NO SMOOTH TRANSITION FOR THE POOR AND UNINSURED

Staff levels at LSU’s Earl K. Long Medical Center and its clinics have declined so much that LSU officials have had to reduce both inpatient and outpatient clinic services to the poor and working uninsured in the Baton Rouge area.

The number of employees leaving picked up in late January when LSU officials moved the Earl K. Long facility’s closure date up to April 15 from its original November target and decided to turn over operation of its four free-standing clinics to Our Lady of the Lake Regional Medical Center, locally called the Lake, instead of keeping them under LSU.

The Lake becomes home to LSU’s inpatient hospital care and medical education programs on April 15. The state employees lose their state jobs with the privatization move. Who would ever have expected...?  Me, for one.  Poor planning and hasty implementation of the transition to privatizing public hospitals and clinics resulted in poor outcomes.  But we're talking about the poor and working uninsured, and do they really count here in Louisiana?  Are they deserving of any kind of decent health care?

The impact is being felt more dramatically on the outpatient side, where current patients are having difficulty scheduling appointments and new patients are on waiting lists, he said. Surgical clinic activity has also been negatively affected.

So.  When sick people do not have access to primary care, they get sicker, and some end up in the emergency room to be treated at far greater expense.

Keep in mind that Bobby Jindal refuses to participate in Obamacare's Medicaid expansion plan, which could cover as many as 400,000 of the uninsured, even though adopting the plan would be a winner for Louisiana.

Reed said the reduction in patients also will affect physicians in training and medical student experiences needed for graduate medical education and degree programs during the transition.

With Louisiana's sterling history of falling at or near the bottom in educational surveys at every pre-university level, and budget cuts to the bone for public universities, including the flagship university Louisiana State University, why worry that medical education will be affected?  Fewer doctors and other medical staff in Louisiana will hit the most vulnerable among us the hardest, but it seems they don't really count.

How can I assign Governor Jindal any grade but F, graduate of an ivy league university and Rhodes Scholar though he may be?  How much more of the shenanigans of the governor and the obliging legislators can the state take before the entire house of cards erected by our leaders collapses? 

ARE YOU PAYING ATTENTION, BOBBY?

The recent mass killings in Tucson, Aurora and Newtown have sparked public conversations about the deficiencies in state-run mental health systems across the United States. But few states are poised to spend their own money to reverse as much as a decade of budget cutbacks in those areas.

Instead, many of them are counting on an infusion of federal mental-health dollars. Because Medicaid includes mental-health benefits, those states that opt into the Medicaid expansion included in President Obama’s Affordable Care Act will be able to make mental health coverage available to thousands of their citizens who do not now have it.
For the first three years that additional coverage would cost the states nothing: Under terms of the Affordable Care Act, the federal government  will cover 100 percent of the costs of new Medicaid enrollees for the first three years and 90 percent after 2020.

Louisiana is not presently known for its sterling mental health care system.  Nevertheless, our governor, Bobby Jindal, has opted out of the Medicaid expansion which would cover mental health care on conservative principles, but I wonder if he may reconsider.   The majority of the citizens of Louisiana are against any sort of regulation of firearms or ammunition, giving as their reason that it's not guns that kill people, but deranged individuals who manage to get their hands on guns who kill people.  How about it, members of the NRA in Louisiana?  Why not start a campaign to urge the governor to sign on to the expanded Medicaid program that will enable more persons with mental illness to get treatment? 

The mentally ill deserve the same treatment as those with physical illness, because it's the right thing to do, but whatever your motive behind opting into the Medicaid expansion, just do it, Governor.  The Medicaid expansion program would serve a good many people with physical illnesses and offer preventive care.  What's not to like?  If conservative principles prevent you from giving the citizens of Louisiana services they need, then, in the name of simple compassion for the well-being of the people you serve, you should ditch your principles.

Also, Governor, in the event you hadn't noticed, the line of Republican governors who refuse to participate in the Medicaid expansion program is broken.  I expect more Republican governors will decide to adopt the program, so you would not stand alone if you changed your mind.  Perhaps you and your good friend Rick Perry (Tweedledum and Tweedledee?) from Texas might have a conversation about a change in policy. 

Arizona will participate in the expansion of Medicaid, Gov. Jan Brewer said Monday in her State of the State address, making her the third Republican governor to agree to one of the key components of President Barack Obama's health care reform.

Brewer said that if she did not accept the Medicaid funds for Arizona, other states could claim those federal dollars and create jobs that otherwise would be created in Arizona. Fellow Republican governors Susana Martinez of New Mexico and Brian Sandoval of Nevada also plan to expand Medicaid to anyone who earns up to 133 percent of the federal poverty level, which is currently $14,856 for an individual.

But 10 other Republican governors have already decided not to participate. The Supreme Court's 2012 ruling that affirmed Obama's health care law allows states to refuse to take part in the Medicaid expansion.