Topic:

September 15
HEALTHCARE

Background

Biographies

BACKGROUND

Overview

Louisiana is one of the most beautiful places in America. Its people are among the most interesting, friendly... and, unhealthy in the nation, according to John Matessino, President of the Louisiana Hospital Association,

Louisiana ranks at the bottom of many of the lists that you see on health outcomes ..... We don’t have a health care lifestyle in this state. We have access to health care issues. We have a huge problem with poverty in this state.
John MATESSINO, CEO, Louisiana Hospital Association

In fact, 2003 Census data shows Louisiana with the highest poverty rate in the nation. Doctor Holley Galland, primary care physician with Earl K. Long Hospital ’s North Baton Rouge Clinic, explains how it affects her patients.

Our number one problem is poverty. Poverty is the main cause of mortality and morbidity. Morbidity is basically being poor health. If you don’t read well, if you haven’t been taught good health habits, if you don’t have access to transportation, to therapeutic recreation, to resources that people who have funds have access to, then you are going to have a poor level of health.
Holley,GALLAND, MD, Primary Care Physician, Earl K. Long Hospital

Louisiana spends about 80 percent of what the average state does on health, hospitals and public welfare. About a third of Louisiana ’s entire annual budget – nearly 6 billion dollars – goes to the Department of Health and Hospitals.

Much of that money funds 10 hospitals and about 350 outpatient clinics spread across Louisiana . This is the charity system, the oldest in the nation, and the only statewide healthcare safety net with a principal mission of providing access to care for the uninsured. And in a state with one of the highest rates of uninsured citizens, costs are staggering: 510 million dollars spent by the state last year on the care of indigent patients.

Senator Don Hines brings his experience as a medical doctor to the debate.

The biggest health care issue facing Louisiana today is that 40% of our population depends upon public funds for health care. We have about 20% or about 800,000 people on Medicaid and another 20% or 800,000 who are uninsured and using our public hospitals for health care.
State Senator Don HINES, MD

Budget cut backs have resulted in very long waits for treatment and appointments, clinic closures and other reductions in service. Diversion of funds intended for capital improvement has taken a toll in both New Orleans and at Earl K. Long in Baton Rouge .

I want people to understand care at Earl K. Long is not substandard care – it’s excellent care. The problem is getting in; we don’t have the resources.
Holley,GALLAND, MD, Primary Care Physician,
Earl K. Long Hospital

If you go to EKL or big charity, you might see a good doctor, but you have to wear a hard hat to keep the damn ceiling from falling on your head, or stand in line for 3 hours to get to see them, and those things – even the Medicaid patients don’t go there.
State Senator Don HINES, MD

The loss of Medicaid and Medicare patients is a big blow to the bottom line, because federal dollars from those patients could help defray the costs of care for the uninsured. The spiral continues downward, extending out to private sector players. Our Lady of the Lake Medical Center CEO, Bob Davidge, explains.

Private hospitals in Louisiana , and really across the country, more and more, if not already, are safety net facilities for the community. We provide indigent care – large amounts of indigent care ...
Bob DAVDIGE, CEO,
Our Lady of the Lake Medical Center

John Spain is Vice President of the Baton Rouge Area Foundation, which funded a study on the future of the Baton Rouge charity hospital.

You go to an ER now, and in BR, depending on your problem, you may have to wait 2 or 3 hours on certain nights to be seen by a doctor in an ER – even if you are a paying customer. That’s because we are being overwhelmed by people who are using the ER as their primary care physician, instead of having a doctor.
John SPAIN , Vice President,
Baton Rouge Area Foundation

The public hospital system is filled; it’s full; it’s at capacity.... a lot of our patients will use private emergency rooms. And this is hard on the private emergency rooms. And, it’s also hard on state funding because emergencies are not an effective way to spend health dollars.
Holley,GALLAND, MD, Primary Care Physician, Earl K. Long Hospital

Spending health dollars effectively has never been more important. The state is facing new deficit warnings, and the costs of healthcare continue to rise. Some health planners are giving a close look at a community-based model for health care delivery; one that turns the nearly three centuries-old Charity paradigm on its head.

