March 15, 2006 — -- When floodwaters after Hurricane Katrina inundated New Orleans' downtown hospitals, it struck the final blow to an already fragile system.
Charity Hospital, the cornerstone of the downtown hospital system, was built in the 1830s and, at one time, was the largest hospital in the world. It now sits empty as the state struggles to find beds for patients elsewhere.
"The hospitals that are operating are filled to the brim," said Don Smithburg, CEO of the Louisiana State Hospital Systems, which runs Charity Hospital. "The emergency departments are clogged up with long queues that see a growing patient population."
Before Katrina, Louisiana was second in the nation in uninsured residents, according to a Department of Health and Hospitals/Louisiana Hospital Association study. Almost 38 percent of New Orleans residents were uninsured, which put a major burden on the state hospital systems.
Now, with the closure of Charity Hospital, the major care provider for the city's uninsured, hospitals outside the New Orleans area have seen on average a10 percent to 20 percent jump in the number of patients, many of them without health insurance.
In the three months following Hurricane Katrina, Louisiana hospitals provided $131 million worth of uncompensated care. Most of these hospitals, concerned about the bottom line, still await reimbursement from the federal government.
The post-Katrina labor shortage is also of critical concern, and hospitals across the state havestruggled to bring workers back. There is a huge shortage of nurses across the state, as well as technicians and support staff.
"Those that weren't significantly damaged but are trying to ramp up could ramp up more if they could get staffing," said Smithburg. "It's very hard to recruit people, to find reasonable housing nearby and a quality of life that's conducive to career development."
The Louisiana University Hospital System has done what it can to care for as many uninsured patients as it can with the staff that has returned.
It opened a triage center in the New Orleans Convention Center immediately after the hurricane and now continues to operate in an abandoned department store, treating about 4,500 patients a month in tentlike facilities.
The hospital system plans to open another acute care facility in nearby Jefferson Parish by the end of the month to try to ease the pressures on emergency rooms within driving distance of New Orleans.
Although these are signs of progress, many fear there are now more uninsured in New Orleans than ever before.
Smithburg, though, is optimistic. "We're far from out of the woods, but there are signs of progress in the interim," he said. "Our ultimate plan is to replace University and Charity [hospitals] with one hospital. We're in a cooperative planning process with the VA, which also lost their hospital during the storm."
Until then, the surrounding hospitals will have to deal with limited staffing as they battle for federal funds to cover the treatment of residents who lack health insurance.