Deadly Times Ahead in Baton Rouge

Within the next week, the oldest continuously operating hospital in Baton Rouge will close its Emergency Room. In February, The Baton Rouge General announced the closure of the Emergency Room at its Mid-City hospital on Florida Boulevard. In 1900,  there was a train wreck on the Yazoo & Mississippi Valley  near downtown.  Dr. T. P Singletary treated victims in a nearby building and realized that Baton Rouge needed a hospital. For over 100 years, the Baton Rouge General has provided emergency care to Louisiana’s capitol city, first at its original location on Government Street and, since 1950, at the “new” hospital at Florida and Acadian. Like most people in Baton Rouge, I was shocked to hear this and wondered “how could that happen and who is responsible for such a reckless decision”? It turns out that the responsibility falls squarely at the door of the Governor’s Mansion on the other side of Baton Rouge.

Yep, the conclusion is inescapable and the conclusion is this: Starting on April 1, PEOPLE IN BATON ROUGE ARE GOING TO DIE BECAUSE BOBBY JINDAL WANTS TO RUN FOR PRESIDENT. There, I said it. Everybody in Louisiana knows it, but I said it.

We are all familiar with “Bobby Brady” Jindal and his aspirations for higher office. We all know that in the past 3 years, he has spent more time out of the state than he has in it. And, not coincidentally, those trips are almost always either to states where early presidential primaries are held or where he can court ultra-conservative Republican voters and donors. We also know that most of his policies, or lack thereof, have more to do with being a viable Republican presidential candidate than what is best for Louisiana. Think privatization of state health insurance and prisons, school vouchers, meddling in education, tax credits for billionaires, tax incentive financing schemes, etc. And even though he inherited a surplus when he took office and Louisiana is now facing a $1.7 billion budget hole, he refuses to look for new sources of revenue, i.e., raise taxes, since good conservative Republican candidates avoid tax increases like the plague. But, unfortunately, this latest stunt will become much more personal and deadly for some of us who live, work and shop in Baton Rouge.

The Baton Rouge General has been a fixture in Baton Rouge forever. Like many Baton Rouge natives, I was born there in 1962. The Mid-City campus was once a thriving, sprawling medical facility. People were born there and died there. Baton Rouge’s first open heart surgery was performed there. It housed the region’s only burn unit. And it had a very busy and vital emergency room. Over time, many things changed in Baton Rouge. Eventually, those who were able left Mid-City and North Baton Rouge for the suburbs. New hospitals were built. Our Lady of the Lake, located right behind the State Capitol, moved across town to Hennessy Lane. Woman’s Hospital took over labor in delivery on Airline Highway. And, a new hospital, now Ochsner Medical Center, was built on O’Neal Lane, near the parish line. And finally, the Baton Rouge General built a second campus off of Bluebonnet Boulevard. And, although the Mid-City campus has seen better times, it is still a viable and important part of Baton Rouge’s healthcare landscape. Especially since Bobby Brady decided to close the old Earl K. Long charity hospital on Airline a few years ago.

Although in 2014, the Baton Rouge General emergency room treated over 46,000 patients, it was losing about $2 million per month. You may ask why? Well, first the closing of Earl K. Long, a Jindal plan, shifted more and more uninsured patients to Baton Rouge General where, under federal law, the hospital was required to provide emergency care, regardless of whether the patient could pay or not. Secondly, and more importantly, Governor Jindal refuses to accept federal funding to expand Medicaid, since he is vehemently opposed to Obamacare. The problem is succinctly summed up in a recent editorial in the L. A. Times:

“Jindal has tried to position himself as the last stalwart Republican opponent of the ACA, but his state’s experience shows that his position is folly.

“The ACA was designed to encourage states to expand Medicaid–almost entirely at federal expense–as a means of cutting the uncompensated medical care hospitals had been forced to provide for low-income individuals and families. Much of that care has been customarily delivered through the ER.

“In the expectation that Medicaid would pick up the slack, the ACA reduced so-called disproportionate share hospital payments, which went to hospitals serving a large number of the uninsured. So institutions in states that have refused to expand Medicaid, like Louisiana, have faced a double-whammy–they still have to serve a large number of uninsured patients, but they have less money to do so.

