Sunday, January 15, 2012

Greenstein Officially Replaces Levine as Jindal's Healthcare Hack

Bruce Greenstein replaced Alan Levine as Bobby Jindal's Secretary of the Department of Health & Hospitals (DHH) in 2010, but it wasn't until the second week of 2012 that Greenstein succeeded Levine as Jindal's partisan hack on healthcare.

The official coming out event in Greenstein's transition from technocrat to political operative was Greenstein's full-out attack on the Louisiana Budget Project (LBP) for their having pointed out the obvious — namely, that there are a lot of jobs tied to the state's $7 billion Medicaid program.

In a statement to Gannett's Capitol Buruea, Greenstein went ballistic.
"It's a fallacy to say reductions in Medicaid rates impact the economy," Greenstein said. "The liberal Louisiana Budget Project is simply making the same tired case for raising taxes and maintaining the status quo that has gotten us 49th in health outcomes.
It's not clear what about the LBP report so upset Greenstein. After all, the LBP report only echoes claims being made by the Louisiana Hospital Association (LHA) for a number of years, dating back to the period before Greenstein's arrival at DHH.

In reports the LHA issued in 2009 and 2011 on the economic impact of hospitals and healthcare in Louisiana, the LHA quantified the number of hospital jobs tied to Medicaid spending by region and by member hospitals.

In 2009, when the Jindal/Levine regime was threatening cuts of $300 million or more due to budget deficits caused primarily by the repeal of portions of the Stelly Plan, the LHA detailed the importance of Medicaid to hospital and healthcare employment by region and by hospital in a report entitled "Hospitals: Economic Agents in the Louisiana Economy" (PDF).

Included in both reports is information on the size of the healthcare segment in Louisiana — more than 250,000 workers employed in more than 11,000 locations, with an annual aggregate payroll in excess of $8 billion.

The LHA 2009 report declares, "The payroll of the healthcare sector in Louisiana is larger than the payroll of any other industrial classification in the state."

The LHA's 2011 report, "Hospitals and the Louisiana Economy, 2011" (PDF), makes the Medicaid/jobs link explicit and detailed: "In Louisiana, approximately 19% of net revenues are Medicaid- related. Medicaid-related expenditures lead to the creation of 47,483 jobs with personal earnings of $1.8 billion." (Page 6 of the 44-page PDF).

The LBP declaring that there is a link between Medicaid spending and job creation, then, is not radical or liberal. It is just a restatement of established fact made so by the industry that has first-hand knowledge of the impact of that funding — the hospital industry.

Sure, the LHA has a lot of skins in the game but that didn't seem to be a concern when Jindal, the Louisiana Oil & Gas Association (LOGA) and their cronies were whipping up the anti-moratorium hysteria back in the summer of 2010.

Greenstein's claim that there is no connection between jobs and the flow of more than $7 billion through the state's economy in the form of Medicaid-paid healthcare delivery is ludicrous on its face. In effect, he's arguing that there is no connection between the revenue that hospitals, clinics and doctors have and the number of people they employ.

That's not a fallacy. That's a delusion.

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