E-mail a friendRep. Charlie Melancon
airdate August 7, 2007
Rep. Charlie Melancon is serving his second term in Congress representing Louisiana's 3rd District. He's a member of the Energy and Commerce and Space and Technology Committees and has introduced/co-sponsored legislation to help solve myriad problems resulting from the '05 hurricanes, which devastated much of his district. A member of the Blue Dog Democrats, Melancon previously owned several small businesses, was president of the American Sugar Cane League and served in the state legislature.
Rep. Charlie Melancon
Tavis: Congressman Charlie Melancon is the vice chair of the Congressional subcommittee looking into the healthcare situation in New Orleans. As the second anniversary of the Katrina disaster approaches, new reports indicate the city's hospitals and healthcare facilities remain substandard.
Congressman joins us tonight from Oakland. Mr. Melancon, nice to have you on the program, sir.
Charlie Melancon: It's a pleasure being with you, Tavis.
Tavis: Let me just start with this: why would we think that the healthcare system would be any better off than the rest of the city two years later? And I ask that because there's so many things that are still not right in New Orleans. Is there a reason that we should believe that this particular part of the recovery would be better off than anything else?
Melancon: Well, Tavis, in order to bring people back to the region, you've got to have the basics. Healthcare is one of the basics. If people can't feel safe coming back with their families - particularly if there's any acute ailments - they've got to have a place to be able to go and readily get treatment.
And healthcare, we've been trying to tell the Department of Health and Hospitals for two years now, and giving them the money to stand healthcare up, and they've just not ever done it. It just seems like they don't know how to do it.
Tavis: I asked that first question not out of any particularly naïveté but because I figured that might be your response, which leads to question number two, then. How is it that the healthcare system is still lagging so far behind two years later?
Melancon: Well, there's many complicated issues that are there. Reimbursements for Medicaid and Medicare, reimbursements in payments for the resident doctors that are in the med schools there, the complete loss of all the teaching facilities - i.e. Tulane University med school, the Charity hospitals system. Those two alone were probably pushing 1,000 beds in the region.
We only have about maybe one-quarter of the total number of beds. We're about two-thirds, I guess, of the population that's back in there. Average wait for emergency room doctor, eight to 10 hours. So if you really want to see a doctor quick, you get in a car and you head west; go to Baton Rouge, if you're lucky, or maybe Lafayette. And if it gets real bad, go to Beaumont or Houston and you'll still see the emergency room physician quicker than you can get an opportunity to see him in New Orleans.
The beds are being occupied by uninsureds; the hospitals aren't able to get reimbursed. There are issues that need to be addressed by DHS and CMS, and they're just not doing it.
There was an article I read yesterday about the bridge in Minnesota. What's our problem here in this country that we can't seem to respond and do things that need to be done, and do them quickly? We seem to be a government of bureaucracy and I think that's what frustrates most Americans, and that's some of the things that we're trying to address with reform of some of the Stafford Act rules and regulations.
And of course, the things that have happened in New Orleans have made us come to realize that this is not a normal disaster, and that we have to take steps that are unprecedented. And some of these bureaucrats are afraid of setting precedents.
Well, the precedent has been set; the disasters have occurred. It's time that we respond and do the things necessary to bring that region of the country back.
Tavis: I hear the point you're making, and I know these two things are inextricably linked together - that is to say, money to solve the problem and bureaucracy to get out of the way so that work can be done. But is this primarily - this particular crisis, where healthcare is concerned, or the lack thereof in New Orleans almost two years later - is it more about bureaucracy, to your latter point, or more about the lack of money for the system to be repaired?
Melancon: It's a combination of had the system - had the rules and regulations been put on the side and allow to reimburse the hospitals for the uninsured to allow for Medicaid and Medicare, to encourage the hospitals to be able to get the doctors back in, in some way, shape, or form.
But the bureaucracy didn't allow for that, so now what we've got - we're faced with is the few hospitals that are still left up and running, several of them are public hospitals - if we don't do something, like, in the next two to three months, the people that are carrying their bonds are going to start wanting foreclosure on those hospitals, or at least taking them over.
The private hospitals that are still there are struggling. Collectively, those hospitals have about $158 million of debt this year, projected over three years. It'll be well over $400 million. They opted, instead of closing the hospitals right after the disaster, to come back and serve the community that was there. Instead of collecting for the insurance coverage that they may have, if the insurance carriers would have reimbursed them, for the loss of income.
But instead they're back there and they're struggling, and the bureaucracy is keeping them - the bureaucracy is a combination of getting them the funding that is available for what they do, and opening up the rule so that they can do the things that help get them back on their feet.
