Cause and effect in Louisiana

A major hospital in Baton Rouge, Louisiana is closing its emergency room because it is hemorrhaging money:

 Baton Rouge General Medical Center-Mid City will close its emergency room within the next 60 days, a victim of continuing red ink and the Jindal administration withdrawing the financial support that kept it open….

The closest emergency rooms from Baton Rouge General’s Mid City campus is Lane Regional Medical Center, 30 minutes to the north in Zachary, and Our Lady of the Lake Regional Medical Center, 30 minutes to the south on Essen Lane. Mid-City’s ER recorded 45,000 patient visits last year…..

More and more poor and uninsured patients from the low-income neighborhoods of north Baton Rouge ended up at the Mid City hospital, which was the next-closest facility.

Mid City hospital reported losses of $1 million a month as more and more patients who could not pay arrived…. Officials projected losses would grow larger, reaching $25 million to $30 million in 2015.

Poor people can’t pay full freight nor are they likely to be covered by insurance. There just happens to be an extremely attractive offer to get lots of poor people covered by insurance. Medicaid expansion would help safety net hospitals in high poverty areas the most. Poor people covered by insurance will either be able to pay something towards their emergency room visits or divert to lower levels of appropropriate care.

Part of PPACA’s financing mechanism was a reduction in Disproportionate Share Hospital (DSH) payments by the federal government to hospitals that served large numbers of uninsured individuals.  The program logic was simple.  Medicaid expansion would cover most poor and working poor people who are the most likely not to have been currently covered by insurance in 2010 and the most likely to not be able to pay for their treatments.  The total value of unpaid for care would drop significantly over time as Medicaid and Exchanges covered more people, therefore the need for DSH payments would decrease.  This logic was based on the assumption that all states would expand Medicaid.  And then the Supreme Court said the deal was too damn good and therefore co-ercive and made Medicaid expansion voluntary, blowing up the scheme here.

So Louisiana decided to not expand Medicaid.  Its public safety net hospitals have the same demand as before with fewer resources because of a voluntary decision by the state to fuck the poor as well as fucking over some of the largest employers in the state.  Cause meets effect.

This is the dynamic that fueled the Tennessee Hospital Association offer to pick up that state’s Medicaid expansion tab.  THA hospitals face declining DSH funds without a significant decline in the number of people who can’t afford to pay anything more than a pittance.  Medicaid expansion would have been a massive relief valve for their budgets while also helping a quarter million people live better, more stable lives.

The innumerate, paranoid reactionaries in the Tennessee legislature put a kibosh to a plan for the state to receive massive amounts of effectively free money, so the THA members will see significant financial problems in the future as their non-compensated care costs stay constant without some balancing factors from DSH.

It is this interaction of very large employers (as hospitals tend to be one of the two or three largest employers in most state legislature districts that have a hospital) and their cash flow which has a chance of creating a political dynamic that turns out Tea Baggers.  What has to happen is the THA or the any of its Confederate state compatriots have to be willing to go to war with Republican opponents of Medicaid expansion.  They have to be willing to fund primary challengers, they have to be willing to fund general election challengers, they have to be willing to withhold funds from incumbents that they’ve previously been friendly with if Medicaid expansion is one of their top two or three priorities.  If it is not, the Southern poor are fucked.

93 replies
  1. 1
    satby says:

    If it is not, the Southern poor are fucked.

    Of course, that’s the point of refusing to expand Medicaid, isn’t it?
    Feature, not bug.

  2. 2
    Schlemazel says:

    If the poor had health insurance it would just encourage them to get sick. Then they would become dependant on the healthcare ‘handouts’. Far more humane to allow them the freedom to develop resistance through self-reliance.

  3. 3
    Richard Mayhew says:

    It is only a feature if kicking the poor occurs while all of the in-power elites aren’t getting kicked as well. Medicaid non-expansion combined with declining DSH payments means some of the in-power elites are either currently getting kicked or can see a Size 12 boot coming for them in the near future.

