May 23, 2011; Source: San Antonio Express-News | Louisiana State University’s Charity Hospital was flooded and destroyed by Hurricane Katrina and remains today perhaps as important a visible icon of the devastation as the Superdome. Charity was the public hospital in the region that served the poor – like most public hospitals, regardless of their economic circumstances or health insurance.

The legislature has planned a 424-bed University Medical Center as a new public hospital to replace charity. The $1.2 billion proposed facility has been criticized as too large and too lavish, particularly as a teaching and research hospital in addition to its public hospital functions.

In an apparent split with Republican governor Bobby Jindal, Republicans in the House Ways and Means Committee decided to cut $900 million in borrowing authority that had been set aside for the new hospital. Rather than size and complexity, the opposition may really be a matter of the projected $70 million to $100 million annual subsidies that the hospital will need to operate, though LSU officials say that the new hospital will attract paying patients and insured patients obviating the need for state subsidies.

Somehow this sounds like a scenario that will play out over and over again as national health care reform staggers toward partial implementation. This is particularly true because the health reform debate was much more about insurance coverage, than health care provision and delivery. The availability of facilities and doctors to treat the inner city and rural poor is still an unresolved challenge.—Rick Cohen