Crime Blotter: Reported offenses in the Tri-parishes
October 2, 2012
Bayou D Jon’s headed to Houma’s East Side
October 2, 2012
Louisiana Treasurer John Kennedy is concerned about Medicaid. With that, he told members of the Rotary Club of Houma that, “This is not a time to panic … but we still need to make changes.”
Kennedy addressed the federal/state Medicaid program last Wednesday before a group of business government and medical professionals. He noted up-front that while two-thirds of Medicaid funding comes from the federal government, the state is responsible for an additional third of all funds.
The treasurer also said Louisiana became accustomed to having extra money during the past seven years. Now it faces doing without it.
“[In Louisiana] we spend a lot of money on our Medicaid program,” Kennedy told his audience. “Between $7.5 billion and $8 billion a year, that is over a third of our budget.”
Following Hurricane Katrina in 2005, the U.S. Congress approved increases in Medicaid assistance for Louisiana on a temporary basis.
That income supply ended Monday.
With 1.3 million Louisianans receiving health coverage through Medicaid, federal cuts of $860 million caused state shortages just as the state health system became dependent on the added cash flow.
A loss of federal financing caused, and will continue to require, cuts in public hospitals in the LSU Health Care System, the speaker reminded his listeners.
“Our Department of Health and Hospital was not prepared,” Kennedy said.
The state treasurer said he expects Gov. Bobby Jindal to recommend a public/private partnership to save what remains of the so-called charity hospitals. “We will have to examine that carefully, because public/private partnership is sometimes a fancy word for sale,” he said.
Kennedy offered his own list of ideas to address Medicaid concerns in Louisiana, which includes transitioning how public health concerns for the poor and uninsured might be resolved.
The treasurer said while medical care in emergency cases would never be denied, he would require patients to assist with expenses by offering co-pay for treatment ranging from $2 to $10.
Kennedy would prohibit the use of Medicaid for non-emergency or serious medical treatment. He related the story of a Medicaid patient that allegedly went to an emergency room because the tip of her finger nail had broken. “The physician referred her to a nail salon,” he said.
The state treasurer’s other ideas include allowing the state to purchase private insurance offered by employers for low-income workers when it proves less expensive than Medicaid.
Kennedy wants to reform the state medical preferred pharmaceutical drug list to include the most effective drugs at the lowest prices.
He calls for a review of Medicaid hospitalizations based on necessity and a reduction to the size of a $1.1 billion charity hospital being built in New Orleans.
Kennedy said eliminating advisors and demanding a 5 percent discount on consulting contracts that do not directly involve health care could save the state money.
With legislative action, Kennedy wants to see a return of $300 million in state capital outlay to the general fund to generate health care cash flow.
Kennedy said the state would also benefit with an upgrade to its computer system, should sell an uncollectable portion of its $1.3 billion in accounts receivable to pay on debt and free up money for health care.
He would also place the 10 charity hospitals on an inventory control system that provides supplies on an as-needed basis.
Kennedy opposes a proposed closing of the Southeast Louisiana Mental Hospital.
He said having patients treated there costs taxpayers less than having them on the streets and in emergency rooms.
Kennedy, joined with comments from state Sen. Norby Chabert, said that Louisianans have become accustomed to an all-or-nothing approach to services. Both men called for an attitude change.
“We need to increase moderately how much our citizens pay and what they receive,” Chabert said. The legislator said an attitude of everything being free or costing millions of dollars needs to change.
Buquet Distributing Co. owner J.J. Buquet said that asking for more accountability in regards to Medicaid should not be viewed as class warfare. “We are struggling as a community to maintain the survivability of a charity hospital,” he said regarding Leonard J. Chabert Medical Center in Houma and the entire public hospital system.
“If that is not compassion I don’t know what is, but at the end of the day there is no free lunch for anybody,” Buquet said. “If you really need an emergency visit for an appendectomy, is $2 too much to ask? Maybe there could be a sliding scale where there is a different percentage for upper income or lower income. There is middle ground and we’ve got to work to find it.”
“I agree with some of the views [Kennedy] had on getting people to contribute when they enter the emergency room and funnel people from it when possible,” Enterprise Rent-a-Car employee Jerry Keys said.
“If you can help yourself out by any means you need to factor in income to some extent. With an $8 billion deficit you need to squeeze pennies and see if you can get that to families that really cannot take care of themselves,” he said.
“The long and the short is we’ve got to make changes to Medicaid,” Kennedy said. “We need to be very careful for all hospitals. They are not only providers of health care. They are providers of jobs. They are part of the fabric of a community.”
Louisiana Treasurer John Kennedy interjects humor to prepare members of the Houma Rotary Club to face a hard message concerning Medicaid and what it means for the poor and uninsured.