  4. 4
    I'mNotSureWhoIWantToBeYet says:

    Wasn’t this dynamic – “of course states will pass Medicaid expansion because hospitals in poor areas are hemorrhaging money, and it’s free federal money (from taxes already collected in the state and sent to the feds)” – there from the beginning? Something else must be going on for these hospitals not to have been in torches-and-pitchforks mode already. What is it? Do these hospital administrators have a secret desire to use the continuing crisis to squeeze their nursing and support staff even further (“sorry, you’ve got to work 18 hour shifts now with no overtime – we can’t afford more people”)?

    Is it lingering shock among the hospitals that they can’t believe that they’re in this predicament, and figure sometime soon the states will come to their senses, so they don’t want to piss off the legislatures?

    It doesn’t make sense. There must be some other reason that there’s been so little push-back from the hospitals. A lot of “free” money is sitting on the table and that’s usually a nearly unbeatable motivator.

    What are we missing?



  5. 5
    MomSense says:


    Going hungry, getting sick are character building for poors but those jerb creators need lots of incentives and breaks.

    It’s such an obvious scam that the American electorate keep falling for.

  6. 6
    Richard Mayhew says:

    @I’mNotSureWhoIWantToBeYet: I think a couple of things are going on.

    1) Class/political solidarity at the C-level as most hospital execs are conservatives and a decent number are reactionaries

    2) An expecation that this was too damn obvious to need intensive lobbying

    3) An expectation that some hospitals will close and there is value in grabbing a bigger portion of a smaller pie

    4) Medicaid expansion is one issue of dozens that a hospital has to concern itself with its state regulators. Is it worth burning relationships with the Republican Party when the hospital needs something else from them… so it is a prioritization issue.

  7. 7
    Elizabelle says:

    Call these the Justice John Roberts Hospital Closings.

    His family gets great medical care. Yours? Not so much.

    Richard: I think you should submit this essay (rework it a little, if needed) to Louisiana newspapers in the vicinity, and maybe to some alternative weeklies.

    Or maybe a letter to the editor. Fight idiocy with information.

    It won’t work on the idiots, but it might wake some people up.

  8. 8
    Steeplejack says:

    @Richard Mayhew:

    Should be “is hemorrhaging money” in your first sentence.

    I’ll put the kibosh on my backseat driving now.

    Another excellent piece, by the way.

  9. 9
    WereBear says:

    @satby: The Southern poor are always so. It’s baked in.

    We were watching Ken Burn’s The Civil War this past weekend, and discussed some of the dirt poor Confederate soldiers profiled therein. A culture-wide scam does not allow too many escape hatches, and keeping them malnourished and badly educated undercuts any cleverness further.

    Yes, the slaves had the ultimate raw deal. But these white guys were getting mangled and dying for a system that afforded them a deal only slightly seared on both sides.

  10. 10
    Iowa Old Lady says:

    I have to admit I thought hospitals would prevail. I figured Baylor would get Texas to accept the expansion for instance. I guess there’s just too much fun in beating up poor people. Rs–the party that can’t resist a fight in which they get to punch down.

  11. 11
    Baud says:

    Won’t this force the poors into the upscale hospitals for emergency treatment? Does nobody value segregation in the South anymore?

  12. 12
    Richard Mayhew says:

    @Steeplejack: yep — that is what happens on a pre-first cup of coffee/typing on my phone on the bus post :)

  13. 13
    Tommy says:

    Did I read that correctly that Baton Rouge does not have an emergency room?

  14. 14
    Richard Mayhew says:

    @Tommy: I don’t know my Baton Rouge geography, but it sounds like there is one on the southside of town or just over the city lines.

  15. 15
    MomSense says:

    @Iowa Old Lady:

    I thought the hospitals would prevail up heah in Maine, too. I was wrong.

  16. 16
    Elizabelle says:

    NYTimes today on Piyush Jindal, the Sam Brownback of the Gulf Coast: Governor’s Tactics at Center of Louisiana Budget Vortex

    “Since I’ve been in Louisiana I’ve never seen a budget cycle as desperate as this one,” said Robert Travis Scott, the president of the Public Affairs Research Council, a nonpartisan group based in Baton Rouge.

    Louisiana’s budget shortfall is projected to reach $1.6 billion next year and to remain in that ballpark for a while. The downturn in oil prices has undoubtedly worsened the problem, forcing midyear cuts to the current budget. But economists, policy experts and lawmakers of both parties, pointing out that next year’s projected shortfall was well over a billion dollars even when oil prices were riding high, turn to a primary culprit: the fiscal policy pushed by the Jindal administration and backed by the State Legislature.

