In the late 1980's, when the Japanese economy was roaring but Louisiana's wasn't, wealthy Japanese business people wanted to discuss buying the New Orleans Superdome. The state could have used the money, but then-Governor Roemer said no. Where do you think New Orleans would be today if he had said yes?
Now the state needs money yet again, after the federal government's decision to stop sending the extra Medicaid funds Louisiana was receiving because of Katrina, resulting in a $859 million deficit in the state Medicaid Program. One option the Jindal administration is looking at is selling the LSU Health Sciences Center Shreveport and using the proceeds to minimize the cuts to the state's nine remaining Charity hospitals. LSU Charity Shreveport is the strongest of the system, with the most paying patients and deep community support, and likely would attract the best price.
Lord knows, Louisiana needs a health care delivery system that looks like somebody designed it on purpose. Governor Jindal is right to consider alternative ways of achieving that goal. But before we hock the family silver, we need to think carefully about the consequences (intended and unintended) and get satisfactory answers to a few questions:
1. What will happen to the LSU Medical School in Shreveport if we sell LSU Charity Shreveport?
2. What will happen to the hospital's Level 1 Trauma Center, its Regional Burn Unit, and its extensive and impressive medical research?
3. Why would a national hospital corporation want to buy one of our safety-net Charity hospitals (even, arguably, the best one) and what would be the mission of the new facility? Would Louisiana and Shreveport-Bossier have any say in the determination of that mission?
4. What are the implications for access to and cost of health care in Northwest Louisiana?
5. Who gets the proceeds of the sale and what will they be used for? Will the money be reinvested in health care in a way that permanently adds value and moves us closer to our goal, or will it be quickly spent to fill a funding gap in a broken system?
6. What will be the economic impact to Northwest Louisiana?
7. How will the viability of other hospitals in Northwest Louisiana be affected?
8. Have the doctors, nurses and other health care professionals who are responsible for LSU Charity Shreveport's success been consulted?
9. Can we really expect to fix Louisiana's Medicaid Program without addressing the inefficiencies in the program itself, such as the rampant use of emergency rooms for non-emergencies, an un-reformed pharmaceutical drug formulary and DHH's aversion to Medicaid alternatives like LaHIPP and LRS 22:1065?
Easy answers are often wrong. Like the Meatloaf song says, "there ain't no Coupe de Ville hiding at the bottom of a Cracker Jack's box." Let's examine carefully the pros and cons before we decide to hock the family silver.
John Kennedy is state treasurer of Louisiana.