Louisiana does as well.
Campbell Robertson's article for the New York Times focuses on just that: what health-care reform means for Louisiana and its politicians, and how it may, according to Robertson, "drastically alter the state’s traditional system" -- perhaps making it obsolete.
“Health care reform will be more of a burden to Louisiana than any other state I can think of, and that’s primarily because of the charity hospital system,” David Hood, a former state health secretary, says in the article.
Language in the bills floating around Congress would cut disproportionate share hospital payments "significantly" over the next decade, Robertson says, for a broad expansion of Medicaid coverage. And because Louisiana receives three times the national average of those payments, those cuts may slice deep into the budget for the state's charity hospitals because nearly 20 percent of the state's Medicaid spending comes from those payments. That's three times the national average.
Should health-care reform pass in its current form, almost half of Louisiana's population would find themselves Medicaid-eligible, meaning there would be thousands of previously uninsured patients potentially without a need for the charity system.
But would that be a bad thing?
“A model in which people are dependent on going to a facility for all their care as opposed to having insurance coverage so that they can use the broadest array of the health care system is at best antiquated,” Diane Rowland, executive director of the Commission on Medicaid and the Uninsured, says in the article. “Louisiana probably stands to gain more from health reform than lose.”
The primary weakness of the charity system, according to the article, is how centralized and antiquated it is. LSU officials say that has been changing, and the state has already been moving to a more decentralized approach. As a result of Hurricane Katrina shuttering Charity Hospital in New Orleans, there are 93 clinics and community health centers now in the area serving the uninsured, according to Robertson.
On the cusp of passing reform, there is of course other local news concerning health-care reform circling around the country:
- Senate GOP rallies the troops: Sen. David Vitter appears briefly in a GOP ad's call to arm against health-care legislation. His line? "An urgent call for action." Sound like an incomplete sentence? Check out the ad to see why.
- Senators Add the Ornaments and Trimmings: For more on pet projects being added to the bill (the Louisiana Purchase is mentioned), head to the New York TImes.
- Landrieu: Blame Coburn for middle-of-the-night healthcare votes: Don't like how the debate has stretched on and on and on? Blame Sen. Tom Coburn -- "a Republican obstructionist," Landrieu says -- for forcing a reading of a lengthy amendment on the Senate floor, delaying the debate possibly into Christmas.
- CQ Transcript of Landrieu on Face the Nation: Landrieu debates health-care reform on CBS's Face the Nation.
- Senators defend deals to Nelson, Landrieu: The Hill reports on a "Fox News Sunday" segment in which Sen. Kent Conrad, D-N.D., stands behind last-minute deals to health-care reform, like the $300 million one Sen. Mary Landrieu secured. Read more about what some are calling The Louisiana Purchase here.