    …. In a phone interview, Mr. Jindal defended his record, attributing “the vast majority” of the shortfall to the downturn in oil prices and insisting that a shrunken state government was the goal, not an unfortunate side effect.

    “We made an explicit decision and commitment that we were going to cut the government, the public sector economy, as opposed to the private sector economy,” he said, adding that per-capita income in the state is at its highest. “We made the intentional policy decision we think it’d be better to shrink government and cut taxes. That’s unusual for Louisiana.”

    Pelicans, meet roost.

    Lucky Louisianians. Oh, and David Vitter is leading contender to replace Piyush.

  17. 17
    I'mNotSureWhoIWantToBeYet says:

    @Richard Mayhew: Yeah, the upper management too-often being Galt-wannabes probably has something to do with it.

    I wonder if they’re also thinking, “well, if it gets bad enough, we can get the Teabaggers to repeal the Reagan-era “hospitals that accept Medicare must treat and stabilize anyone who shows up at the ER door” rule (EMTALA) (because we obviously can’t afford it anymore)”.

    That would also solve the problem that Baud pointed out in #11 above. Everyone (who matters) wins!!1



  18. 18
    satby says:

    @Richard Mayhew: Aren’t most hospitals now part of larger “health care systems” of hospitals? I think they see this as a triple: they get to close money losing outlets while squeezing their staff by making the jobs in the area more competitive and knowing full well that lots of those people will never end up going to the hospital further away because they won’t be able to. If this causes unneeded suffering and some premature deaths, too bad. Gotta break a few eggs for the profit omelet.

  19. 19
    Tommy says:

    @Richard Mayhew: I know the city pretty well and I can’t wrap my mind around there isn’t another ER in the entire town. It is the freaking state capital. That hospital in the news story is one trek from the University. If you really, really needed an ER, because I don’t know it is an emergency, I could see folks dying trying to get across town to it.

  20. 20
    Schlemazel says:

    Because I enjoy drawing parallels between now & the antebellum South I’ll point out the train of thought then that is so recognizable today.
    1) You have it good because you can’t be sold so don’t bitch
    2) If you work hard & mind your business you too can own humans one day
    3) Without slavery you have no chance of advancement and you would be no better than those people

    You can almost hear Ayn Paul saying it, can’t you?

  21. 21
    Steeplejack says:

    @Richard Mayhew:

    Jeez, now I’m impressed that you banged that out on your phone. I hate typing anything longer than a short text on my phone, and if I absolutely have to answer an e-mail when I’m out and about it’s usually just “Got your message. I’ll get back to you later.”

  22. 22
    Elizabelle says:

    More on Hurricane Piyush, and what he and the legislature are inflicting on Louisiana:

    A movement to re-examine tax credits and exemptions — which quickly add up to over $1 billion a year — has been gaining steam in the Republican-controlled Legislature. But Mr. Jindal is firmly against any changes that would result in net new revenue. Last year he even vetoed a bill that would have required the state to tally up the costs of tax expenditures on the grounds that it could “create uncertainty about the state’s commitment to job creation and economic development.”

    … With revenues limited, Mr. Jindal has turned to privatization and cuts to balance the budget, commended by some policy experts as corrections to a bloated government and roundly condemned by others as shortsighted.

    Louisiana’s higher education budget, one of the few discretionary targets, has been slashed by more than just about any other state since 2008; there are a thousand fewer full-time college faculty members on the state payroll, and next year Louisiana State University, the state’s flagship institution, is facing a potential 40 percent cut in its operating budget. Cuts to health care proposed for next year, when compounded by the loss of matching federal dollars, could approach $1 billion. [Richard’s fine point.]

    But deep cuts like these have not closed the gap before, leaving Mr. Jindal to turn to other sources of revenue. The use of ad hoc money to plug holes is by no means a new practice here, but it has rarely been done on this scale: Trust funds for infrastructure and the low-income elderly have been sapped, buildings sold, tax amnesties repeatedly declared, legal settlements spent and reserves drained.

    Governor Jindal. Drowning his constituents, in their own bathtubs if they’re so lucky.

