HITHER AND YON: Know-It-All Politicians And Money-Losing Emergency Rooms

This may shock you, but the Baton Rouge Advocate actually published a story over the weekend which exploded a liberal myth that took hold in Louisiana following the closing of the emergency room at Baton Rouge General Hospital’s Mid-City campus – namely, that malign neglect by the Jindal administration in refusing to expand Medicaid closed that ER and deprived the people of North Baton Rouge of access to health-care services.

The truth is, and always was, that the Mid-City ER was a money-loser and destined to fail. Emergency rooms are fiscal disasters for practically every hospital, because the practices hospitals are forced to engage in to treat ER customers insure a maximum of expense and thus a maximum of waste – and then when the hospitals go to the government to be reimbursed for treating the indigent or Medicaid patients in those emergency rooms, they find their reimbursement rates are nightmarishly low.

There are much better ways to treat patients who don’t have bona fide life-in-jeopardy medical situations than emergency rooms, and North Baton Rouge has them. Meanwhile, for bona fide medical emergencies there is Our Lady of the Lake Hospital right beside I-10 on Essen Lane; the state of Louisiana has made an arrangement with OLOL to handle those cases for patients without private insurance.

People in North Baton Rouge were flooding the ER at Baton Rouge General Mid-City, and what they flooded the place with was red ink.

Baton Rouge General President and CEO Mark Slyter said he has no plans to reopen the Mid City emergency room, despite the governor’s statement. The hospital reported that its Mid City campus lost $23.8 million in 2014, before the ER closed.

Our Lady of the Lake CEO Scott Wester goes far as saying that it is a myth that north Baton Rouge needs an emergency room. Data from Our Lady of the Lake Regional Medical Center, which took over providing indigent hospital care in Baton Rouge in 2013 after the state closed the north Baton Rouge-based Earl K. Long Medical Center, shows decreases in emergency room visits throughout the market between January 2015 and 2016, with more people instead getting treated at urgent care facilities they run in north Baton Rouge and Mid City.

Lane Regional Medical Center CEO Randall Olson said the politicians are not listening to the hospitals and understanding why there is too much economic risk in building out in a part of the city with a higher percentage of uninsured patients or those on Medicaid, the federal government’s health insurance for low-income families.

“At this point, I don’t see any way for a private (hospital), whether for-profit or not-for-profit, they just cannot afford to open up in a low-paying area,” said Walter Lane, a health care economics expert and professor at the University of New Orleans who also sits on the board of Slidell Memorial Hospital.

“Most hospitals are struggling to keep their head above water in an even patient area,” Lane said, referencing areas where more privately-insured patients live rather than a majority of people on either Medicaid or Medicare, which provides insurance for senior citizens.

And yet Gov. John Bel Edwards is vowing to re-open an emergency room in North Baton Rouge, amid the state’s woeful budget situation and amid the evidence the area is fulling its basic medical needs without one.

Only 13 percent of the patients in the Mid-City ER had private insurance, 36 percent of the patients had no insurance at all, and four-fifths of the patients did not have bona fide medical emergencies. What killed the Mid-City ER was an avalanche of people looking for free treatment of athlete’s foot, acne and indigestion. Now that it isn’t there to be abused, those people moved on to something else that was available.

Hospital leaders say critics aren’t looking at the successes in north Baton Rouge since Earl K. Long closed, particularly the expansion of services provided at clinics run by Our Lady of the Lake. These clinics, which not only have primary care doctors, but also some key specialities, like treatment for cancer patients, have truly expanded options in the area, said Wester with Our Lady of the Lake.

Wester said the clinics — called the LSU Health Baton Rouge Urgent Care clinic and located on Airline Highway and North Foster Drive — are filling the gaps.

Total emergency room visits across Baton Rouge have dropped by 41 visits a day within a nine-month period in 2014 and 2015 compared with 2015 and 2016, according to data compiled by Our Lady of the Lake. At the same time, visits to the LSU Health clinics have increased by about 49 visitors a day over the same period.

Wester said those statistics show the system is working.

“We’ve done such a good job of starting to have people think about using alternative access points, urgent care, or primary care, but then at the same time, what you’re hearing from the outside is emergency room, emergency, emergency room, we need another emergency room,” Wester said.

Recognize that Louisiana’s budget contains some $9.5 billion for the Department of Health and Hospitals. This is where the money is being wasted. And even after the people who run the hospitals in Baton Rouge warn that directing those resources into venues where a maximum amount of money is wasted, even after state treasurer John Kennedy has spend months yelling from rooftops that Medicaid and indigent health care is wasting hundreds of millions of dollars of taxpayer money, Edwards is plowing ahead with a project to renew the red ink.

It can’t even be called incompetence at this point. You have to see it as actively, purposefully setting your money on fire and then coming back to you to demand more.

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This, after federal regulators have made Louisiana the most regulated state in the union. Even more money stolen out of our economy.