Proponents of Community Health Centers, also known as FQHCs [Federally Qualified Health Centers] claim their non-profit, patient-driven approach reduces costs, increases accessibility and improves quality. There are currently 35 clinic sites in Louisiana .

Every community has somewhat of a different problem. Indigent care – charity hospitals is a problem everywhere. But what I think we learned looking at the charity hospitals in the last year is that there is no one solution that fits all communities. My guess is that if you look at issues, we’ll fine unique answers for each community, because they’re very different.
John SPAIN , Vice President,
Baton Rouge Area Foundation

In the end, the inertia of the mammoth charity system will tend to resist radical change, but change will come. The need for teaching, residency and intern programs will probably keep most of the big hospitals hobbling along. Additional community clinics will help deal with the seemingly unending flood of needy patients. And, hopefully, other institutions will foster the improvements in education and economic opportunity that create a truly healthy society.

BIOGRAPHIES

Dr. Frederick P. Cerise
Secretary of the Louisiana Department of Health and Hospitals

Dr. Frederick Cerise, a native of Monroe, LA, was appointed Secretary of the Louisiana Department of Health and Hospitals by Governor Kathleen Babineaux Blanco in January 2004. Dr. Cerise is an internal medicine physician who has spent over 13 years of his career both teaching medical students and treating patients in the state’s public hospital system. Prior to assuming his position as Secretary, Dr. Cerise served as chief executive officer of the Earl K. Long Medical Center in Baton Rouge. He had been on staff in some capacity at Earl K. Long since completing his medical residency in 1991. He previously served as medical director of Earl K. Long and medical director for LSU Health Care Services Division. Dr. Cerise is an associate professor of clinical medicine at the LSU School of Medicine. He previously served as an assistant clinical director of the Earl K. Long internal medicine residency program and as an instructor of medicine. Dr. Cerise received an undergraduate degree in science from the University of Notre Dame in Indiana and a graduate degree in medicine from the Louisiana State University School of Medicine in New Orleans. He completed his residency at the University of Alabama Medical Center in Birmingham. Dr. Cerise later received a master’s degree in public health from Harvard University. Dr. Cerise serves as a board member of the Baton Rouge Area Foundation. He is also a standing member of the Louisiana Health Care Review Clinical Advisory Board.

Dr. Gary M. Wiltz
Chief Executive Officer of Teche Action Clinic in Franklin, Louisiana

Dr. Gary M. Wiltz is the Chief Executive Officer of Teche Action Clinic in Franklin, Louisiana. Prior to his appointment as CEO in May 2003, Dr. Wiltz held the position of Medical Director since his arrival at Teche Action Clinic in 1982, as part of an obligated service to the National Health Service Corp (NHSC). Dr. Wiltz is a native New Orleanean. He did his medical school training at Tulane University School of Medicine and while at Tulane he incurred his three-year commitment to the NHSC. Dr. Wiltz’s three-year commitment has turned into a lifetime commitment to the people that he serves in Franklin, Louisiana. Dr. Wiltz has served in many capacities on a local, state and national level including the Chairman of the Area Health Education Centers (AHEC) of Louisiana, Chairman of the Louisiana Primary Care Association, Board Member and Chairman of the National Advisory Council for the NHSC, he also served on Former Governor Mike Foster’s Health Care Transition Team and most recently served on Governor Kathleen Blanco’s Health Care Transition Team. Dr. Wiltz and Teche Action Clinic are frequently referred to as the model for the state and possibly the nation for delivery of health care in a community health center setting. While his service and recognitions are far to many to name, some include: Medical Director of the Year 1994-95 by the Louisiana Primary Care Association. He was chosen as of only ten recipients nationally selected for the Robert Wood Johnson’s prestigious “Community Health Leadership Award.” Still serving as their ‘ambassador’, Dr. Wiltz travels around the country assisting other community health centers improve services provided to their patients. In 2000, he was featured on the “Discovery Health Channel” in their presentation of “Bayou Medicine”. A family man, Dr. Wiltz and his wife Diane of twenty-eight years, are the proud parents of two adult children – Suzanne, a grad student at Loyola and Jonas, a third year medical student at Tulane.