Kevin, M.D. - Medical Weblog

As much as I sympathize with these physicians, I'm not sure what grounds they have for a lawsuit. The state will argue that it doesn't "owe" these doctors anything, and claims of contractual or social obligation will be very tenuous at best. All charity care comes out of the doctor's pockets. Post-Katrina there has been no incentive--in fact, only DISincentive--to provide charity care for the poor and uninsured.
Clearly, an inexcusable situation, but until the government can be convinced to pony up, that's how it is.
Katrina has created a dangerous precedent where post-disaster, physicians may (and probably should) feel that they can't shoulder the burden of charity care, and simply refer all of these patients to the free clinics or the ER. We're willing to see the poor and uninsured, but not at the expense of the financial stability of our practices.
Interesting article--thanks for posting it.
 

We need some tort reform to stop all these suits by these greedy physicians. I bet they even want it to go before a jury made up of citizens, rather than the defendants' peers from the reimbursement depts. of insurers and the like.

What an outrage. I hope to see this ridiculousness highlighted soon on Overlawyered!
 

I can't think of a single good reason for the government to be in the business of providing health care. But since government derives its powers and mandates from the will of the people, if people want this then they can have it. The only hurdle left is for the people to pay for what they want. What is truely daft is the present hybrid system where some of the people are medical wards of the state, while others who cannot afford all the health care they would like are not wards of the state.
Jadem das Seine, to each what he has earned. We just need to learn to do what every other business does, which is to cut off charity care before it becomes a crippling burden.
 

To put the West Jefferson docs situation in perspective, one needs to consider the local conditions:

The docs are not accustomed to large indigent loads as Louisiana had a Charity hospital from the 1730's until Septermber 2005 to which the poor were acustomed to going.

Ochsner has gobbled up nearly all other hospitals in the area and now has a near monopoly position--but thier docs are employed by the hospital essentially meaning that the subsidy that flows to the hospital to help with indigent care also is a support their income. Given that, it is understandable that, from their perspective as the only people left out as the money is passed out, the West Jeff docs feel picked on.

Neither of these facts compell on to take their side of course. If others are feeding at the public trough unjustly, that doesn't give them the right to do so. It is ironic however that the government is willing to extend all sorts of subsidies to attract new docs to the gulf coast and spend gazillions of dollars to erect shoddy temporary clinics with rotating temporary volunteer and federal physicians, when relatively minor financial assistance to established physicians whose business is struggling with the new post-hurricane world would yield more fruit in keeping access to services.

Failing to provide a subsidy is not an injustice. In this case, when spending more money for the same purpose to much less effect elsewhere, it is stupid public policy.
 

Anon 7:07am--
Spot-on analysis of the situation; I've been preaching the same message for weeks now as well.
Actually, it's even a little worse than you make out: pre-existing physicians have not received "relatively minor financial assistance." It's actually been NOTHING.
The government has allocated a grand total of $2 billion to healthcare in the wake of Katrina and Rita. While that sounds like a lot, we gave $5 billion in unrestricted subsidies to the air traffic industry after 9/11.
The difference, of course, is that CEOs and well-paid lobbyists need subsidized air travel; it's only the indigent that need assistance with health care.
 

Yes your right Dr. Scott, I was referring to the SBA loans and such for all business in the area as physicians could access that.

The difference in the recovery assistance for the coast versus New York is dramatic. I think that it is a matter of how close the respective events were to the power centers. What we call national media for example, are really just the New York City local news hounds.

Over the last twenty years, there has been a marked increase in the extent to which important positions of power are held by the graduates of the elite ivy league. Take the Supreme Court as just an example. Only a generation ago we had a prominent member of the court who was not a college graduate even. With this concentration of the reigns of power in our governing and major social institutions in the hands of a regional and social elite, the problems of the plebs in the rest of the country have just become less and less real. Only things that happen in or threaten the Boston-DC axis feel real to them.
 

Another irony about the federal government, Katrina, and healthcare on the Third Coast that illustrates the "not made here" arrogance of the East Coast. They clamor incessantly for universal healthcare. Louisiana has had a working universal healthcare system (not insurance) for generations that has gotten not recognition as such, which is fine. But now the federal government is trying to take advantage of the Katrina tragedy to force the state to give up what it knows works and is affordable so they can use the state as an experienment ground for their own ideas.