I was in New Orleans today for the Saints game against Da Bears. The Superdome is walking distance from the old Charity Hospital and Tulane School of Medicine. We were dropped off by old Charity and walked over to the ‘Dome. I found myself looking at the once familiar cityscape but could only think of the events post-Katrina. Charity Hospital was originally established to serve the city in 1736 and is named for the Daughters of Charity who provided care. It was Huey Long who located Big Charity (as it was known when I was in Medical School) on Tulane Avenue and placed the new public medical school (LSU) on the other side opposite Tulane in the 1930s. The two schools both used Big Charity for clinical instruction, but at the time I was in school (the 1980s) the truce was uneasy at best. Tulane, with a private school swagger, had opened a private hospital across the street named Tulane Medical Center (TMC). The poor on the Charity “service” did not get the wonders of the care delivered at TMC from the Tulane faculty. The LSU faculty, feeling outflanked and resentful, soon moved their private practice to another local hospital. As I understand it, the trauma care at Big Charity was still world class, but much of the other specialized services, as well as a lot of bread and butter medical care, had moved from Charity well before the storm.

The storm managed to do what the state of Louisiana could not: close Big Charity. As a symbol of the commitment to the citizens of the State of Louisiana to the health of  its poor, Charity was second to none. However, even before Katrina, it was known as an expensive and not very efficient symbol and as a  rich source of patronage for well-connected Louisianians. Post-Katrina Tulane reopened TMC, moved some clinical care to the suburbs, and moved some of their clinical training (as I have discussed before) into the community. LSU moved into other facilities as well but now seems to have talked the state of Louisiana into a new hospital.

This hospital will cost $1,100,000,000 and will be funded using a combination of general funds, Katrina recovery money, as well as some yet-to-be determined sources. The financial viability seems to be based on the fact that they will attract patients from the  New Orleans region  who are currently using competing health care venues but their physicians have an LSU affiliation (repatriation), they will create new demand (destination programs), and they hope to appeal to the newly “Obama-insured.” There is also a belief that some of the insured citizens are more likely to view a new hospital as less “Charity” than the previous Charity and so will choose to make this their preferred care facility.

My interest was piqued because the construction was blocking the way for us to walk from the Superdome to Canal Street, as it is a huge site. I wish LSU and the state of Louisiana luck, although it seems that they are planning more to capitalize on illness than on health.  To quote:

New Orleans Business Alliance President and CEO Rodrick Miller said, “The UMC Teaching Hospital will be a center for innovation and learning that will dramatically increase the quality of care options for patients in New Orleans, and serve as a key economic engine to spur job growth and new investment in the community. Getting this hospital on-line will solidify Louisiana’s long-term commitments to expand high quality healthcare options for New Orleanians and support a robust bio-medical industry.”

I am glad I’m not a taxpaying citizen of Louisiana. If anyone wants to know why, I refer them to The Amazing Health Care Arms Race.