A policy analyst with the Louisiana’s Department of Health and Hospitals on Thursday discussed the state’s transition from the charity hospital system to a network of public-private partnerships.
While speaking at a Leaders With Vision health care forum, DHH Policy Director Calder Lynch also defended Gov. Bobby Jindal’s decision to reject a federal Medicaid expansion.
The forum came just one day after LSU’s Board of Supervisors approved agreements that would allow private companies to operate public hospitals in New Orleans and Lafayette.
The board’s vote was expected after the governor released a budget proposal for the 2013-14 fiscal year that didn’t include any state funding to run or staff the hospitals.
Lynch said Louisiana has a “proud history” running a charity hospital system, before adding that it can be extremely challenging to maintain.
“How do we design a system with better value for the dollars we spend,” Lynch said. “In many cases government is better served as a payer of services, and not necessarily being the deliverer of services.”
He added that public hospitals in Atlanta enjoyed success after going through similar changes.
During the forum, former DHH Secretary David Hood took issue with the speed of the transition, noting that plans to pair public hospitals with private operators took shape over the course of months and not years.
Hood referenced a 2007 report from the Public Affairs Research Council that explored reorganizing the state’s charity hospital system through a Medicaid expansion and a slow transition toward public-private partnerships.
Hood compared the Jindal administration’s approach to a swift unraveling of a well-performing system to care for the state’s uninsured population.
“If this was done like we said, it would take three to five years,” Hood said. “That’s a little different than three to five months. I wonder if it wasn’t driven by an urge to privatize.”
Other panelists included Jan Kasofsky, executive director of Capital Area Human Services District, and Dionne Viator, executive vice president of Baton Rouge General Medical Center.
Both said they disagreed with the governor’s decision to reject a federal Medicaid expansion that would extend coverage to roughly half a million or more Louisiana citizens, many of whom are employed but cannot afford health insurance.
Medicaid is a government health insurance program for the poor — mainly children, the disabled and elderly.
It relies on the federal government contributing most of the dollars and state government paying the rest.
Under the expansion, the federal government would pick up 100 percent of the costs for the first three years and then 90 percent of the costs for at least the next seven years.
Gov. Bobby Jindal rejected the expansion, contending it would cost the state $1.7 billion over the course of the 10 years.
Lynch described the federal policy as an overreach and called it too inflexible to deal with the state’s demands.