For 2013, Louisiana ranked 1st for impact of federal regulation, with a score of 1.74 on the FRASE index. By design, the FRASE index for the United States overall in any year will equal 1, so a score of 1.74 indicates that the impact of federal regulation on Louisiana industries was 74 percent higher than the impact on the nation overall.

Although the ratio of the impact of federal regulation on the state to its impact on the nation fluctuates some from year to year, more dramatic growth has occurred in the total number of regulatory restrictions affecting Louisiana since 1997. One way to measure this impact is to scale the weighted restrictions to the total weighted restrictions for the national economy in 1997. Doing so allows us to calculate the growth of the FRASE index relative to 1997. We call this the constant-basis FRASE index. For Louisiana, the constant-basis FRASE index has grown by 54 percent from 1997 to 2013. For historical ranks and scores, see table 1.

It’s the size of the petrochemical industry which drives all the federal regulation, so it’s not so much that the feds are out to get us as you’re going to have the EPA down your throat if you have a lot of oil refineries and petrochemical plants in your state. Still – how many of those federal regulations are a waste of money that could be spent paying Louisianans higher wages?

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Our old pal Lamar White stumbled on something shocking – Jennifer Treadway was a straw candidate against Kennedy last year.

No, really. Through months of painstaking research, he found out that Kennedy’s political guru Jason Redmond bought Treadway some Baton Rouge Symphony tickets and that showed up in a campaign finance report. So he put two and two together and came up with proof that  Kennedy put her up to running against him.

So, the obvious question is: Why, on earth, was John Kennedy’s most trusted and valued employee providing nearly $300 in in-kind contributions to his competitor’s campaign (albeit a month and a half before she officially jumped into the race), and why is he now responsible for putting together her campaign committee reports?

This seems highly unusual and more than a little suspicious. Perhaps there are some perfectly reasonable explanations as to why Kennedy’s most trusted ally, most loyal employee, and the head of his federal SuperPAC would assist a woman who pretended to run against him, raised practically no money, and got herself humiliated by losing in a sixty point obliteration. Maybe he felt sorry for her.

Or maybe, just maybe, she never intended to run a real campaign at all. That’d sure make things easier for John Kennedy.

Kudos to White for all the amazing research, including the fact that Redmond is now listed as preparing campaign finance reports for Treadway’s campaign (she’ll probably run for something else in 2019) going forward.

Virtually everybody in Louisiana with an ear to the ground knew Treadway was a straw candidate. Virtually everybody knew she was a friend of Kennedy’s. And it was patently obvious why she was in the race – Kennedy wouldn’t have been able to run biographical ads last year setting himself up as a Senate candidate if he hadn’t had an opponent.

But kudos on that hard-nosed investigative reporting. It’s super-impressive.

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Edwards is doing everything he can to try to roll back Louisiana’s education reforms, something we’ll be talking about on this week’s Red Bayou Show. In the meantime, the Republicans in Louisiana’s House of Representatives are doing everything they can to hang on to those reforms. Jeremy Alford reports the House Education Committee is the battleground

During the past few weeks there have been at least seven changes to the House Education Committee’s membership and there could be more alterations to come. Those removed from the committee received their appointments early on in the term, during a rush to fill seats, and made requests to be reassigned.

In many respects their replacements represent solid votes in favor of the education reforms of recent years ushered in by former Gov. Bobby Jindal and the business community. Some of those reforms, including vouchers and charter schools, have been targeted by Gov. John Bel Edwards’ administration for overhauls.

The committee being stacked with votes to block Edwards’ push is partly the spoils of having an independent speaker. Committee members, however, say some of the governor’s package may slip out to allow for floor hearings. Rep. Chris Broadwater and Rep. Reid Falconer were added a couple weeks ago. Removed from the education committee during the last few weeks were Reps. Dodie Horton, Barry Ivey, Rogers Pope and Julie Stokes.

Not all of those coming off that committee were opponents of those reforms, though Pope is a shill for the school board in Livingston Parish who voted against them. But that committee is getting more and more hard core in favor of school choice, and it’s going to serve as a firewall against going back to the old Soviet model of education Bobby Jindal poked holes through with his 2012 reform package.

Edwards has gone so far as to write in the Wall Street Journal that Louisiana’s C-schools aren’t failing schools, in defending his efforts to stop parents of kids in those schools to have access to something better. Here’s a clue for him: when your state is in the bottom five in educational outcomes, the C-rated schools in your state are failing. They suck. And for you to demand the kids in those schools be trapped in them makes you complicit in ruining their educations.

Thank you to House Speaker Taylor Barras for stepping up the fight against Edwards’ immoral shilling for bad public education.

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And now, for Today’s Last Thing, which is an artistic, if eardrum-bursting Today’s Last Thing…

They actually do a “Stella and Stanley” screaming contest in the French Quarter once a year, in honor of Tennessee Williams and Streetcar Named Desire. We’re not making this up.

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