You can read the whole article here: When a state blocks Obamacare, ERs close: The lesson of Louisiana

So, Louisiana could have solved this problem by expanding Medicaid and having the Feds pick up the costs. But, since Bobby is opposed to Obamacare, and wants to be able to prove it on the campaign trail, he opted out of the deal. And in doing so, he left the Baton Rouge General holding the bag.

Now, like many of you, I am not a fan of the Affordable Care Act. I think it is wrong in a number of ways. But, at the present time, it is the law of the land. And turning down federal money which would solve a serious healthcare crisis, at no costs to the State, does not seem like what you would expect from someone who is supposed to be a healthcare genius. But hey, what do I know?

However, the point here is not about money or political ideology or politics. It comes down to some serious numbers.

Last year the Baton Rouge General emergency room treated 46,000 patients, or about 3800 per month. And we all know that a lot of emergency room visits are not really emergencies. We all get that. However, the American College of Emergency Physicians estimates that 0.5%-1% of all ER visits are classified as critical cases. That is, people who are bleeding, have suffered gunshots, head injuries, internal injuries, are in cardiac or respiratory arrest, have severe burns or other serious conditions. In other words, people who are going to die if they do not get extensive medical care right now. Taking those numbers and doing the math, that means that each month, between 20-40 people in Baton Rouge are going to need critical medical care that they would have received at the Baton Rouge General. And some of those people are going to die. Even at a conservative rate of 5%, that means at least one to two people each month, maybe as many as three or four.

Because now they are going to have to travel across town to another hospital, probably the Lady of the Lake, to get to an emergency room. On a good day that will take an additional 15 minutes. On a bad day, with Baton Rouge traffic, it could take 30 minutes or more. Thirty minutes that they don’t have. Thirty minutes that could mean the difference between life and death. Emergency medical professionals refer to the first 60 minutes after a traumatic injury as “The Golden Hour”, the time that is crucial to treat a patient to save their life. Unfortunately, soon many people in Baton Rouge will spend the first half of that Golden Hour being driven to the hospital. Because Bobby Jindal wants to run for President.

And if you don’t live in the Mid-City or North Baton Rouge areas and don’t think this will affect you or yours, think again. This is not just a poor person or uninsured issue. Not only will the uninsured be turned away from the Baton Rouge General emergency room. After next week, it won’t matter how good your insurance is, because the emergency room will be closed. For good. And just because you do not live in North Baton Rouge, that doesn’t mean you may not need it one day. What if you work at Exxon or one of the other plants along the riverfront and suffer a heart attack or on the job injury? Or if you work for the State in one of those new office buildings around the Capitol? Or if you eat, drink or party downtown? Or if you are in an automobile accident on I-110? Or if you suffer some trauma while at Baton Rouge Metro Airport? Or if your child is seriously injured on a field trip to the Centroplex or the old Governor’s Mansion? Or if you commute down Government Street or North Boulevard to work each day? All of these scenarios involve people who would typically have been transported to the old EKL. But it is closed now. So, the next nearest hospital would be Baton Rouge General Mid-City. But it will be closed as well. So now you, your spouse, your child or other loved one will be off to OLOL on what maybe a half hour ride. A half hour you don’t have. And some of them will be among the two to four people per month that are going to die in Baton Rouge because there is no ER at the Baton Rouge General. And that is because Bobby Jindal wants to run for President.

Mary Landrieu Owes You.. and Me.. An Apology

Mary Landrieu owes the voters of Louisiana an apology.  A great big, fat, sincere one.

Unless you have been living in the woods for the last 6 months, you know that on Tuesday, November 4,  the biggest political battle of Landrieu’s life is coming to a head.  And, chances are it may not turn out so well for Mary.  It definitely seems like Louisianians have finally grown tired of her and her liberal policies.  For 18 years she has held a Democratic seat in the U.S. Senate,  in what is a decidedly Red State. The polls seem to indicate that those Red State voters are ready for a change.   Mary seems to be running scared, and it is starting to show.  Support for the Senior Senator from Louisiana has been falling off of Mary like leaves off a dead tree, and she knows it.  Like most incumbent Democrats, she has been trying to distance herself from the failed policies of President Obama, to no avail

Well, apparently desperate times call for desperate measures.  In an interview with NBC this week, Landrieu was asked why the electorate in Louisiana is so hostile to Pres. Obama.  Her response first paid lip service to the problem with Obama’s energy policy. But then she threw down the race card.  She went on to say:

“I’ll be very, very honest with you: The South has not always been the friendliest place for African-Americans. It’s been a difficult time for the president to present himself in a very positive light as a leader.”

