Sunday, July 17, 2011


First up, the hospital. Yeah, that's right, THE hospital. You know, the one we should have, the one we can have, and the one we have to have if we are to have the healthy and prosperous future we deserve to have.

The new University Medical Center (UMC), as proposed by LSU, easily will be the sweetest and most trans formative economic development in New Orleans or Louisiana since Etienne de Bore teased out a way to granulate sugar from cane here in 1795, and thereby revolutionized the agricultural base of the colony. It will anchor a world class Medical District bolstered by the almost billion dollar on-campus Veterans Administration Hospital facility, already underway. These two hospitals, together with the nearly completed LSU Cancer Research Center and the just finished New Orleans Bioinnovation complex neighboring on the downtown/river flank of the District, leave no room to doubt that we are on the threshold of  the greatest economic, intellectual, and social investment in our history.

As the comprehensive plan and vision for the District is realized, it will rival or surpass even the likes of MD Anderson. The best medical practitioners and research professionals from around the country will want to participate in its successes and achievements, people of means with the need for the best medical care available anywhere will flock to it, and, yes, people without means, who once depended upon old Charity, will enjoy a far superior level of treatment, care regimen, and outcomes than ever before.

Oh, that is of course unless the usual cast of self-interested money grubbers, in concert with their "Best in Show" well-kept kennel of political barkers, as well as those clueless dupes, the self-righteous (and deluded) do-gooder preservationist saviours of the city, can put across enough lies, stunts and tricks to derail the proposal. So let's look at the grubber-barker-gooder cabal (the GBGC or, if you prefer, the Unhealthy Alliance) and see what mischief they've been up to.

The grubbers include all those virtuous souls who long ago perfected a strategy of living high while raking money off the bones of the sick and dying, often even to the very last penny, and then some. For my money, all of the private health care operators - including the so-called non-profits - have earned the right to be so characterized. In the New Orleans area, Tulane and Ochsner enjoy marquee roles.

As for Tulane, it (and HCA, its partner in the operation of the Tulane Medical facility, which admits brags that its Nashville founding in 1968 places it among the very first hospital corporations in the country, a distinction some might imagine could have only been outshone by Marcello touting his pioneering work in the South) has more or less taken the lead in publicly maneuvering to exercise unwarranted control and undue influence over the scope, governance, and operation of the new Medical Center.

You see, Tulane Medical has long enjoyed a sort of free-rider status relative to the old Charity across the street. Tulane claimed training spots for its students and creamed high-end, insured, paying patients who might have initially been brought to Charity for emergency treatment, while LSU shouldered the real burdens of maintaining an aging, outmoded, and often underfunded public charity medical facility in a seriously impoverished urban setting. Now, good old Tulane is once again gaming the system hard to reap a huge portion of the benefits from whatever eventually comes about in the new District, while sticking LSU with the load. No wonder they call themselves the "Green Wave," always wanting to just swim in the money.

Although to date Ochsner has kept a low public profile, make no mistake that its financial interests would be clearly challenged by the full development of the UMC, as envisioned by LSU. And when such powerful financial interests are on the block, their political power always pushes hard (often behind the scenes) to insure an outcome wildly in favor of the health of the old pocketbook. I'd sooner bet against there being snakes in the swamp than Ochsner having politicians in its pockets.

Speaking of pocket politicians, I give you David Vitter. This cad is well-known for being interested in what's in his pants, as well as what's in others' - if you get my meaning. Anyway, as for his 11th hour crazy scheme to buy some used goods from Tulane/HCA and scatter-shoot pitiful little satellite clinics, significantly distant and inaccessible from the area where the indigent most need them, it was always only intended as a distraction. Meanwhile, Vitter's more serious attack on the UMC took the form of using his exalted senatorial status to block any effort at securing Federal backing for the bonds needed to complete funding for the new teaching hospital. Can you think of a dirtier abuse of power than intentionally jeopardizing health care for the most vulnerable among us just to satisfy some peculiar ideological idiocy and grovel at the feet of  political financiers? Thankfully, all the poster boy for Christian hypocrisy accomplished was to prove that the private market is actually awash in money, which can be had at dirt cheap interest rates by those - including public entities - willing to borrow and invest, contrary to scare mongering claims of imminent sky-rocketing interest rates, spread by knuckle headed right-wing conservative economists and pols. Consequently, financing for the UMC development, as proposed by LSU, was not even dented by the rocks little David slung at it.

Still, our would-be giant slayer did manage somehow to enlist two other little guys in the disreputable business of trying to scuttle the UMC, Treasurer John Kennedy and House Speaker Jim Tucker. Actually, the how part is not so difficult to figure out. John Kennedy is easily the silliest gadfly on the Louisiana political scene in generations. He wants to be everything, and imagines that he already is. He has tried and failed to become governor and a U.S. senator, and so has to content himself in the relatively useless post of treasurer. He is constantly ignorantly running his mouth on every subject under public consideration, in whatever media format is made available. When Vitter gave him the chance to make a big public splash, another belly-flop command performance was simply not to be avoided. As for Tucker, well, he is after all a legislator, a Louisiana legislator. And in the inimitable words of Earl Long, "There is not a man, woman, or child safe in the state of Louisiana when the legislature is in session." This guy has been all over the map on this one because he is only being true to legislative form. My guess is he will wind up where he started, in the camp of those pushing for the LSU plan, because that is where a Louisiana House Speaker would naturally be most comfortable.