    Someone should go to jail for mismanagement on this level. I include legislators in that too.

  23. 23
    Tommy says:

    I guess this would be a good example of it is nice living in a “blue” state and even more of a “blue” district. The big hospital in my little part of the rural midwest is building a new, state of the art hospital. The next time I see a news story and somebody bitches about the permits or this or that I will have to send them this article and note at least we have two ERs near us.

  24. 24
    Baud says:

    Thank God a spoonful of Obama hate cures all that ails ya.

  25. 25
    WereBear says:

    @Schlemazel: You can almost hear Ayn Paul saying it, can’t you?

    Yes. In the words of my favorite lawyer, Vinny Gambini: Dead on balls accurate.

    I know they’re not geniuses, and the system was stumbled upon over centuries of successful oppression. But it’s fiendishly efficient: create layers of poor, so the ones on top will kick down for you.

  26. 26
    ET says:

    But didn’t that Republican congressman say a year or so ago that the poor didn’t need insurance because they could use the emergency room?

  27. 27
    Tommy says:

    @Elizabelle: I went to LSU. Loved the place. Later I would work with people that went to Harvard or Yale and I always noted I’d put my education I got there up against their education any day of the week. As your article you quoted said it is a “Flagship.” I shutter to think how many millions in research grants go through the place on a daily basis. Heck it is the only land and sea grant college in the US. I have no idea how they can/will keep the top professors if their budget gets gutted by 40%.

  28. 28
    pluege says:

    I don’t understand why wrongway republican governors like jindal aren’t charged with criminal misconduct and purposeful endangerment for their refusal to allow tens of thousands of people in their states to have life-saving medical insurance purely on their basis of their ideological whims. A clearer case of crimes against humanity would be hard to find.

  29. 29
    xenos says:

    @I’mNotSureWhoIWantToBeYet: the only people who wind up running these non-profits are the independently wealthy. They work as unpaid or barely paid employees for years, until their political allies get a chance to elevate them to a healthy position. Maybe they don’t care about the public welfare Because they have never cared.

  30. 30
    WereBear says:

    @pluege: It doesn’t happen when General Motors does it, so why should a Governor worry?

  31. 31
    Tommy says:

    @pluege: Say what you will about Huey Long, but he must be turning over in his grave at what Jindal has done to the state. Huey was about as corrupt as you can get, but he made the companies (and those that ran them) making billions off the state pay taxes and he built much of the infrastructure that is still used today. Willing to bet he built Baton Rouge General Medical Center-Mid City. But then again he was a true believer in populism. He actually felt “poor” people mattered. His core constituency.

  32. 32
    RSA says:

    Cause and effect in Lousiana
    A major hospital in Baton Rouge, Lousiana…

    Things are lousy, yeah. (Typo alert.)

  33. 33
    Lurking Canadian says:

    @I’mNotSureWhoIWantToBeYet: I think that’s been in the background all along. Back during the debate over ACA, I kept seeing the argument, “Why don’t they get that we’re ALREADY paying for the health care of the poor at the emergency rooms, so this’ll be cheaper.”

    If you are sadistic enough and don’t object to (or enjoy) stepping over the corpses on the sidewalk, the way to save that money is obvious.

  34. 34
    azlib says:

    In AZ I always thought we got the Medicaid expansion because of the hosiptal lobby. It did cause a fissure in Republican ranks, though. Our Gov only got the bill passed with Dem support. There is still a lawsuit out there to nullify the legislation.

  35. 35
    Elizabelle says:

    @Tommy: Thought of you when I saw the LSU budget cuts.

    You cannot cut and gut your way to prosperity. It did not work in Kansas, it’s not working in Louisiana, and now people are even losing their ER care.

    30 minutes makes a huge difference in an emergency.

    Plus: they are traveling on Louisiana roads, are they not? State is famous for having roads in poor condition; I cannot speak of Baton Rouge’s.

  36. 36
    Tommy says:

    @Lurking Canadian: Exactly. I am not a rocket scientist (clearly). But it is very clear to me it is far cheaper both in the short term or long term for everybody to have access to health care. Cheaper for a person to be able to go to a doctor, get treatment needed, then not do that and wait until the ER is the only option.

