Really?
Here’s something interesting:
Louisiana currently cares for its uninsured and underinsured patients mainly through a statewide network of charity hospitals, the only state in the nation to run a statewide system of public hospitals.
Really? Is that true?
I mean, Mississippi used to have tons of charity hospitals–there was even one in my rinky-dink hometown–and if Mississippi has ‘em, you’d think maybe Connecticut had a few… But then, maybe all those have been shuttered, making Louisiana the last state to realize that public hospitals are a losing game….
Healthcare professionals, please weigh in. Me, I’m just a marketing guy.
Related posts:
This isn’t really an answer, but my M.D./Emergency physician boyfriend responds, “Every hospital ends up being a charity hospital. If you can’t pay, they don’t force you to pay …” but that’s not really the question.
It would be heartening to think that LA cares for its uninsured not as a feature of a broken system but rather as a goal of the system/state itself.
Well, in those progressive places in the Northeast they have these government subisdized community healthcare programs, where if you don’t have health insurance you can enroll in this program and pay a pittance (like $10 a month if you’re poor enough) and then get treatment at private hospitals and clinics. I assume this system is probably far more efficient than a state-run hospital, which is why we don’t do it here.
Actually, this discounts the fact that people used to use
the “traitors”, healers, on a much more regular basis.
They still do.
Laurie
I moved up here to Colorado in september. They seem really impressed with our charity hospital system and from what I gather (direct personal experience and talking to people) they essential don’t do a damn thing to take of their poor health-wise. There is a clinic ’round here that I heard does some sort of discount but the copay is $25 a visit if you get approved. And that seems to be a big if.
I think what they mean it is the only “state wide” system like it. In other areas of the country they have County or Regional hospitals that provide indigent care but no state system.
I think eventually indigent care will be allocated through private hospitals who will be reimbursed by the state. At least that’s what I think Dr. Smithberg wants.
The charity system was the brainchild of Huey P. Long, I believe, and the goal was to make quality health care available to every citizen of the state, regardless of income or abaility to pay. Roux is right that it is the only state-funded and operated charity system - other areas do the reimbursement thing with privately owned facilities, but Louisiana’s charity system contains hopitals and facilities which are owned and oeprated by the state, such as Conway in Monroe. yeah - occasionally Louisiana gets it right - like free textbooks and supplies for all school children (another Long contribution). Seldom - but sometimes. :-)
A.
I am a nurse from New Orleans and work in the public hospital system. I attach a list found at the national association of public hospitals site NAPH.ORG.
List of Members
National Association of Public Hospitals and Health Systems
*
Most NAPH members have websites, which are hyperlinked from the list below. To visit a member’s website, click the name of the hospital.
Alameda County Medical Center (Oakland CA)
Broadlawns Medical Center (Des Moines IA)
Cambridge Health Alliance (Cambridge MA)
Carolinas HealthCare System (Charlotte NC)
Central Georgia Health System Inc. (Macon GA)
Community Health Network of San Francisco (San Francisco CA)
Laguna Honda Hospital & Rehabilitation Center (San Francisco CA)
San Francisco General Hospital (San Francisco CA)
Contra Costa Health Services (Martinez CA)
Cook County Bureau of Health Services (Chicago IL)
The John H. Stroger, Jr. Hospital of Cook County (Chicago IL)
Oak Forest Hospital (Oak Forest IL)
Provident Hospital of Cook County (Chicago IL)
