New Orleans Still Struggling Two Years After Hurricane Katrina

Health care challenges and the lack of affordable housing in New Orleans "will continue to influence the pace of recovery" two years after Hurricane Katrina struck, the AP/San Francisco Chronicle reports. According to Leslie Hirsch, who took over management of Touro Infirmary one week before the hurricane, nearly half of the area hospitals remain closed, and the hospitals that continue to treat people are losing money. Since the start of the year, area hospitals have lost a combined $56 million and project yearlong losses of $135 million, Hirsch said, adding that if substantial changes are not made, such as significant increases to Medicare and Medicaid reimbursement levels, the hospitals will continue to lose money and there could be few options for care.

This trend also has affected the dynamics of the area's population, with many elderly residents leaving the area because of poor access to care. The population of New Orleans is estimated at around 270,000 people -- about 60% of the population before Katrina -- and the city could have a younger population than before the hurricane. Rich Campanella, associate director of the Center for Bioenvironmental Research at Tulane and Xavier universities, said, "Being elderly and in need of health care in this city might inspire many older people to relocate."

Meanwhile, the AP/Chronicle reports, the "failure of federally funded, state-administered recovery programs to quickly take hold, and the city's struggle to define and fund plans for neighborhood redevelopment, have shaken confidence about New Orleans' short-term future" (Breed/Burdeau, AP/San Francisco Chronicle, 8/25).

Louisiana Health Insurers Covering More People
The state's four major health insurers are providing coverage for more people than before the hurricane, company executives said on Friday at an Insurance Department Louisiana Health Care Commission board meeting, the Baton Rouge Advocate reports. Mike Reitz, chief marketing officer for Blue Cross and Blue Shield of Louisiana, said, "We're seeing more and more employers seeing the need to provide a better benefits package, and that includes health insurance." Reitz added that Blue Cross is not insuring more companies, but companies are offering health benefits to more workers. According to Humana Health Plan of Louisiana CEO Jamie Schlottman, the trend is due to a work force market that has dwindled after the hurricane, creating the need to offer health benefits as a way to attract employees.














Some industries, such as construction, and small businesses that in the past have not offered health coverage are starting to create employer-sponsored programs, insurance executives said. However, the trend might be temporary, according to the executives. The executives also spoke about the impact of wellness programs on health care utilization and cost (Griggs, Baton Rouge Advocate, 8/25).

Safety Net
Since Hurricane Katrina disrupted New Orleans' health care system in August 2005, the area's uninsured are finding help through "goodwill and ingenuity of providers" who use a "patchy and provisional" safety-net system "propped up by miracle and chance and heavily reliant on the charity of high-minded doctors, nurses and social workers who scrap for ailing patients," the New Orleans Times-Picayune reports. With fewer available hospital beds and limited services, many uninsured people have problems with access to care. Some uninsured residents forgo treatment until their condition worsens, at which point they might end up in a private hospital's emergency department. Other uninsured people travel to hospitals in Baton Rouge, Houma and Lafayette for care, but facilities there often cannot handle the extra patient load, causing substantial wait times for treatment.

Providers who remain in New Orleans often call in favors to try to find specialists who will see and treat their patients at no cost or will allow them to pay for treatment. However, providers say such solutions are limited and can help only some of the uninsured people in need of care. They also say that the patchwork safety net is not a solution and that the whole health care system needs to be reformed (Moran, New Orleans Times-Picayune, 8/24).

Obama Outlines New Orleans Relief Plan
Democratic presidential candidate Sen. Barack Obama (Ill.) on Sunday said the U.S. cannot fail New Orleans again and outlined a plan to help restore the region, the AP/Washington Post reports.

Obama's plan includes a loan forgiveness program that would help attract physicians and college students to the area, as well as several initiatives to improve the housing situation and community safety. Presidential candidates Sen. Hillary Rodham Clinton (D-N.Y.) and former Sen. John Edwards (D-N.C.) also have outlined plans to rebuild the city.

"Part of the problem ... [is that] I just don't think there is a sense of urgency in the White House, where the president is cracking the whip, day in, day out, and saying, 'Why is it that we're not getting this done," Obama said (Bohrer, AP/Washington Post, 8/26).

Recovery Effort Stymied by Bush Administration, Political Officials, Op-Ed Says
The recovery effort in New Orleans has been stifled largely because "[b]old action has been needed for two years now," and "all that the White House has offered is an inadequate trickle of billion-dollar Band-aids and placebo directives," Douglas Brinkley, a history professor at Rice University, writes in a Washington Post opinion piece. Brinkley continues, "Then there are egregious contractor crimes such as overbilling and price gouging. The medical infrastructure has largely collapsed. Mercy and Charity hospitals remain closed."

There also is a "severe crisis in mental health care" and the "Environmental Protection Agency refuses to clearly state that it's safe to live in the metro area," Brinkley writes. Brinkley concludes that the U.S. must "decide whether the current policy of inaction is really the way" the nation wants to "deal with the worst natural disaster" in U.S. history (Brinkley, Washington Post, 8/26).

Additional resources from the Kaiser Family Foundation on health care in the aftermath of Hurricane Katrina are available online, including new audio interviews with Cathi Fontenot, medical director of the Medical Center of Louisiana at New Orleans, and Clayton Williams, director of Urban Health Initiatives for the Louisiana Public Health Institute, on the current health care situation in New Orleans.

"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.