    I’d go even a step further. My father had a mild heart attack years ago. They put in a stint and told him he needed to change his diet and put him on a few pills, including Lipitor which isn’t “cheap.” I am sure it would have been cheaper in the long term for his health provider to hire a chef to come to his house and teach my mom and dad how to cook better. Buy him a treadmill.

    Help him change his lifestyle so he doesn’t need to take those pills daily he has been taking for the past 15 years.

    Or I guess what I am saying is I want our health care system to work for us not to get sick in the first place. I know, radical idea :)!

  37. 37
    kc says:


    Richard: I think you should submit this essay (rework it a little, if needed) to Louisiana newspapers in the vicinity, and maybe to some alternative weeklies.

    Or maybe a letter to the editor. Fight idiocy with information.

    I was thinking the same thing.

  38. 38
    dp says:

    @Tommy: East Baton Rouge Parish now has four emergency rooms. The problem is that they are now spread around the suburban periphery, as the two central ERs have now closed in the last two years.

    This is all a direct result of Bobby Jindal’s healthcare policy. The first one (state-run) was shut down, now this one can’t keep the lights on due to Medicaid expansion rejection. It really puts the lie to the Republican claim that “anybody can get health care by showing up at the ER.”

  39. 39
  40. 40
    dp says:

    @Tommy: Well, you should see what Bobby is doing to LSU as well. It ain’t pretty.

  41. 41
    Tommy says:

    @Elizabelle: There is a part of me that isn’t that sorry. I went to grad school at LSU. My father got his PhD there and taught there. We have a lot of friends that still teach at LSU. After Katrina hit many of them were firing off emails to us saying Jindal (and these are mostly moderate to liberal people) was about the only politician in the state with a clue. They’d vote for him any chance they had.

    I had not heard of the guy so I went to Google. Took about 10 seconds to realize this was not a person I liked that much. I recall telling them to be careful. This guy isn’t your friend. I went as far to tell them there would be a day I’d recall their “love” of Jindal and say I told you so.

  42. 42
    WereBear says:

    The Deep South still has a plantation mentality; these lesser beings just have a habit of catching hookworm and will die anyway.

    Look at the former Confederacy and we see utter indifference to most of their citizens because they don’t have the Northern model of educating workers to contribute to an economy based on creation and innovation. (Exported to the West Coast, by the way. The movie industry was founded by mostly Jewish people from the New York City ghetto culture. Silicon Valley would never have sprung from the kinds of public high schools they have in Mississippi.)

    The Confederate mindset is based on the extraction of brute labor until broken bodies go away, by the cheapest means possible. They create franchises built on cheap labor, they expand into empires based on goods made under serf conditions, they shamelessly and parasitically feed on the brains of the rest of the country while ruthlessly suppressing the equally good brains in their own area, lest they “get ideas.”

    All to keep the good ol’ boys playing at gentility while they cut each other’s throats. They love this system. It’s the only kind they could possibly thrive in.

    So no, expecting sense from them is never going to work, because they never use it. Despite what they say, they don’t want a thriving economy or new industries or an educated populace or an egalitarian society.

    Or they would do that. It’s really not hard to do, it really isn’t. It’s just that in places like Louisiana and Mississippi and Alabama and South Carolina and Arkansas, people don’t get into power by wanting to do that. So they do not.

  43. 43
    raven says:

    @WereBear: Yea and in 1964 MLK said people from Mississippi needed to come to Chicago to learn how to hate.

  44. 44
    Manyakitty says:

    @satby: Yep. Beat me to it. All part of the systematic program to keep “those people” in their place.

  45. 45
    Mr Stagger Lee says:

    @Elizabelle: Where have you gone Huey P Long? the bayou casts it’s suffering eye to you, ooo oooo ooo. what did you say Mrs Robinson, the Kingfish was shot and passed away, hey hey hey.

  46. 46
    Tommy says:

    @dp: No it isn’t. I went to grad school at the Manship School of Mass Communications. The Manship School has a huge plus, donors with deep pockets. The Baton Rouge Advocate, the major paper, is owned by the Manship family (along with a lot of other media outlets). I used to be pretty close with the Dean (he has since moved on) and he told me they had long ago felt the University itself couldn’t support all they wanted to do. They’d “roll their own” and get the money they needed from donors. They did just that.