Really?  I will agree that it has been difficult for Obama to present himself in a positive light as a leader, but the reasons do not have anything to do with race.  Of course, the criticism of Landrieu’s remarks was loud and swift from many quarters.  However, rather than trying to clarify or retract such a divisive untruth, Landrieu reiterated it  and also played the sexism card too. In a statement released Friday, Landrieu was defiant, saying that Obama’s energy policy is the primary difference he has with Louisiana voters.  Then she went on to say:

“In addition,”the South has not always been the friendliest or easiest place for African-Americans to advance, and it’s been a difficult place for women to be recognized as the leaders we are. Everyone knows this is the truth, and I will continue to speak the truth even as some would twist my words seeking political advantage.”

So, in other words, Louisiana voters are both racist and sexist, and St. Mary speaks the truth!  In a word, “Bulls***.”

I have been teaching swimming and basic lifesaving to kids for about 20 years.  Rule Number 1 is never get to close to a drowning person.  They are so desperate and panicked that they will do anything to save themselves, including dragging you down with them.  Apparently, the same thing is true of career politicians who fear their days of getting fat on the public teat are about to come to an end.

First, let’s take on the race issue.  I, like most voters in Louisiana, do NOT support President Obama. But, it has nothing to do with his race or ethnicity.  It has to do with the fact that he is a pathological liar, a malignant narcissist, a socialist, associates with known radicals, has a poor view of the U. S. military, is openly embarrassed about America, fails to take even the most basic responsibility for his actions, by his own admission has no clue about what is going on in his administration and in general, as my Momma used to say, “doesn’t know his ass from a whole in the ground” about what it means to be President of the United States.

Informed voters in Louisiana, and the rest of the country, vote for or oppose candidates based on that candidates views and policies and whether or not they are the same as ours.   I have no problem with supporting an African American candidate if this is the case.  I was a supporter of Herman Cain.  I would happily support other black candidates, such as Allen West or Dr. Ben Carson, should they choose to run.  Not because of race, but because their values and ideals are similar to mine.   Ironically, one of the people who called out Landrieu on her comments was Gov. Bobby Jindal.  If racial bias is such a big deal in Louisiana, how is it that we have a twice elected a a brown skinned man, who is about as far from a white Anglo-Saxon protestant as you can get, as governor?

In his famous “I Have A Dream” speech, Martin Luther King, Jr. said he had a dream that one day his children would be “judged by the content of their character and not the color of their skin.”    I do that.  I believe most people in Louisiana do that.  It appears that the only people these days who don’t do that are Democratic politicians when it suits them to stir up unrest and divisiveness in an effort to gain votes.

And, when it comes Mary’s contention that Louisiana is a difficult place for women to be recognized,I am almost speechless.  I seem to remember that we have elected a woman Governor in this state before.  We have had two women serve as Chief Justice of the Louisiana Supreme Court.  Moreover, it is a special kind of hypocrisy for Senator Landriue to make that claim.  She is a perfect example that women can succeed in politics in Louisiana.  She was elected twice to the Louisiana Legislature, where she served from 1980-1988.  She was twice elected in a statewide race in Louisiana, serving as State Treasurer from 1988-1994.  Since then, she has been elected to the Senate three times and has been the Senior Senator from the Great State of Louisiana since 2004.  Not bad for someone who comes from a state where women have a difficult time being recognized as leaders, huh?