Singing backup en falsetto in this grand ensemble we find our dear friends, the self-labeled preservationists. Bless their little hearts, or should I say heads? They only want what's best for us, right? I guess the best health care available anywhere in the country doesn't meet that standard though. Nor does the chance to put New Orleans on a footing for First World economic standing again, the first time in over one hundred fifty years. But before I go too far in portraying these guys as all the same, let me quickly point out that they are indeed of two distinct types. The leadership group is most assuredly never confused or mistaken about the whys concerning the campaigns they undertake. Their mission and motivation is always to preserve the status and standing of the upper-crust. They are the public front for the established money interests in this town who, more than anything else, are dedicated to remaining big fish in a small bowl, even at the cost of grinding poverty and endless deprivation for the majority of the population desperate for hope, for opportunity, for economic vitality and growth. Their greedy designs and schemes have been and are at work and on display in venues ranging from the Harrah's/Rivergate confrontation to the fight for the commercial revitalization of Canal Street to the instant case of a fight for the preservation of a "historic" district that never was. Sadly, the truly idealistic, well-intentioned citizen activist foot soldier preservationists are clueless dupes in this confrontation of competing and irreconcilably oppositional social interests. What is worse, they are dupes on two scores. The first and easiest one to expose is that, while they see themselves as executing audible calls from a Heavenly playbook, all along they are mere camp arms or, at best, back-ups to Hades' first string. The aristocratic, upper-crust  "PRESERVATIONIST" banner wavers gin these unsuspecting guys and gals up with all manner of "High Popalurum and Low Popahirum," throw them against the ramparts of progress and prosperity, and tell them it's really Rampart Street, and must be defended from the infidel despoilers of our pristine, sacrosanct heritage. What hooey!

Pathetically, they buy it. All of it. They swallow and repeat, even in letters to the Times-Picayune newspaper, blatantly false, and  intentionally  misleading costs assigned to operating the new UMC. Such a figure is the 100 million dollar annual state subsidy projected as necessary to sustain the new facility. This number is stupidly batted about to discredit the brilliant new Medical District, without ever caring to note the fact that the old, decrepit Charity was already knocking down 70 million dollars of that annual subsidy, just to keep it limping along. Additionally, they rely on the highly suspect and dubious conclusions of a firm that specializes in "Historic Architecture Preservation" which assert that a modern, state-of-the-art, high-tech modern medical facility could be shoehorned into the hoary, ossified, fossil of a structure which once housed Charity. Pshaw! These are the findings of an outfit with a clear interest in the outcome of this debate. Utter, utter, stupefying nonsense.

Worse, these luminescent intellects uniformly lack the perspicacity to question the basic foundation of their so-called "progressive" approach to these matters. In fact, their perspective is decidedly reactionary and backward. Preservation is for items kept in a museum or jars of formaldehyde. Vibrant, vigorous, thriving life requires the freedom to change and grow, to take paths not trodden and explore dimensions unknown and untested. Conservation of natural and cultural resources bequeathed to our generation is what is needed to move confidently and exuberantly into the future, not morbid preservation of what has already flowered and gone to seed. Preservation is a deadend.

Lastly, we turn as promised to the subject of restaurants. And, no, I am not here contemplating the notion of a last meal. But I do intend to deal, however briefly, with matters touching on life and death, and the so-called hospitality industry. Seems like a fitting conclusion to a piece dealing in the main with hospitals and health care, don't you think?

Anyway, we have recently experienced two very tragic traumatic events involving life-threatening injuries to highly regarded, well known restaurateurs/chefs in New Orleans. One was the result of a shooting, and the other a vehicle accident. In both cases, medical expenses were reported to have gone stratospherically out of reach. And just a year of so before these two incidents, a similar set of dire financial circumstances obtained for another high profile chef, as a consequence of unexpected complications arising from a rather mundane, day in-day out bump on the leg. In each of these cases, a widely publicized and ballyhooed fund raising campaign was undertaken by the hospitality industry as a whole to retire the staggering debts piled up by the need for expensive care, and the lack of adequate or, perhaps, any medical insurance coverage. Good for them, the leaders of the local hospitality industry, you might say, for extending help to colleagues in time of need.

But is that really the appropriate take away from these episodes?  I think not. What about the legions of ordinary work-a-day employees, uncelebrated and nameless to most of us, save for maybe a stamped plastic pin-on tag announcing that she indeed is Stacy, as in, "High, I'm Stacy, and I'll be your server today." What about the hard working people who take your order and bring your dinner, who dutifully answer your call for more of this or that or something else altogether, or who sweat and swelter over sizzling and searing surfaces preparing the day's bill of fare for your consumption and satisfaction, what happens to them when illness, accident or crime lays them low? I'll tell you what happens, they suffer mightily, sometimes they die, never are they celebrated and rescued from financial calamity courtesy of industry sponsored, party hardy, fund raising public displays of phony sympathy and concern. Almost all employees in restaurants and related businesses are  meagerly, nay, miserably compensated. Their greedy employers don't give a fig about providing even a decent wage, much less health insurance. Tip well, they sure as hell need it. But don't kid yourself, tips never fill the hole their stingy employers put them in. So, I'll give you a tip: when you see a rich restaurateur feigning social responsibility by coming to the "rescue" of a quaint little theatre in the hottest tourist district, while wanting to open yet another in a string of restaurants there, think how many workers have gone without the basics so that the boss could go around so casually flush, a real sharpie seeming so like a swell. Hospitality industry my left foot.

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