Tuesday, May 12, 2009

Strange...

Vitter, according to spokesman Joel DiGrado, believes that a public hospital should have already been rebuilt downtown, that LSU has delayed that far too long, that its plan is too big and expensive and that "gutting the old Charity shell and rebuilding a state-of-the-art hospital in it could save a lot of money."



... let's go with bedfellows.

Link

15 comments:

jeffrey said...

Today Puddinhead left a pretty interesting comment on the yellow blog culminating in this:

The role of Tulane in attempting to muddy the waters to it's own benefit has become more publicly understood, but I will be very surprised if before all is settled another "powerful interest" isn't revealed to have a behind the scenes hand in attempts to scuttle the entire project to replace the teaching hospital in New Orleans, and their name turns out to start with "OCHS" and end with "NER". I'll become more suspicious of this if our beloved Sen. Vitter begins to take a more vocal "slow things down" position.I think Vitter is just pleased to see LSU stymied at this point.

jeffrey said...

Not clear from my formatting but the final non-bolded sentence in the previous comment is mine.

E said...

Well the truth is that Vitter has been skeptical of LSU's plans since very early on in the process but I do think there's a very bizarre balance going on here and I don't think it's as simple as New Orleans v. Baton Rouge or Red v. Blue. This is quite the wedge issue.

Anonymous said...

Nothing bizarre at all. Just David Vitter getting his way in the power play and getting to stick it to New Orleans and score more points with his right-wing constituents, both the New Orleans-haters and the country club set, as well as the private hospitals.

Puddinhead said...

Vitter's goal (my speculation, of course): Get health care for the indigent back into the old Charity building much like it was pre-Katrina, with just enough funding to give the minimal care to the poor as to "get by". Recreate the New Orleans medical ghetto, so to speak. This way he can scuttle any thought by the state and LSU (or Tulane or anyone else responsible for public health care, for that matter) of attracting "paying" customers (the insured) alongside the indigent by following some form of the University of Texas or Alabama-Birmingham models, because the institutional memory in this community of what Charity Hospital had been for years means anyone who could afford to go anywhere else would do so.

I'm sure it's just serendipitous that the "anywhere else" for patients with insurance in the New Orleans market has more and more become one place--a Vitter benefactor, and the place where Vitter attempted to steer the new university teaching hospital in the first place.

E said...

That may in fact be Vitter's assumption but it would, like most of Vitter's stances, be flawed. The decision about where to build a new hospital is independent of decisions related to how care within that facility will be managed.

Puddinhead said...

"The decision about where to build a new hospital is independent of decisions related to how care within that facility will be managed."

Ergo, for those whose main concern is the quality and efficient management of health care for the indigent, the physical location that said care is given should be a secondary concern at best. Although I don't accept your contention that the selection of a location and the decision on how care will be managed are independent. On the record, they may be, but in the quid pro quo world of politics no decision is unrelated to any other decision.

Jeffrey said...

I don't think we should give Vitter too much credit here for thinking: going back into Charity is the cheaper route, so he has nothing to lose by advocating for that position--if it fails, he said he went for the fiscally conservative position, and if it succeeds, he still went for the fiscally conservative position AND he helped bring healthcare and economic development back to the city. I am sure there are a number of other ancillary benefits (sticking it to NO and LSU, scheming about the insured/uninsured mix that the new hospital will attract), but never underestimate the reductionist power of saying 'I voted for the cheaper position.'

Also, I am not alone in thinking that Cowen has made some critically poor decisions since Katrina, but advocating for independent oversight over the new medical center is not one of them. Tulane, Xavier, Delgado, and Southern all use the hospital as a part of their educational programs, so they should all have a voice on its governance. Besides that, MCLNO was never LSU's to begin with.

Anonymous said...

Vitter can say whatever he wants. As long as the new facility proposal is effectively blocked then he wins. Does he really care about how best to provide medical care to the indigent patient population? It makes too much sense that he would want only to restore the "medical ghetto" of the old Charity Hospital and thus thoroughly ensure that the whole entity is not viable and will attract no insurance-carrying patients. Who indeed are his benefactors? Who put the legislature up to authorizing the consultants' study of the possibility of renovating the old Charity Hospital building? Who is paying for this media campaign? And isn't he on record as favoring having Medicaid dollars follow the patients to whichever hospital that they choose?

E said...

I don't even know that Vitter is thinking that deep. I think he just sees the New Orleans legislative delegation and does the opposite without really even weighing the issues. He's so lost as a Senator and a candidate I'm not certain he really has much of an agenda beyond self-preserving political calculation. I mean the blockage of Fugate totally blew up in his face because his whole strategy is a very simple and stupid "block obama = win." Yesterday's statement was about changing the subject.

jeffrey said...

Jeffrey,

You may not give Vitter credit for thinking about protecting Ochsner but I certainly do. It's his main dog in this fight. All the other stuff is just window dressing.

As far as shared governance is concerned, I tend to disagree there as well (although LSU appears to be giving ground on this point) I would prefer to see a state institution in charge of a state facility. Cowen just wants Tulane in a better position to leech as it always does.

jeffrey said...

E,

Vitter is a lock to coast to reelection. Bank it.

E said...

He's certainly in a better position than any of his potential rivals but make no mistake about it - he's nervous.

Anonymous said...

Why on earth would he be nervous? About a Tony Perkins challenge from the right? Maybe, but sticking it to New Orleans scored plenty of points for him.

E said...

There's a lot of time between now and November 2010. I think there are a lot of GOP vultures circling over the weakening Vitter. I think it's going to be a lot of fun to watch ultimately.