09/04 - Healthcare
Is the Louisiana healthcare system working for our citizens?
Do we still need the Charity Hospital system in the state? These are just a couple of the topics that will be discussed on the September edition of Louisiana Public Square. Louisiana Public Square is Louisiana Public Broadcasting’s monthly public affairs program which allows average citizens to get background information on that month’s topic and pose questions to experts. Health and Hospitals Secretary Dr. Fred Cerise will field the questions this month.
Louisiana is one of the most beautiful places in America. Its people are among the most interesting, friendly... and, unhealthy in the nation, according to John Matessino, President of the Louisiana Hospital Association,
Louisiana ranks at the bottom of many of the lists that you see on health outcomes ..... We don’t have a health care lifestyle in this state. We have access to health care issues. We have a huge problem with poverty in this state.
John MATESSINO, CEO, Louisiana Hospital Association
In fact, 2003 Census data shows Louisiana with the highest poverty rate in the nation. Doctor Holley Galland, primary care physician with Earl K. Long Hospital ’s North Baton Rouge Clinic, explains how it affects her patients.
Our number one problem is poverty. Poverty is the main cause of mortality and morbidity. Morbidity is basically being poor health. If you don’t read well, if you haven’t been taught good health habits, if you don’t have access to transportation, to therapeutic recreation, to resources that people who have funds have access to, then you are going to have a poor level of health.
> Holley,GALLAND, MD, Primary Care Physician, Earl K. Long Hospital
Louisiana spends about 80 percent of what the average state does on health, hospitals and public welfare. About a third of Louisiana ’s entire annual budget – nearly 6 billion dollars – goes to the Department of Health and Hospitals.
Much of that money funds 10 hospitals and about 350 outpatient clinics spread across Louisiana . This is the charity system, the oldest in the nation, and the only statewide healthcare safety net with a principal mission of providing access to care for the uninsured. And in a state with one of the highest rates of uninsured citizens, costs are staggering: 510 million dollars spent by the state last year on the care of indigent patients.
Senator Don Hines brings his experience as a medical doctor to the debate.
The biggest health care issue facing Louisiana today is that 40% of our population depends upon public funds for health care. We have about 20% or about 800,000 people on Medicaid and another 20% or 800,000 who are uninsured and using our public hospitals for health care.
State Senator Don HINES, MD
Budget cut backs have resulted in very long waits for treatment and appointments, clinic closures and other reductions in service. Diversion of funds intended for capital improvement has taken a toll in both New Orleans and at Earl K. Long in Baton Rouge .
I want people to understand care at Earl K. Long is not substandard care – it’s excellent care. The problem is getting in; we don’t have the resources.
Holley,GALLAND, MD, Primary Care Physician,
Earl K. Long Hospital
If you go to EKL or big charity, you might see a good doctor, but you have to wear a hard hat to keep the damn ceiling from falling on your head, or stand in line for 3 hours to get to see them, and those things – even the Medicaid patients don’t go there.
State Senator Don HINES, MD
The loss of Medicaid and Medicare patients is a big blow to the bottom line, because federal dollars from those patients could help defray the costs of care for the uninsured. The spiral continues downward, extending out to private sector players. Our Lady of the Lake Medical Center CEO, Bob Davidge, explains.
Private hospitals in Louisiana , and really across the country, more and more, if not already, are safety net facilities for the community. We provide indigent care – large amounts of indigent care ...
Bob DAVDIGE, CEO,
Our Lady of the Lake Medical Center
John Spain is Vice President of the Baton Rouge Area Foundation, which funded a study on the future of the Baton Rouge charity hospital.
You go to an ER now, and in BR, depending on your problem, you may have to wait 2 or 3 hours on certain nights to be seen by a doctor in an ER – even if you are a paying customer. That’s because we are being overwhelmed by people who are using the ER as their primary care physician, instead of having a doctor.
John SPAIN , Vice President,
Baton Rouge Area Foundation
The public hospital system is filled; it’s full; it’s at capacity.... a lot of our patients will use private emergency rooms. And this is hard on the private emergency rooms. And, it’s also hard on state funding because emergencies are not an effective way to spend health dollars.
Holley,GALLAND, MD, Primary Care Physician, Earl K. Long Hospital
Spending health dollars effectively has never been more important. The state is facing new deficit warnings, and the costs of healthcare continue to rise. Some health planners are giving a close look at a community-based model for health care delivery; one that turns the nearly three centuries-old Charity paradigm on its head.
Proponents of Community Health Centers, also known as FQHCs [Federally Qualified Health Centers] claim their non-profit, patient-driven approach reduces costs, increases accessibility and improves quality. There are currently 35 clinic sites in Louisiana .
Every community has somewhat of a different problem. Indigent care – charity hospitals is a problem everywhere. But what I think we learned looking at the charity hospitals in the last year is that there is no one solution that fits all communities. My guess is that if you look at issues, we’ll fine unique answers for each community, because they’re very different.
John SPAIN , Vice President,
Baton Rouge Area Foundation
In the end, the inertia of the mammoth charity system will tend to resist radical change, but change will come. The need for teaching, residency and intern programs will probably keep most of the big hospitals hobbling along. Additional community clinics will help deal with the seemingly unending flood of needy patients. And, hopefully, other institutions will foster the improvements in education and economic opportunity that create a truly healthy society.
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What concerns are on citizens’ minds as they go to the polls this fall?
The presidential election may be getting all of the attention, but Louisiana residents will be making several important decisions at the ballot box in November. The U.S. Senate seat left up for grabs by retiring Sen. David Vitter has drawn a field of 24 candidates. Louisianians in the south- and northwest parts of the state will also be voting on congressmen. So, what national concerns are on citizens’ minds as they go to the polls this fall? What statewide issues should be on the mind of Louisiana’s next Congressional leaders? Louisiana Public Square looks for answers on “Election 2016” Wednesday, October 26 at 7p.m. (Taping Tuesday, October 25)
• Elizabeth Crisp / The Advocate
• Greg Hilburn / Gannett Newspapers
• Martin Johnson, Ph.D. / LSU Manship School of Mass Communication
• Albert Samuels, Ph.D. / Mandela School of Public Policy, Southern University
• Guest Host: Patricia Smith / Assistant to Dean of Political Science Dept., Southern University
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What lessons did residents and state officials learn from this historic event and what challenges remain?
How well is the state’s public school system really performing?
What difference has a decade made?
Who are the winners and losers in Louisiana’s budget battle?
Is the display of Civil War statues in public justified or do they belong only in museums?
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