    I might argue that the Manship School along with places like USC and Columbia have some of the best communication programs in the world as it relates to “new media.” They did it on their own. I find this both amazing (in a good way) and amazing (in a bad way, they have to do it this way).

  47. 47
    WereBear says:

    @raven: True. But people fled TO Chicago for a reason. And the hate was because they were more successful there.

  48. 48
    raven says:

    @WereBear: The hate was because people in Chicago are just as racist as anywhere else.

  49. 49
    dp says:

    @Tommy: It’s an excellent university (knock on wood), and the Manship School is one of the best. The problem is that it’s been cut to the bone already, and bigger cuts are on the way. It’s difficult to see how it will survive in its current form, without lopping off whole departments. Sad.

    You (and I) were right about Jindal. It’s just sad to see that prescience come true (and it’s actually worse than even we nay-sayers predicted), no matter how much the electorate asked for it.

  50. 50
    WereBear says:

    @WereBear: I’m not bashing the Democrats in the South; I used to be one of them. And of course there are Athens, Georgias and Austin, Texases.

    But I lived ten years in the South and never made a single African-American friend. In the North, I had many.

    Because it wasn’t dangerous for them to be friends with a white woman in the North.

  51. 51
    SP says:

    When there was a Black Lives Matter protest in Boston that blocked a highway and an ambulance had to be detoured there was a huge fit about the irresponsibility of protesting even though the patient was fine. But don’t you dare suggest that Republican policies will kill people.

  52. 52
    Tommy says:

    @raven: @Mr Stagger Lee: I mentioned Huey in another comment. Louisiana needs another populist. The state has so many resources. People might think of Louisiana and tourism, but 30% of our energy comes through the state. Close to 40% of our seafood. Take the Port of New Orleans and the Port of Mississippi as a pair, and it is the largest port in the world. If it wasn’t for that, nothing we grow in the field in front of my house in Illinois, corn, would go to a world market.

    The state shouldn’t always fall just a step up from Mississippi on this or that thing.

    Louisiana should be “rocking and rolling.” It isn’t IMHO.

    They need a modern day Huey ….. minus the grifting!

  53. 53
    peach flavored shampoo says:

    I could see folks dying trying to get across town to it.

    Quite certain that’s a feature, not bug.

  54. 54
    rikyrah says:

    yes, this is the consequences of GOP actions.

  55. 55
    GregB says:

    Today’s Republicans look to pre-conversion Ebenezer Scrooge for their moral guidance.

  56. 56
    Punchy says:

    Louisiana State University, the state’s flagship institution, is facing a potential 40 percent cut in its operating budget

    /Jaw hits floor

    How does LSU deal with this? Cant fire tenured profs, can’t just close all the dorms, can’t fire all the campus police officers….seriously, do they raise tuition by 40%?

  57. 57
    Starfish says:

    @Baud: No. The poor don’t have cars and can’t drive to upscale hospitals.

  58. 58
    dp says:

    @Tommy: He exists. His name is John Bel Edwards.

    The problem is getting him elected.

  59. 59
    Face says:

    @Punchy: If LSU really wanted to make a statement about how screwed they are by JIndal’s budget, they’d axe the the football program. The populace would burn Jindal’s office. They’d literally run him out of office. He’d need to hire dumptrucks to deliver cold cash to the football stadium to keep his job.

    As long as Les Miles still puts out a team, however, nobody in LA gives a shit about LSU eliminating their engineering and biology programs.

  60. 60
    Fred Dickinson says:

    Medicaid expansion is putting a band aid on a motherfucking shotgun wound.

    ObamaCare is nothing more than a crony corporatist cock sucking , leaving for profit healthcare with all its bloodsucking in place.

    Heathcare based on need, not profit, should be the slogan of the Left. ObamaCare, Medicaid expansion or no, leaves corporate criminals in charge of the health of human beings .

  61. 61
    gene108 says:

    @Iowa Old Lady:

    I figured Baylor would get Texas to accept the expansion for instance. I guess there’s just too much fun in beating up poor people.

    I view it as a calculated political risk by Republicans. When people get angry over hospital closing, who are they going to blame? The state government or President Obama?

