The recently announced plans by Baton Rouge General to close the emergency room on its Mid City campus are more than just a Baton Rouge story.
The hospital’s financial losses, which have multiplied since the closure of the city’s charity hospital and the creation of a new public-private partnership at another hospital, point to some basic challenges facing other health care institutions in other parts of Louisiana.
Communities around the state, even in widely varying situations since the closure of the charity system, may find that unintended consequences of such a dramatic shift are going to cause problems in the near future.
Perhaps elsewhere it will not be exactly the situation of the General’s Mid City Campus, suffering for some time by declining population in the central city along Florida Boulevard. The General reported, though, that losses in the ER surged because of the lack of a public ER in the northern part of the city, where the old Earl K. Long public hospital once was located.
The Mid City crisis erupts as many neighborhoods in the area are coming back from decline, with new residents, including many young families, moving there.
In other cities, the difficulties may be different, but the sudden decisions to make particular hospitals in each region of the state into partners with LSU and the Department of Health and Hospitals may have created a set of winners and losers in medical care. The partners, such as the General’s competitor in Baton Rouge, Our Lady of the Lake, have received handsomely preferential financial deals for treatment of the uninsured.
For the moment in Baton Rouge, what the administration of Gov. Bobby Jindal should have done before the abrupt shift is now underway: planning. The administration is working on extended hours at an urgent care center in Mid City, among other short-term responses.
That idea isn’t bad at all: The majority, perhaps the vast majority, of ER visits by the poor can and should be handled by doctors or clinics instead of expensive emergency facilities. In some cases around the state, too, the partnerships may well have expanded needed services without harmful impacts on peer hospitals. It’s not an all-is-unwell story.
Nevertheless, from Mid City it’s going to be a long trek to an ER in Baton Rouge traffic, known nationally for its delays. And the precedent set by the Jindal administration — we’ll try and help once the finances hit the fan — is not encouraging for other communities. Institutions may already be under stress, but where is the community mechanism to assess the problems and suggest solutions?
The old charities were under the Jindal-controlled Board of Supervisors, which is supposed to represent the best interests of LSU — and not necessarily reflect the will of the community where its decisions produce such unintended consequences as that in Mid City Baton Rouge.
DHH officials, slammed by budget cuts, are sent into the breach without money to fix the problem; the cash is soaked up by the winners, the LSU-selected partners. And Jindal appears to have little interest in these matters until they end up on the front pages.
Whether Jindal’s budget provides enough money to operate the new LSU hospital under construction in New Orleans is only one facet of this statewide problem.
Where is the mechanism that will assess in each region whether these LSU partnership contracts are working for the benefit of the community as a whole?