In contrast to his previous agitation regarding the possibility of job losses, the Governor seems eerily serene as he prepares to unleash new rounds of state budget cuts that will cut services and cost jobs in both the public and private sector.
In a note to supporters last week, Jindal reiterated his opposition to any form of tax increases. He also took credit for all good news in the state and laid blame for any bad news at the feet of others. That's just the way he rolls.
But a funny thing happened while Jindal was on an out-of-state jaunt: some inconvenient facts escaped into public view.
Turns out that the Governor's plan to close Earl K. Long Medical Center in Baton Rouge will cost about 400 people their jobs. That fact came via testimony from the hospital's CEO before the Louisiana Senate Finance Committee. That number is significant on a couple of scores.
First, according to the LSU Health System's 2008 annual report (PDF — the most recent one available), there were 1,266 full-time employees at the hospital. So, about one-third of the people working at the hospital will lose their job as a result of the shut down. Ostensibly the hospital is being closed to save money, but LSU VP for the Health System, Dr. Fred Cerise has pointed out that the shift of services to private hospitals will actually drive up the cost of Medicaid services in the Baton Rouge area due to higher reimbursement rates the hospitals are being promised by the state to take the increased patient loads resulting from the closure.
The other reason that the job loss number is significant is that it is larger than the actual number of jobs affected by the deep water drilling moratorium. The Baton Rouge Area Foundation was selected to administer a $100 million fund created to help those who lost their jobs as a result of the moratorium.
Fewer that 400 workers applied for the funds.
So, this single example of Jindal's focus on dismantling public institutions will have a larger negative impact on jobs than the moratorium he so passionately excoriated, yet his allies have not rented any large arenas to rally the populace against the extermination of these jobs.
More Job Losses Are Coming
House Speaker Jim Tucker and Jindal don't agree on much these days, but they do still appear to share a desire to dismantle much (if not all) of the state's public hospital system now run by LSU. Three hospitals are run out of the Shreveport Health Sciences Center in Shreveport (Shreveport, Huey P. Long in Pineville, and E.A. Conway in Monroe). The rest of the system is run by the LSU Health Sciences Center in New Orleans. The hospitals run there Earl K. Long in Baton Rouge, Bogalusa Medical Center, Leonard Chabert Medical Center in Houma, University Medical Center in Lafayette, Walter O. Moss Regional Medical Center in Lake Charles, the Interim Public Hospital in New Orleans, and Lallie Kemp Regional Medical Center in Independence.
The two systems employ about 13,000 doctors, nurses, aides, orderlies, and staff.
In the minds of Jindal and his Republican legislative allies, just about all of those hospitals and most of those jobs are on the cutting table.
Coming on the heels of the most recent session where Jindal successfully pushed for the privatization of three state mental health hospitals, the people running these hospitals feel threatened, particularly those at the smaller hospitals.
Last Friday, State Rep. John Bel Edwards, Sen. Ben Nevers, and Tangipahoa Parish President Gordon Burgess took part in a meeting at the hospital about the facility's future. The hospital handled more than 100,000 cases last year. Beyond the essential healthcare services it provides to its patients, 39 percent of which did not have health insurance last year, Lallie Kemp (like the other hospitals in the LSU system) is an economic engine in that region.
According to Rep. Edwards, Lallie Kemp has a $90 million annual economic impact on Independence and the surrounding area in the Florida Parishes. In the 2008 annual LSU annual report, the hospital was listed as having 400 full-time employees or their equivalent.
Although Rep. Edwards said he knows of no current plan to close or cut back services at the hospital, he said that the planning for a 35 percent cut in state funding Jindal has ordered all departments to plan for could change that dramatically.
The loss in access to care would be devastating to the people in that region. But those losses could pale in comparison to the economic impact on communities closing of Lallie Kemp or any of the other public hospitals in the LSU systems would have.
Still, Jindal insists that no taxes will be raised and that the state will make do with the revenue base it currently has.
The Medicaid Rebellion
Jindal's initial DHH Secretary Alan Levine confected a plan to bring private insurance companies into manage the Medicaid program and to reduce funding for the program but claim that the quality of care would not diminish. Brazenly branded "Making Medicaid Better" the plan has met with fierce opposition from the provider community (doctors, hospitals, ambulance providers, etc.).