Cooper Green Hospital (Birmingham AL)
Denver Health (Denver CO)
Erlanger Health System (Chattanooga TN)
Governor Juan F Luis Hospital & Medical Center (St. Croix VI)
Grady Health System (Atlanta GA)
Halifax Community Health System (Daytona Beach FL)
Harborview Medical Center (Seattle WA)
Harris County Hospital District (Houston TX)
Ben Taub General Hospital (Houston TX)
Lyndon Baines Johnson (LBJ) General Hospital (Houston TX)
Hawaii Health Systems Corporation (Honolulu HI)
Hale Ho’ola Kamaku Hospital (Honokaa HI)
Hilo Medical Center (Hilo HI)
Ka’u Hospital (Pahala HI)
Kauai Veterans Memorial Hospital (Waimea HI)
Kohala Hospital (Kapaau HI)
Kona Community Hospital (Kealakekua HI)
Kula Hospital (Kula HI)
Lana’i Community Hospital (Lanai City HI)
Leahi Hospital (Honolulu HI)
Maluhia (Honolulu HI)
Maui Memorial Hospital (Wailuku HI)
Samuel Mahelona Memorial Hospital (Kapaa HI)
Health Care District of Palm Beach County (West Palm Beach FL)
Glades General Hospital (Belle Glade FL)
The Health and Hospital Corporation of Marion County (Indianapolis IN)
Wishard Health Services (Indianapolis IN)
Hennepin County Medical Center (Minneapolis MN)
Hurley Medical Center (Flint MI)
Howard University Hospital (Washington DC)
Jackson Memorial Hospital (Miami FL)
JPS Health Network (Fort Worth TX)
Kern Medical Center (Bakersfield CA)
Los Angeles County Department of Health Services (Los Angeles CA)
Harbor/UCLA Medical Center (Torrance CA)
Martin Luther King/Drew Medical Center (Los Angeles CA)
LAC+USC Healthcare Network (Los Angeles CA)
Olive View-UCLA Medical Center (Sylmar CA)
Rancho Los Amigos National Rehabilitation Center (Downey CA)
LSU Health Care Services Division (Baton Rouge LA)
Bogalusa Medical Center (Bogalusa LA)
Earl K. Long Medical Center (Baton Rouge LA)
Huey P. Long Medical Center (Pineville LA)
Lallie Kemp Regional Medical Center (Independence LA)
Leonard J. Chabert Medical Center (Houma LA)
Medical Center of Louisiana at New Orleans (New Orleans LA)
University Medical Center (Lafayette LA)
Dr. Walter O. Moss Regional Medical Center (Lake Charles LA)
Maricopa Integrated Health System (Phoenix AZ)
Memorial Healthcare System (Hollywood FL)
Joe DiMaggio Children’s Hospital at Memorial (Hollywood FL)
Memorial Hospital Miramar (Miramar FL)
Memorial Hospital Pembroke (Pembroke Pines FL)
Memorial Hospital West (Pembroke Pines FL)
Memorial Regional Hospital (Hollywood FL)
Memorial Hospital at Gulfport (Gulfport MS)
The MetroHealth System (Cleveland OH)
Natividad Medical Center (Salinas CA)
New York City Health and Hospitals Corporation (New York NY)
Bellevue Hospital Center (New York NY)
Segundo Ruiz Belvis Diagnostic & Treatment Center (Bronx NY)
Coler-Goldwater Memorial Hospital (Roosevelt Island NY)
Coney Island Hospital (Brooklyn NY)
Cumberland Diagnostic & Treatment Center (Brooklyn NY)
East New York Diagnostic & Treatment Center (Brooklyn NY)
Elmhurst Hospital Center (Elmhurst NY)
Gouverneur Nursing and Diagnostic & Treatment Center (New York NY)
Harlem Hospital Center (New York NY)
Jacobi Medical Center (Bronx NY)
Kings County Hospital (Brooklyn NY)
Lincoln Medical and Mental Health Center (Bronx NY)
Dr. Susan Smith McKinney Nursing and Rehabilitation Center (Brooklyn NY)
Metropolitan Hospital Center (New York NY)
Morrisania Diagnostic & Treatment Center (Bronx NY)
North Central Bronx Hospital (Bronx NY)
Queens Hospital Center (Jamaica NY)
Renaissance Health Care Network Diagnostic & Treatment Center (New York NY)
Sea View Hospital Rehabilitation Center & Home (Staten Island NY)
Woodhull Medical and Mental Health Center (Brooklyn NY)
North Broward Hospital District (Fort Lauderdale FL)
Broward General Medical Center (Fort Lauderdale FL)
Coral Springs Medical Center(Coral Springs FL)
Imperial Point Medical Center (Imperial Point FL)
North Broward Medical Center (Pompano Beach FL)
The Ohio State University Health System (Columbus OH)
Parkland Health & Hospital System (Dallas TX)
