Louisiana Has Much at Stake in Health Care Debate

[douglas9]

NEW ORLEANS — It is no accident that three of Louisiana’s best-known politicians have been at the center of the national health care debate.

Last month, Anh Cao, the congressman who represents New Orleans, created a ruckus as the sole Republican to vote for the health care bill in the House. Shortly afterward, Senator Mary L. Landrieu, a Democrat, became a crucial vote in support of health care after winning $300 million in Medicaid aid for Louisiana, drawing loud criticism from Republicans for her deal-making.

And the governor, Bobby Jindal, a former state secretary of health, has been one of the most prominent Republicans to offer an alternative proposal for a health care overhaul.

Because of the unique way it delivers health care to the poor, a model that has a long history, Louisiana has a great deal at stake in the outcome of the debate in Washington, which could drastically alter the state’s traditional system. Especially in light of the state’s desperate need for investments in medical care in the years since Hurricane Katrina, Louisiana politicians of both parties are scrambling to make sure their priorities are addressed in the legislation.

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What sets the state apart has been its charity hospital system, which has existed in various forms since the early 18th century, and has been championed for generations by the state’s populist leaders, including the Depression-era governor and senator Huey Long. While other states have public hospitals, they are usually locally operated; care for Louisiana’s poor and uninsured rests squarely on its 10 state-operated charity hospitals.

http://www.nytimes.com/2009/12/20/health/policy/20louisiana.html?_r=1&emc=eta1&pagewanted=print