New Orleans Health Care Another Katrina Casualty
Friday, November 25, 2005
NEW ORLEANS -- Campaigning here in 1936, President Franklin D. Roosevelt visited Sister Stanislaus, the revered nurse-administrator of Charity Hospital. Painting a dire portrait of a 1,800-bed facility teeming with 2,700 patients, the nun begged Roosevelt for money for a new public hospital. Three years later, thanks to $3.6 million from the federal government, Sister Stanislaus opened a new 20-story hospital, the most modern of its day.
It became one of the Unites States' most storied health care institutions, a place where Michael E. DeBakey -- pioneer of the first artificial heart -- trained, military surgeons learned how to treat gunshot wounds amid urban crime, and Mayor C. Ray Nagin, hip-hop star Master P and Democratic consultant Donna Brazile were born. But today, Charity is padlocked, another victim of Hurricane Katrina.
Some suggest the Charity complex -- including the main "Big Charity" hospital, its sister University Hospital, research labs and offices -- should be razed. Others demand it be rebuilt. And because any public hospital here -- new or old -- would be built with federal dollars, every U.S. taxpayer has financial a stake in the fight.
But the debate over Charity, once the linchpin in this city's health care system, has come to symbolize much more than a battle over a cherished relic. Providing medical care is one of the most daunting challenges for New Orleans as it rebuilds, and the choices made now will determine whether one of the nation's poorest cities can adequately care for its legions of uninsured.
Katrina damaged more than a dozen hospitals and uprooted thousands of private physicians. Now, nearly three months later, health care remains scarce. The last military medical unit in the city is gone, leaving only Touro and Children's hospitals partially reopened.
At the emergency room at Oschner Clinic Foundation in neighboring Jefferson Parish, visits are up 35 percent over this time a year ago, the number of uninsured patients has tripled and some wait as long as 10 hours for care, emergency chief Joseph Guarisco said.
But for most of the 25,000 clean-up workers -- many of them uninsured -- and an estimated 75,000 residents, health care is delivered in military tents that recently moved from a parking lot to the concrete floor of the convention center.
"Now my fear is the entire country will think it's appropriate to care for our patients in a tent," said Peter DeBlieux, director of resident training at Charity. "I don't think the rest of the country appreciates we are seeing people in a tent."
Even with the city deserted, his team sees about 150 patients a day. Many end up in the tents even though they have insurance, because they cannot find their personal physicians or cannot bear the longer waits in Jefferson Parish.
The complex dubbed "Spirit of Charity" has a lab, a pharmacy, an intensive care unit and dental stations. Charity, which had 325,000 outpatient visits last year, has even relocated its rape crisis unit, a specially trained team that stays with a patient through court proceedings -- an approach DeBlieux said increases prosecution rates threefold. Still, the makeshift operation does not meet federal standards, so Charity has been unable to bill Medicaid or Medicare.
The lack of health care -- and the ripple effects on medical education and the local economy -- prompted three House Democrats to write Comptroller General David M. Walker, warning of a "potentially catastrophic public health crisis." In the immediate term, a single bus crash or influenza outbreak would instantly overwhelm the limited number of health care providers in the city, they warned.
Over the long term, "no one's going to come [to New Orleans] without access to medical care," said Rep. Bart Stupak (D-Mich.), who signed the letter. "You will never get the reconstruction until you get some basic services like health care. If we can rebuild Iraq, we should be able to rebuild the Gulf."