Regional Medical Center at Memphis (Memphis TN)
Riverside County Regional Medical Center (Riverside CA)
San Joaquin General Hospital (Stockton CA)
San Mateo Medical Center (San Mateo CA)
Santa Clara Valley Health & Hospital System (San Jose CA)
Schneider Regional Medical Center (St. Thomas VI)
Roy Lester Schneider Hospital (St. Thomas VI)
Myrah Keating Smith Community Health Center (St. John VI)
Shands HealthCare (Gainesville FL)
Sinai Health System (Chicago IL)
Stony Brook University Hospital (Stony Brook NY)
Thomason Hospital (El Paso TX)
Truman Medical Centers (Kansas City MO)
TMC Hospital Hill (Kansas City MO)
TMC Lakewood (Kansas City MO)
TMC Behavioral Health (Kansas City MO)
UMass Memorial Health Care (Worcester MA)
UMDNJ-University Hospital (Newark NJ)
University Health System (San Antonio TX)
University HealthSystem Consortium (Oak Brook IL)
University Hospital, The University of New Mexico Health Sciences Center (Albuquerque NM)
University Medical Center of Southern Nevada (Las Vegas NV)
University of Arkansas for Medical Sciences (Little Rock AR)
University of Chicago Hospitals & Health System (Chicago IL)
University of Colorado Hospital (Denver CO)
The University of Kansas Hospital (Kansas City, KS)
University of South Alabama Medical Center (Mobile, AL)
University of Texas System (Austin TX)
The University of Texas Health Center at Tyler (Tyler TX)
The University of Texas M.D. Anderson Cancer Center (Houston TX)
The University of Texas Medical Branch at Galveston (Galveston TX)
VCU Health System (Richmond VA)
Updated 03/02/2006
If you have any questions please contact Kat Eibensteiner
THANKS
My mom works in the charity system, and I would go there for treatment when I was still living in the state. I always had a good experience with them.
The system that we had in place was a different model than what any other state used. Ann is right in that the system started under Huey Long. It was modeled on true charity hospitals run by certain religious orders at the beginning of the 20th century and designed to provide the best care it could given the medical technology of the time. Remember, back then all that could be done for non-surgical patients was give them a bed and apply cold towels and hold their hand. As medical technology advanced and the price fo healthcare started going up, the Federal government began to help shoulder the cost for the poor and uninsured through the Medicaid program and provision of what is called “disproportionate share” funding. This means that any hospital in the country that cares for uninsured people can apply to their state govt. to get some of the cash Washington sent for that specific purpose. Prior to Katrina/Rita, 100% of the Federal disproportionate share funds for Louisiana went into the Charity system. The other hospitals didn’t care, as it meant they did not have to take care of uninsured patients for the most part.As the cost of healthcare skyrocketed and the funding from Washington failed to keep pace, the Charity system began to go broke as the state legislature could not afford to fund the difference out of state coffers. So, we are looking at going to the model the other states all use which is that private hospitals provide the care for the patients and then get a slice of the disproportiate share funds. This usually means that it takes a bite out of the profits of the private hospitals or else puts a strain on their budgets.
In terms of physician services, most of those came from contracts that the medical centers (Tulane and LSU) have with the state to provide outpatient services. The medical centers then use their residency programs to provide manpower to staff the clinics with a few faculty membesrs providing backup for the residents. It will be interesting to see what happens with the clinics, as they have to compete with the hospitals for limited disproportionate share money.
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