Louisiana spends billions in state and federal dollars each year on public health care delivery, yet our state is recognized as one of the least healthy in the nation. Are we delivering public health care in the most efficient and effective way? What are our options for the future?
Health care is a major issue at the national level, but it is a critical concern in Louisiana. This is true for any number of reasons. First, our population has tremendous need for health care services. Morgan-Quitno Press, a national group that compiles data on a variety of issues, ranks Louisiana second to last in the country in terms of the health of our population. Their rankings look at such things as infant mortality, the uninsured, and access to primary care physicians – all areas where we fare poorly compared to other states.
Certainly, our high poverty rate has much to do with this. The poor are less likely to have health insurance, they often lack access to physicians, and this means they frequently do not receive preventive care. But there are also questions about the way we deliver public health care through our state-operated “charity” hospital system. Is it effective? Is it the most efficient way? Do we need to re-examine the model?
It is clear there are no easy answers, but the pressures are building to find solutions. Louisiana spends $1.3 billion in state money each year on public health and hospitals. That’s 20% of our state general fund dollars, yet our citizens are still not receiving the health care they need, private hospitals are threatened because their reimbursements don’t cover their costs, and health care costs continue to rise. Louisiana’s governor can’t do much to change the national issues surrounding health care, but she can look at public health care in the state and provide the leadership and vision to ensure that the dollars that are available are being spent efficiently for taxpayers and effectively for the citizens whose health is at risk.
Things to Consider:
In 2001, 18.5% of Louisiana’s population received Medicaid, compared to 12.3% for the U.S. as a whole.
In 1999, 63% of the births in Louisiana were paid for by Medicaid.
In 2002, more than 18% of Louisiana’s population had no health coverage of any kind, the fifth-highest uninsured rate in the nation.
At the same time, 12.7% of children lacked health care coverage, the 10th highest percentage in the country. This shows an improvement over the adult population. One reason is the LaCHIP program which, since 1999, as provided health care coverage for more than 200,000 children from low-income families.
Louisiana ranks seventh in the nation in terms of money spent per capita at hospitals, but we’re only 30th when it comes to money spent on physicians and other professional services. Why? One reason might be that we have one of the highest percentages in the nation of citizens who lack access to primary care.
Louisiana currently spends more than one billion state dollars a year on public health and hospitals including Medicaid. That amounts to 20% of all state dollars. Totat state and federal spending is just under six billion dollars.
More than 26% of Louisiana children live in poverty. That’s the second highest rate in the nation and an increase of more than 3% since 2003.
Twelve percent of Louisiana’s children live in extreme poverty, which is below 50% of the federal poverty level.
In Louisiana 10.4% of the children born in 2002 were of low birthweight, which frequently leads to various health and developmental problems. In 1992 it was 9.4% – the situation is growing worse.
Louisiana’s infant mortality rate is the fifth highest in the nation.
Thirty percent of Louisiana’s 2-year-olds still have not received immunizations.
Nearly 20% of the population in Louisiana lacks access to primary health care. This is particularly critical for children because delayed treatment of childhood diseases can lead to more serious and permanent problems.
The national Annie E. Casey Foundation ranks Louisiana 49th in the nation in terms of the overall well-being of children in the state.
Questions to Ask:
- Many have talked about reforming the state-owned “Charity Hospital” system. Suggestions have included closing down hospitals, using private facilities to provide some services, and moving services out of institutions and into community-based centers. What do you believe is the long-term role of the Charity Hospital system in Louisiana and what are your plans, if any, to specifically reform the system?
- Louisiana has one of the highest percentages of uninsured people in the country. What do you propose to do, if anything, to lower the rate of uninsured citizens in Louisiana?
Read what the Governor had to say about this and other quality of life issues in CABL's 2003 Election Candidate Survey. Click Here.
View Related Data from the Louisiana Fact Book
Click Here (PDF)
LA Department of Health and Hospitals – www.dhh.state.la.us
U.S. Department for Health and Human Services, National Center for Health Statistics – www.cdc.gov/nchs
Ann E. Casey Foundation – www.aecf.org
LSU Health Sciences Center – www.lsumc.edu
Children’s Defense Fund – www.chidlrensdefense.org