Today - Monday June 10, 2013 - the Louisiana State Civil Service Commission voted to reverse their decision opposing privatizing 4 of 9 Charity Hospitals across the State.
We will see what landmines await for the indigent, the working poor and uninsured await as we move forward with the Governors great experiment.
Of note is that we have no certainty of the Federal Centers for Medicare & Medicaid Services [CMS] approval to ensure Federal funding for whatever privatization Governor Jindal clearly desires. If CMS cannot get answers from the State to concerns they have regarding the privatizations, any medicaid money that has being allocated for Louisiana for next year will likely have to be paid back.
Sandra Stokes, board member of the Foundation for Historical Louisiana was present to comment at the meeting. Her remarks were particularly prescient. Special thanks to Ms. Stokes from the team at SaveCharityHospital.com for allowing us to print her remarks. [See below]
Civil Service Commission –
We appreciate the Civil Service Commission taking a hard look at the economy and efficiency of the privatization of the UMC Hospital. I love those words….. Efficiency and economy. We have been asking for a realistic examination of the project since August 20th, 2008.
As Executive Chair of the Foundation for Historical Louisiana – I led the study to analyze the reuse of Charity Hospital. Charged by the 2006 legislature in HCR89 - FHL raised the $600K in private funds for the study – and hired the best. This study concluded we could build a new state of the art academic hospital inside the shell of Charity hospital for a savings of at least 34%, or $283M in the hospital portion alone. Now that is economy!
And, with the hospital empty of patients, it could be completed in only 3 years. Jobs, the medical school, and access to healthcare for the city could have been back at full tilt by 2011. Now that is efficiency!
The medical district of New Orleans would have been revitalized, and better yet, we wouldn’t have had to take people’s homes after they returned and struggled to rebuild after Katrina. And the concept plan developed in the study gave LSU all the bells and whistles they wanted in their dream medical center – not the scaled down version that is being built that lacks obstetrics, pediatrics, a parking garage – and much more.
We, along with 77 local and national organizations continually pleaded for the governor to call for an objective cost benefit analysis comparing the reuse of Charity to the LSU’s plan – to determine the most efficient and economic way to proceed. It never happened. The only group that did call for a cost benefit analysis was the Legislative Streamlining Commission. Again, it never happened.
None of this has ever been about efficiency or economy – or even common sense at that. With all the questionable events at Charity after Katrina – the medical staff and military repairing, cleaning and preparing the hospital to reopen while patients were left to be treated in tents and trailers for years in order to push through the misguided agenda for a new building.
We watched bad decision after bad decision being made, with little or no factual basis or independent examination of the decisions. We were assured the hospital would be self sustaining. I won’t bore you with reliving the long litany of misrepresentations made by LSU along the way. But most, if not all things we were told time and again did not come true.
It seems - with the premise of – you can’t turn back now - more and more bad decisions are made – costly decisions that impact every citizen and taxpayer of this state. They have to keep moving this elephant down the road. And always with quick deadlines, so decisions are rushed – like this one.
We had hopes that when the University Medical Center Management Corporation was established that they would start to look at the numbers, and be more realistic. We hoped THEY would commission a cost benefit analysis and finally show that the LSU plan was not efficient or economically sound.
And we hoped there was FINALLY going to be reason when we heard their own consultants say LSU’s Academic Medical Center could NOT be self sufficient – or sustainable. We spoke out in shock the legislature, at Joint Budget Committee in 2010 when, according to the UMC’s own study, taxpayers would have to subsidize the expense of the hospital to the tune of at least $70 - $100M more per year. Now, with privatization, we learn that with the little information we have so far, taxpayers will have to cough up 2 and a half times that amount for the hospital to have any chance of operating in the black.
There are still many unknown numbers. The VA Hospital has a construction price of $995M – has said their opening costs are $707M. What are the openings costs of the UMC hospital and who is paying that? What will happen with the governor refusing to accept Medicaid Expansion – since, under the provisions of the Cooperative Endeavor Agreement, Louisiana Children’s’ Medical Center has the right to withdraw from the deal if the state fails to maximize federal reimbursement. And then there is the complete absurdity of approving this with 50 blank pages in the agreements. How can anyone responsibly judge the economies of this deal? Now – thousands of loyal and devoted state employees who care for the sick are set to lose their jobs and benefits with all of these unknowns?
In my naivety – at the beginning of all of this, I believed common sense would prevail. But that never happened. The latest hope is with you, the Civil Service Commission, with your higher standard of responsibility to the citizens of Louisiana, and authority to ensure efficiency and economy in such transactions, that dedicated state employees will not lose their jobs until we know exactly what all of this truly entails.