Why would providers object to cutting funding for care to the poor? Because Medicaid (like Medicare) works by paying providers to deliver care. That is, the money for these 'public' health programs goes directly to private providers (some also goes to public providers like the LSU hospitals).
Shrinking funding while extending new hands in the till to manage the care delivered will result in reduced funding for providers. You can do the math. Reduced funding for providers results in fewer providers willing to deliver the services which, in turn, results in reduced access to care.
The Medicaid program in Louisiana is huge; in excess of $7 billion flows through the program annually, but the vast majority of the money is federal money as Louisiana has one of the most generous federal match ratios in the country due to the fact that we are a poor state and have had strong champions for the program in the Senate.
The Louisiana Hospital Association, fighting proposed budget cuts in 2009, said a $200 million cut in Medicaid funding would cost Louisiana nearly 2,000 healthcare jobs. Although those cuts were staved off at the time, succeeding budget shortfalls have resulted in far more money being cut from Medicaid since that time.
With Jindal's refusal to consider new funding sources and a budget shortfall approaching $2 billion anticipated at the start of the next fiscal year (and with Jindal still not having made good on his pledge to revised the State Constitution to ensure that not all cuts come solely from healthcare and higher education), new cuts in Medicaid are going to result in significant job losses in both the public and private segments of the healthcare delivery system.
Higher Education Remains Targeted
Higher education is the other segment of the state's budgets that are not constitutionally protected. Jindal has been taking heat publicly for his cuts in this area, owing in no small measure for the affection many alums feel for their old schools.
While large segments of our state like to sneer at the 'pointy heads' in academia, higher education has significant economic impact on the communities fortunate enough to have such institutions in their midst. As a native of Eunice, I can tell you that I shudder to think what that city would be like economically today were it not for the presence of the LSU-E campus there.
The University of Louisiana System put together an economic impact fact sheet (PDF) a couple of years ago when Jindal first locked in on his 'no new taxes for any reason' strategy of pursuing his national ambitions.
The economic impact of LSU on the Baton Rouge area is immense and its impact on the entire state through the AgCenter, the LSU Hospital System, and other initiatives is at least as large as the UL system's.
Jindal maintains that the universities are not delivering enough value, that people take too long to graduate, if they do at all. It might do the Governor some good to actually talk to the people who are working their way through college. He would learn about the kind of balancing act they have to do among work, family and school. He might also take a whack at explaining how increasing tuition is going to make those students move through the system faster.
But, as a man with no ties to any higher educational institution in the state, it's all just about numbers to him.
Jobs, Jobs, Jobs
This summer, Jindal was all about jobs — when he wasn't killing oysters or generally making a nuisance of himself (see page 20) during the BP Gulf Gusher. But the jobs he was worried about were the oilfield service jobs of people employed by his biggest political backers — the Bollingers and the Chouests. His concern, one could convincingly argue, was not about the jobs at all, but about the threat Jindal believed the moratorium posed to his benefactors.
Despite the fact that he is the child of public employees, Jindal exhibits a peculiar disdain for their work and their well being. No doubt his judgment on the worth of these workers and services is clouded by his national Republican ambitions which makes tax increases an anathema, a fact that has been compounded by the rise of the Tea Party wing within the Republican Party.
The complicating factor for Jindal is that 2011 is a statewide election year and his national ambitions cannot be advanced if he cannot get re-elected here.
Democrats are not well positioned now, but neither was the national party in 1991 before Bill Clinton challenged George H.W. Bush (or, 'Bush the Intelligent' compared to his son).
People who value higher education are going to have to step up. Dave Treen is dead and it's doubtful whether another intervention at the Mansion can prevent the new author from pushing ahead with his plans to slash programs.
Jindal was elected, in part, by people who believed that he was a problem solver who understood the value of education and knew how to manage healthcare. He's proven that he is none of the above.
The forces of opposition to his policies are firming. It remains to be seen if someone can step forward and give voice to that opposition in a way that either forces Jindal to change his path — or costs him re-election.
Strange things have a way of happening on the way to coronations in a democracy.
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