We're talking about a manmade disaster when those levies collapsed; a city and a region that was underwater for the better part of six weeks going on two months. It is not an easy rebuild. It's not like you just add a fire come back and clean up; it's not like you had a hurricane came in and the water went right back out, you clean up, the people get back. It's hard to explain to people that haven't been on the group to see it.
Tavis: I was just down there a couple of weeks ago, and I've been down there any number of times over the last two years, and as you well know, certainly, since you represent the area, that a good part of the city is not up and running as yet. A number of people are still not back yet.
I raise that only because I assume that if people en masse have not returned, I assume that many of the healthcare physicians and nurses and other personnel have not returned, as well. How much is that playing into this problem?
Melancon: That's part of the entire equation. What they're having to do to bring in contract nurses and medical professionals is costing them dearly. The cost of insurance is up tremendously because of the hurricane exposure and the collapse of the levees. The entire cost of reconstruction - you name it; everything is up there tremendously, which adds to the burden of loss and also adds to the complications of getting these places back up.
For several months right after, those hospitals that were fortunate enough to have some of their professionals and physicians at state, they housed them in the first two or three floors or the top two or three floors of the hospital so that they could operate the bottom floors. And then of course when these construction workers came - and they came from all over; many of them are illegals, probably - they're out there working without (unintelligible), any insurance.
So they're getting these people that are injured, they're getting these people that are sick. They're not getting reimbursed for it. If you look at the death rate in New Orleans, it's up about 45% over the norm, and that's because there's not quality healthcare available to them. It's finding it that's part of the problem, and then once you find it it's being able to get access to it. So America has a medical problem, a Medicare problem or a healthcare problem, and New Orleans is one right now that looks like a Third World country.
Tavis: Let me ask you - and I don't mean to be negative here, but with all that you are up against, to say nothing of the persons who want to come back home - I've met many of them who want to go back, but because they need healthcare themselves or because their mother or father or loved one needs healthcare, they don't want to be too far away from them.
There are many persons who've had to make choices not to go back home, even though they want to, because they don't have those facilities, to your point, up and running. When you look at the daunting challenge that faces you again now two years later, how do you stay hopeful? How do we fix this?
Melancon: This was the reason for my pushing to have these hearings on healthcare. Two years ago, after the hurricanes, we went to DHS, we gave them the money, we gave them the authority, told them what we needed to do - we need to get Charity back up, we need to get the VA back up. We need to stand up healthcare in the region.
We need to make sure that we didn't lose the physicians. They need to have patients, we realize that, but we need to do these things to make it happen. DHS didn't do anything. They've just sat on it, as far as I'm concerned - or HHS. They have no made the effort to go forward. You've got local officials that have been telling them what they need.
You've got the citizens that have been telling them what they need, and then you've got a bureaucracy that got caught in a political situation where they're debating whether to put a Charity and a VA together, or whether to rebuild a Charity or whether to rebuild a VA, and if you're going to rebuild it, where are you going to build it and how are you going to build it?
Is it going to be clinics? Is it going to be a big building? That is the decisions we could be making, but right now what they should have been doing for these first two years is standing healthcare back up in the region, as was directed by the Congress. Now, is there hope? Yes, there is. We brought these people back in last week; we read the riot act to them.
Mr. Stupak, who is the chairman of the subcommittee - I'm the vice chair of the subcommittee - has basically told the people over at HHS, "You start answering the questions and tell us what you're going to do, and we're going to have another hearing here at the latest late September, early October. And something better have started happening down there for the good, because if not, there's going to be subpoenas."
We're going to subpoena Mr. Leavitt, we've asked him two times - and Ms. Madison, who is his assistant, who has been responsible for the work down in New Orleans that's supposed to be going on - neither one of them have chose to come before the committee yet. If they don't want to come next time, then Mr. Stupak has said we will use the power of the subpoena, and we will start getting down to the nitty-gritty of what the problems are.
And under oath, they best be honest with us, because we believe that there's some smoke and mirrors and a little bit of gamesmanship going on down there, and we don't need any of that. The people in that region are Americans, just like the people in the region of the west coast or any other place that's had disasters, and our government owes it to them to respond positively to help them get the region back up.
Tavis: Louisiana congressman Charlie Melancon. Thank you for your work, and thanks for coming on the program. Nice to talk to you.
Melancon: Thank you, it's always good talking to a Tavis.
Tavis: Thank you, sir, I appreciate it. (Laughter) And always good talking to a Charlie.
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