re: BR General, Jindal administration reach deal to keep ER open

There is plenty of stupidity going around and all parties are to blame. The state worked hard to get BR General on a contract but the General's leadership couldn't see the forest for the trees (this has long been the case with multiple leaders in the organization).

So, the state contracted with OLOL. This was also stupid because anybody would know that the indigent patients would just end up at BG General anyway. But, the shortsighted people at the state wanted a deal so they got it. Now, with a PR disaster looming, they end up paying twice.

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So, the obvious solution is have the reimbursement follow the patient, not the hospital. Right? It just seems surrounding hospitals would have made provisions for this to happen

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So, this is exactly what the Medicaid expansion, that is part of ACA, would have done. By getting all these people signed up into the Medicaid network, the money would have followed the patient to whatever Medicaid facility they choose.

This is the fatal flaw in BJ's health care program. I agree with getting LSU out of the hospital management business. But, as long as we are going to use government money to pay for health care of the poor, it makes the most sense to have these people enrolled in a program that will allow for some control and to have the money follow the patient. By refusing to expand Medicaid, he is continuing this silly program where we pay a hospital a bunch of money to take care of the poor, as opposed to paying a hospital WHEN they take care of the poor.

We can argue about whether the government should be providing the money in the first place, but if we are, then it makes sense to expand Medicaid and use that program to control the money.

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This is the fatal flaw in BJ's health care program. I agree with getting LSU out of the hospital management business. But, as long as we are going to use government money to pay for health care of the poor, it makes the most sense to have these people enrolled in a program that will allow for some control and to have the money follow the patient. By refusing to expand Medicaid, he is continuing this silly program where we pay a hospital a bunch of money to take care of the poor, as opposed to paying a hospital WHEN they take care of the poor.

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If it were only that simple.

Look at the BRGH situation.

They have to keep the ER open no matter what. They may or may not be able to pay for all of its operating costs and it would all depend on the amount of business they received.

Just saying let the money follow the patient means little, if these patients are guaranteed ER services.

The answer is obviously educating people who are sick and having them go to well placed neighborhood clinics throughout the city.

Having ERs treat chest colds, the flu, etc. is not being efficient. It costs too much to staff ERs and have them just treating common illnesses.

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I've always wondered why hospitals didn't stick a 24 hour urgent care center next to their ER.

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That would just expand the hospital's costs and keep them in the business of treating everyday illnesses.

Education and clinics in the various neighborhoods is what is best.

Keep hospitals for true emergencies and major medical needs.

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It should not. Most hospitals have attached medical buildings. Stick one in the first floor of the medical building. Put a NP or a young doc in there. Only have it open outside of regular doctor office hours. I believe OLOL already has an affiliated chain of urgent care centers. This would not be hard to do, and the ER triage staff could be trained to simply redirect patients to the nearby urgent care center. And since it's not actually IN the hospital, you would not need all the affiliated hospital costs. I agree that neighborhood clinics are best. But I don't see why this would be a bad thing. And it should help the hospital as well

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It would be better than what they do now.

The thing is often times hospitals are not the best locations to treat the indigent.

I think we both agree neighborhood clinics close to the indigent, on mass transportation routes, etc. would be ideal.