50% rise in the mortality rate. 3 out of 9 hospitals open, with the only public one of the three stuck in temporary facilities, operating at a third of its normal capacity. 6000 physicians displaced. No mechanisms for reimbursement for any physicians that want to return. Almost no places for Louisianan medical students to train in state, thus losing the doctors of the future. These are only a few parts of the disturbing picture that is New Orleans health care after Hurricane Katrina.

Where is the state? They're enjoying a surplus in the billions, yet refusing to invest in the non-existent hospital system. 

 And where is our federal government? Well, most of New Orleans's own representatives are too busy covering themselves for either corruption or hypocrisy.

In the hopes of raising more awareness about this issue, and getting some assistance for those who actually care, I joined some fellow Columbia students yesterday on Capitol Hill to lobby on this issue. More information about the horrible situation and the lobbying trip inside.

The Louisiana health care system was flawed even before the storm hit. It is a two-tiered system, with insured residents using private hospitals, and uninsured residents using public hopsitals. In the New Orleans area, the Medical Center of Louisiana at New Orleans (MCLNO) served almost all of New Orleans's large numbers of uninsured (In Louisiana, childless adults are not eligible for Medicare, and the many small businesses in New Orleans simply can't provide coverage for their employees). It also was the teaching hospital for the state's two main medical schools, Tulane and LSU. Finally, MCLNO was the only Level One Trauma Center in the region; the next closest one is in the north of the state. 

 Now, everyone is suffering. Uninsured residents receive almost no care at all, and even insured residents have to wait months sometimes for appointments for basic coverage. Doctors who want to treat the uninsured cannot because they simply can't afford to. And the federal funds that allowed MCLNO to treat so many uninsured cannot be used by private clinics to stand in, because Louisiana, in its never-ending pursuit to keep the poor as far away from the rich as possible, refuses to allow those federal funds to be used for private practices. The number of uninsured has risen too, as people drop insurance in order to put food on the table. And the influx of Hispanic migrant workers, filling desparately-needed reconstruction jobs, means that the language barrier has become a much more severe problem.  Finally, without teaching hospitals, Louisiana has no training for its main medical schools, which means they are losing their accreditation, which means no more new doctors (most in-state doctors trained in-state), and critical doctor shortage in a few years.

Before the storm, the system needed to be revamped. Right afterwards, many people thought that a new system could be built from the rubble. At this point, though, there just needs to be a system. There has been basically nothing there for almost two years now. Funding needs to be there. Makeovers and revamps can come later; they need hospitals now.

The state and federal governments, though, have been non-existent. The state seems to be set against funding any changes. Even when the Veterans Administration offered to pick up half the tab for a new public hospital, Louisiana refused to pick up the other half, because the money would be subject to environmental and labor standards that  the state would never burden itself to submit to.

And wouldn't this be the time when the representatives should be working tirelessly to reconstruct the traumatized city? Instead, the congressional representative, William Jefferson, is under indictment for corruption charges, and focuses his time on beating those charges instead of saving the city and people he is supposed to represent. It is disgraceful: his constituents had enough faith in him to re-elect him despite the FBI raid of his office, yet he cares only for himself while they die in the streets of that city. Representative Charlie Melancon, from the neighboring district, has had to take up the fight almost alone, and had to deal with the problems of Jefferson's district along with his own.

Yesterday, after having received briefings from Melancon's chief-of-staff, we met personally with Senators Feingold and Brown, and with staff from several other offices. Reactions came in many shapes, and were for the most part favorable, but almost every office expressed surprise at the gravity of our presentation. While no specific legislation has been introduced yet, we hope that the trip was a start that would allow the few standing up for these people to move forward on making a law. It is unthinkable how awful health care conditions are down there after two years. Please tell others about the situation, and stay tuned for more developments, as we try to get some progress done.