Maybe Mary’s problem is not race or sex.  Perhaps it is the fact that she is a Blue candidate in a decidedly Red State.  Maybe it is because she is a liberal in a conservative Southern state.  Maybe it is because she has supported things like the USA Patriot Act, amnesty for illegals and increased taxes.  Maybe it is because she represents pro-life Catholic voters in Louisiana, but is for same sex marriage and has a 100% pro-choice rating from the National Abortion Rights Action League.  Maybe it is because she represents Louisiana, where guns are a way of life, but has a “C” rating from the National Rifle Association. Maybe it is because she is a 58 year old millionaire who claims she still lives at home with Momma and Daddy.  Maybe its because voters in Louisiana are tired of public officials who violate the law and use OUR money to charter flights to their campaign events.  Or maybe, just maybe, it is because she was the deciding vote in the Senate on Obamacare.

You may or may not support Mary Landrieu, and I am sure many of you reading this do, but for her to attribute her current problems to the people of Louisiana being sexist bigots is a huge insult. HUGE.  And, in the words of Tom Hagen in “The Godfather, Part II”, I think we all deserve to day “An apology Senator!  We demand an apology!’  I doubt we get one before Tuesday, but then again, after hopefully it won’t matter anyway.

How to Vote on Those &%#$ Amendments?

Once again, the November 4 elections will ask Louisiana voters to vote on the approval of 14 proposed Amendment to the Louisiana Constitution of 1974. It seems that every other year, in even numbered years when the Legislature holds a general session, there is another pile of constitutional amendments for us to say “yea’ or ‘nay’ to. The amendments come so regularly and are so technical, even informed voters seem to scratch their heads over what to do. I am regularly asked my opinion on how to vote on “those doggone amendments”. So, since I am now somebody, with my own blog, I an going to give my humble opinion about the 14 amendments on the November 4 ballot.

But, before I do, a little background and history. As a rule, a constitution is different from a regular statute. First, a constitution is generally recognized as a ‘blueprint’ for government in general. Its purpose is to set forth the structure of government, identify the various departments, define the role and limits of each, protect basic rights of citizens and protect certain ideals and principles, such as Civil Service, that are important enough to warrant, well, constitutional protection. Unlike an ordinary statute, a constitution cannot be changed by a simple majority vote of the legislature. For instance, the Louisiana Constitution requires that a proposed amendment be approved by a two-thirds vote of both the House and Senate AND a majority of voters statewide.

Historically, one of the reasons we now have the Louisiana Constitution of 1974 is the absolute mess that had become the Louisiana Constitution of 1921. The 1921 version was wordy to start with and over the years, as legislators, and the string pullers they worked for, began adding amendment after amendment, it constituted over a quarter million words and had been amended over 1,000 times. It had become so burdensome, archaic and unworkable that Edwin Edwards, in his 1971 campaing for Governor, made calling a convention for the establishment of a new constitution a central theme of his campaign. Shortly after taking office, Edwards was successful in doing so, which was the Constitutional Convention of 1973, which lead to the Louisiana Constitution of 1974. The 1974 Constitution was a good one. It was well written, to the point, streamlined the State government and, everyone agreed, was a nice piece of work.

Unfortunately, in the next 40 years, it seems we have fallen into the same trap be had before. Voters are asked again and again to approve amendments, many of which are “pet projects” of one group or another. We are continually adding amendment after amendment, most of which Louisiana voters don’t really understand or know why we need.

So, I said all that to say this. As you read my take on these things, remember that my philosophy on amendments is (1) many things may be a good idea, but that doesn’t mean they need to be in the Constitution: (2) some things may be a good idea but STILL don’t belong in the Constitution; (3) if I am not really convinced that an amendment is necessary, I am going to vote “NO”; and (4) if I do not know or understand what an amendment is supposed to do or what problem is it supposed to solve, my default position is to vote “NO” .

So, with all that in mind, here is my take:

Amendments 1 and 2: NO. No. 1 would establish a Trust Fund for the payment of Medicaid reimbursement. No. 2 would establish the Hospital Stabilization Fund. Both amendments would constitutionally dedicate funds the state is already collecting to a single purpose. While such a thing sounds good, the same thing could be accomplished by the Legislature having the intestinal fortitude not to raid these funds, which are already being assessed, to pay other bills. When you and I do this, it is called “theft” or “embezzlement”. More importantly, we already have way too many constitutionally dedicated funds in the state budget as it is. The result is that, for years, when things run short, the only thing that can legally be cut is health care and higher education. If these amendment pass, higer ed will be the Lone Ranger when it comes to budget cuts.

