On Life Support
New Orleans's against-the-odds struggle to care for the infirm
Despite the limited care, patients are showing up with serious problems, including untreated hypertension, diabetes, bad staph and strep infections, and AIDS. "We diagnose new cancers easily three, four times a week here," says DeBlieux. In the days of Big Charity, cancer patients would be sent upstairs for chemotherapy and radiation; now patients are referred to state-run hospitals in Houma or in Baton Rouge, 90 minutes away. "Who do you think suffers?" asks DeBlieux.
Coming home. For many patients, visiting the tent ER, strange as it is, is like coming home. "I knew Charity was the best place to come," says Rosemary Allen. Katrina flooded her home in New Orleans, and she and her husband are now living in Houston. After two doctors there refused to see her, even though she said she would pay, Allen, 55, and her husband drove the 350 miles back to New Orleans so that she could see the Charity doctors about her diabetes and shoulder pain. Charity helped--to a point. "They tell me I have to go to Baton Rouge," Allen says, "for an ultrasound."
Slowly, the Charity ER is growing. Staffers are planning to shift the beds from the tent to cubicles in the Lord & Taylor, screened by purple plastic shower curtains. Next week, the hospital plans to open a 30-bed trauma center in space leased from Ochsner through the end of the year. By then, hospital administrators hope to have rehabilitated several units in nearby University Hospital with $13 million in FEMA funds. The Lord & Taylor ER will remain open.
Still, the venerable hospital's future remains uncertain. Before the storm, LSU officials planned to replace Charity's 1939 art deco building. In February, they inked an agreement with the flooded Veterans Administration hospital across the street to explore building a shared campus, which could open in five years if funding is available, says LSU's CEO Don Smithburg. Some local politicians and Charity employees say the hospital could be fixed up more cheaply and quickly. "Those very well intentioned folks who want to get back in there will work anywhere," Smithburg says, "but that doesn't mean it's the best for patients."
The LSU system still receives most of the state and federal funds for uninsured care because the money is attached to the hospitals. "We were hopeful that some of that money that had been going to pay for the poor and the uninsured could have been shifted to the private hospitals," says John Matessino, CEO of the Louisiana Hospital Association. Instead, the Legislature cut $136 million. In early April, the state started doling out $382 million in federal relief money to help pay for uncompensated care provided through January 31, with $114 million going to private hospitals. An additional $30 million is under consideration, but it's unclear when--or if--checks will be cut. "It's hard to say that you're not appreciative of any money at this point, but that package did not solve the problem," East Jefferson's Peters says. "The pats on the back don't cut it anymore."