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No More Charity Myths

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Dr. Larry Hollier, chancellor of LSU's Health Sciences Center, is tired of the myths surrounding the proposed joint venture between the VA Hospital and LSU's Health Care Services Division. For starters, he wants the U.S. House Committee on Veterans Affairs, which must approve the VA's part in the deal, to realize that the LSU-VA proposal is not the "Old Charity model," as some critics like to call it. The project shouldn't even be referred to as Charity Hospital, Hollier says. The proposed new medical district -- including the VA Hospital and University Hospital -- will include the only Level 1 Trauma Center in this region, a badly needed Crisis Intervention Unit for psychiatric services, and a modern teaching hospital for medical, nursing and allied health students. It will be an economic juggernaut for downtown New Orleans, as construction will inject $1.2 billion into the local economy. Even more important, it will become the lynchpin for re-establishing the New Orleans Medical District -- only bigger and better this time around. For all these reasons, we support this vital project. We also join Dr. Hollier in trying to dispel misconceptions about the new facility as well as Louisiana's statewide health care system.

Myth No. 1: The Louisiana hospital system is unique and backward.

Truth is, many states have government-run hospitals serving the poor and uninsured. The difference is that city or county governments operate such facilities elsewhere, while Louisiana provides a statewide system. In Colorado, Denver Health boasts a 500-bed hospital with extensive services that provide a "safety net" for the poor. Having a state system gives LSU (which manages Louisiana's hospital system) increased leverage when dealing with federal programs -- and uninsured patients don't have to worry about coverage when they cross parish lines.

Myth No. 2: Private insurance "vouchers" will take care of the uninsured.

The U.S. Department of Health and Human Services put forth a proposal for insurance vouchers, which would use $770 million from funds now spent in the state hospital system, to privately insure 319,000 individuals in Louisiana. Unfortunately, that plan doesn't address more than 300,000 additional uninsured Louisiana citizens. For them, there would be no safety net.

Myth No. 3: The flooded "Big Charity" was a perfect example of Louisiana's antiquated system of the "haves" getting better care than the "have-nots."

Big Charity had a Level 1 Trauma Center and employed -- and trained -- some of the top medical specialists in the state. The level of patient care at Charity was as good as at any private hospital, Hollier says, and often better.

Myth No. 4: The Charity system is responsible for Louisiana having the highest Medicare costs per patient in the country.

According to the Louisiana Health Information Network database, the state's private hospitals provided more than 96 percent of all Medicare services from January to June 2005. LSU hospitals supplied only 3.4 percent of those services. Dr. Cathi Fontenot, medical director for Medical Center of Louisiana at New Orleans, says Louisiana would rank in the top 10 states in the country in Medicare quality outcomes, including costs, if the state ranking was only based on MCLNO's Medicare figures.

Myth No. 5: We no longer need a large, public teaching hospital here.

If that's true, then where will Louisiana send all of its medical students, nursing students and allied health students? Hollier says there isn't enough capacity at area private hospitals, which already train some students. New Orleans has attracted medical students for decades because its large teaching hospital provided case studies for specialists, residents and others. It's a formula that works. Besides, many medical professionals stay in Louisiana after completing their educations here.

Myth No. 6: Rebuilding a large, centralized hospital means that the poor and uninsured will tie up emergency room services with non-emergency situations.

The new hospital is only part of the safety net. One of the goals of University Hospital is to decrease the number of costly emergency room visits. Before Katrina, the system didn't have satellite clinics -- primary care centers for checkups, nonemergency services and chronic disease management -- but LSU will open six such clinics in the city in the next three months. "There is an effort to decentralize the hospital system in New Orleans and bring primary care to the neighborhood," says Marvin McGraw, spokesperson for LSU Hospitals.

And then there's the VA.

The local VA Hospital has a long relationship with LSU, which, along with Tulane Medical School, has provided the VA Hospital with residents and medical fellows. LSU and VA will share clinical areas, support services and information and telecommunications resources. Veterans can only benefit by having a high number of medical specialists, the trauma center and the crisis intervention unit in such close proximity.

LSU and New Orleans have presented a compelling argument for this mutually beneficial proposal. The LSU-VA hospital complex will dramatically improve medical care for everyone in the metro area, is economically feasible, and will anchor the improved New Orleans Medical District. Moreover, Louisiana showed its commitment by approving a $1.2 billion business plan and agreeing to self-finance the hospital. Now it's up to the federal government to follow Louisiana's lead. Rebuild the VA Hospital -- here and now -- as part of the new New Orleans Medical District.

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