Amendment 3: NO. Amendment 3 would allow the sheriff or other tax collectors to employ private debt collectors to “assist” in collecting delinquent tax debts. First, if the sheriff can’t collect a debt, what makes anyone think that a private collector could do more? Of course the only reason to think so is to believe that the ‘collector’ can take actions the sheriff is legally prohibited from taking, or won’t take for other reasons. Which is exactly what makes this amendment a bad idea.

Amendment 4: NO. Amendment 4 is a perfect example of what is wrong with this whole process. It would allow the state to invest public money in something called the Louisiana Transportation Infrastructure Bank. You have likely never heard of the Louisiana Transportation Infrastructure Bank, because it does not exist. The enabling legislation, which would have set up the Louisiana Transportation Infrastructure Bank failed to pass. However, the constitutional amendment to make the enabling legislation legal did, so the amendment is on the ballot, although the legislation it was supposed to bless is dead. For God’s sake, please vote NO!

Amendment No. 5: YES This amendment would remove the 70 year old mandatory retirement age for judges. For some inexplicable reason, Judges are the only elected officials in the State who have such a mandatory retirement. I can think of no office where experience and tenure are more important than the judiciary. I personally know many competent, experienced and capable judges who have been forced to retire when they could still have done a good job.

Amendment 6: NO . This is a special bill that applies only to Orleans Parish. For the life of me, I cannot understand why they can’t play by the same rules as the rest of us.

Amendment 7: YES. This amendment would raise the Homestead Exemption for ad valorem taxes for veterans with a 100% service related disability rating, and their surviving spouses, to $150,000.

Amendment 8: NO . This amendment would give constitutional protection for monies already being collected by the state in connection with establishment of artificial reefs from old offshore oil platforms. First, this would be another dedicated fund. See my argument for Amendments 1 and 2 above. Second, I am all about coastal restoration, environmental clean up and all that. I am even in favor of fishing. But frankly, this Artificial Reef Development Fund will actually only create good fishing spots for a very small handful of offshore fishermen and charter operators.

Amendment No. 9: YES. Louisiana voters have already approved special assessment levels for property owners who are permanently and totally disabled. This amendment would merely remove the requirement that they have to submit income information annually to keep the special assessment.

Amendment No. 10: NO. In the interest of full disclosure, I am a strong proponent of private property rights. I believe we should make it more difficult the government to deprive owners of their property rather than easier, which this amendment would do. It would shorten the redemption period for tax sales from 3 years to 18 months for property which is blighted or abandoned. While it sounds like a long time, 18 months is too short. And, who decides whose property is “blighted” or “abandoned”?

Amendment No 11: NO. One of the reasons we got a new constitution in 1974 was to streamline and consolidate state government. One of the ways this was done was to limit the number of state departments to 20. This amendment would increase that to 21, to create the Office of Elderly Affairs. First, this department would handle services which are currently being performed by other departments. Second, the legislature, in its wisdom, has not allocated funds to expand services to the elderly.

Amendment No. 12: NO. I could do a lot of explaining, but this one would change the membership of the Louisiana Wildlife and Fisheries Commission and won’t make a rat’s *ss bit of difference to anyone who lives south of Bunkie.

Amendment 13: NO. This amendment would allow the City of New Orleans to sell government owned property (i.e., property seized for non-payment of taxes) in the Lower Ninth Ward for a nominal fee to certain buyers. If you have lived in Louisiana longer than 6 months, you would be very uncomfortable about the ‘nominal fee’ and who are the ‘certain buyers’. And, this is a proposed amendment to the State constitution that only affects one ward in one parish. Really?? And, once again, I am not sure why Orleans Parish can’t play by the same rules everybody else does.

Amendment No . 14: YES. This amendment would close a loophole that the Legislature loves to jump through. Under the current Constitution, revenue measures may not be introduced in even numbered years, which are supposed to be general sessions. “Fiscal” sessions are supposed to be in odd numbered years. However, some legislators love to give away tax rebates, incentives and abatement all the time. The amendment would confirm that these things are fiscal matters which may only be considered in odd numbered years.

Okay, I know that was long, but it is what it is. In closing let me say this:

Laissez le bon ton roullier! It’s election time y’all!