Louisiana has the dubious honor of being named this week as the least healthiest state in the nation.  The negative recognition was announced in the 2008 health rankings just released by United Health Foundation. It really wasn’t any surprise.  That’s because the state has held the bottom sport for fifteen of the past eighteen years.  Every now and then, the Bayou State slips up to 49^th.  But it again has fallen to the bottom of the barrel.

There was an assumption that Louisiana Governor Bobby Jindal would make healthcare reform and expansion his top priority when first coming into office.  After all, he had cut his political teeth as Louisiana’s healthcare czar in his late 20s when former Gov. Mike Foster taped him to head up the massive bureaucracy of the Department of Health and Hospitals.  After Foster left office, Jindal headed to Washington at the behest of former La. US Senator John Breaux to direct a major health care commission.  But since taking office as Governor, Jindal has downplayed healthcare as a front burner issue.

Jindal’s pick to head up the state health agency, Alan Levine, was brought in from Florida with the task of both expanding and improving the present delivery system.  But the financial dragon of continuing cost increases has caused him to play defense, with little chance to be proactive in widening the health delivery net to over one million Louisianans who don’t qualify for Medicaid, yet cannot afford health insurance under the present system.

Last week, Levine spoke publicly about financial woes enwrapping the system, and called his headaches the “Four Horseman of the Healthcare Apocalypse. His list included the rising cost of the state Medicaid program, the growing expense at the state’s public hospitals for the uninsured, more money in New Orleans to replace Big Charity, and a debt of over $771 million dollars the feds say Louisiana was overpaid.  So the focus is really not on creative healthcare, but basically it’s about paying the bills due.  It’s all about money.

The focus is on paying for previous and current programs, with little thought of addressing the needs of hundreds of thousands of Louisianans who do not qualify for either Medicaid or Medicare, and who are either self employed or who work for small businesses that cannot afford to buy a traditional health insurance policy.  The Louisiana Legislature has exasperated the problem by requiring that every health insurance policy sold include a lengthy list of mandated benefits, making the average family policy just too expensive for many citizens throughout the state.

The average health insurance policy cost for a middle-aged adult in Louisiana is over $5,000 a year.  This cost is out of the range of well over one million Louisianans who do not qualify for other governmental programs.  So what can be done?  A national health-insurance solution would be best.  But unless the new President can confect a consensus for a national plan, the state may and should consider going its own way.

Any Louisiana plan will need limitations.  It can’t be gold platted.  A basic Chevy, not a Cadillac.  Such a plan would need to be basic with shared costs.  And do not do what has traditionally been the norm in Louisiana of defining what benefits should be included.  Go the other way of first seeing how much those buying and paying for such a policy are able to pay?  Then you could determine just how much healthcare could be bought.

 Such any idea is not new.  Tennessee implemented a similar plan a few years ago with a basic policy costing an average of $150 dollars a month.  And the cost is split three ways, between the individual policy holder, the employer and the state.  Each puts up 50 dollars.  Blue Cross in Tennessee agreed to underwrite the plan through competitive bidding.

When limited plans were discussed in the past, the focus to keep coverage less expensive was to have high deductibles, often requiring a person to spend a thousand dollars or more before the plan kicks in.  But I’ve learned during my time in public life and now in the private sector on the radio that Louisianans are interested in help with the basics: a doctor’s visit, prescriptions and a short hospital stay.  Such a plan would no doubt be caped in the $25,000 range.  No catastrophic coverage.  Not perfect, but a good beginning.

The system right now is keeping, financially, the healthcare system’s head barely above the water.  But the Governor and the Legislature will be doing a disservice to over one million Louisianans if they do not give serious attention to structuring an affordable basic plan that will be a tool in obtaining the goal of much more affordable healthcare.  Staying number 50 in the nation year after year should be unacceptable, and a wake up call for a simple but doable alternate.  Louisiana citizens deserve better choices.

                                                                   *******

“Life expectancy would grow by leaps and bounds if green vegetables smelled as good as bacon.” ~Doug Larson

Peace and Justice.

Jim Brown

Jim Brown’s weekly column appears in a number of newspapers and websites throughout the State of Louisiana.  You can read Jim’s Blog, and take his weekly poll, plus read his columns going back to the fall of 2002 by going to his own website at http://www.jimbrownla.com.

Jim also has a new book out on his views of Louisiana.  You can read about it and order it by going to www.jimbrownla.com. .

Jim’s radio show on WRNO (995 fm) from New Orleans can be heard each Sunday, from 11:00 am until 1:00 pm.

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