Louisiana Treasurer John Kennedy is just both inside and outside of state government who are nonplussed over the current state of healthcare in Louisiana.

According to Louisiana Treasurer, John Kennedy the state was caught  a little “flat-footed” and  “without a plan” when Congress reduced the amount Louisiana would receive from the federal government for Medicaid.

This summer the LSU Board of Supervisors (“BOS”) held a retreat.

In the relative scheme of things, perhaps early December, 2012 will be viewed in Louisiana political history as the health care policy equivalent of the peaceful breaching of the Berlin Wall. The ending of the era of a state-operated charity hospital system has begun peaceably, and both clients and taxpayers are better off for it.

With news that most of Louisiana’s charity hospitals may get downsized confirms the move to dismantle the system as it is has come to the stage of a realistic alternative future, also bringing big change to some other related areas of policy, and not a second too soon to benefit the state.

Spurred by the sudden loss of a good chunk of its Medicaid reimbursement from the federal government – the vast majority of these public hospitals’ business is paid for that way, making Louisiana public institutions a wildly disproportionate user of those funds – at first former system leaders developed a strategy to cope by using mainly reserve funds, necessary because they remained invested in the notion that public hospitals providing free care to the indigent must exist.  In retrospect, this appears now accepted then only because of the compressed time frame, but that the basing of the response on the concept of necessity of public hospitals was not considered viable over the long haul.

Today, Governor Bobby Jindal announced the appointment of Scott Angelle to the Louisiana State University Board of Supervisors.

Angelle, one of his cabinet secretaries and currently ahead of the state's Natural Resources department has been appointed by Jindal to be his legislative lobbyist and the administration's liaison for federal oil and gas permitting issues. 

Yet another reason has emerged to reevaluate again the size of the new Medical Center of Louisiana – New Orleans, or “Big Charity.” Scheduled for completion in 2015 but with no building of it having begun, just site preparation, there’s still time to take into account the changing policy landscape that reinforces the need to scale back on the facility.