    Given our failed media experiment, I’d say there’s enough people who will blame President Obama and reward the Republicans in state government that it is worth the risk of any potential blowback, if voters figured out who was actually responsible.

  62. 62
    NonyNony says:


    Cant fire tenured profs

    This is untrue – at most universities even tenured professors can be laid off in the event of funding issues at the university level. Other universities have done this in the past. Firing a tenured professor for cause is hard and requires a lot of work and process. Laying off a whole bunch of tenured professors all at once due to budgetary issues is much easier.

    I suspect that Jindal et. al know this and this is intentional – a way to try to force the state universities to lay off professors and replace them with untenured poorly-paid part-time and full-time instructors.

  63. 63
    Elizabelle says:

    @Tommy: The NYTimes article addressed that. Piyush began his governorship awash in a budget surplus and federal money from Katrina and Rita.

    Mr. Jindal’s first term began in 2008 with a heady surplus of around $1 billion, high oil prices and a stream of federal disaster recovery money. He threw his support behind the largest tax cut in the state’s history and, for a time, had reason to boast about an economy that outperformed the nation’s. But oil prices are fickle, and the recovery money dried up and the recession arrived, if late and in a milder strain than in other states. Since 2010, here as elsewhere, middling has been the new normal.

  64. 64
    RSA says:


    How does LSU deal with this? Cant fire tenured profs…

    Actually, they probably can. Tenure provisions, most places I’ve looked at, allow for professors to be fired if big organizational changes are required (maybe only as a result of funding changes, but I don’t remember). So if LSU has to absorb that hit, it might in principle do it by closing down the college of engineering or of agriculture, or maybe individual departments.

    ETA: @NonyNony got there before me.

  65. 65
    Bobby B. says:

    “Sire, the peasants are revolting!”
    sniff “I’ll say!”
    Bel Edwards? You sure you want a southern Catholic in there?

  66. 66
    Violet says:

    @dp: That’s a hard to read website. Tommy should offer his services to this guy. The thin white text on the blue background? Blurs together. Front page has no actual picture of him except a thumbnail near the bottom–requires scrolling to see it. There’s a video but I’ve got Flashblock on my browser so I don’t see it. Having the only picture of you on the front page of your website be in a video is not a good idea.

  67. 67
    Elizabelle says:

    @Face: I wish that LSU had the (courage) balls to suspend their football program until the university is better funded. Make Louisiana own that. These Tigers run on brains, and that takes public investment. And YOU, Ms. and Mr. Taxpayer, are the investors.

    Get tired of these big sports team grafted onto a school. It perverts the mission.

  68. 68
    D58826 says:

    @Schlemazel: OR DIE QUICKLY!!!!

  69. 69
    NonyNony says:


    by closing down the college of engineering or of agriculture


    I think you mean by cutting down the colleges of art & design, humanities & social sciences, and music & dramatic arts. They won’t scrap their engineering or agriculture colleges because those are going to be bringing in far more in grant money, student tuition dollars, and alumni donations than the others. The STEM related colleges aren’t completely safe, but they’ll be on the chopping block sometime after the humanities and liberal arts departments have all been replaced by non-tenured instructors.

  70. 70
    Jado says:


    Magical thinking.

    “Sure, the guy we are donating campaign money to SAYS he won’t expand medicare, but nobody’s THAT stupid, right? He’ll do it. And besides, our other option is a DEMOCRAT. Can’t have that.”

    And so these big hospitals get hoist on their own petard, but they carry all those poor people with them to get hoist as well.

    Way to go, conservative lunatic racist hospital administrators.I hope you all get fired.

  71. 71
    Elizabelle says:

    @Tommy: Need to find out what Jindal was doing before his turn as governor. Was he budget director? Katrina hit in 2005; he was elected in 2008.

    One forgets that Bobby Jindal had a reputation as a technocrat and a smart one (he was a Rhodes Scholar) early on.

    Excellent Politico magazine piece by writer Tyler Brooks. Governor Jindal propped up his early years with federal largesse — hello, Katrina money — but took Grover Norquist’s idiotic pledge and stuck to it. And so has been sticking it to his constituents, on principle, and a discredited one at that.

    In 2003, as a private citizen running for governor (he narrowly lost), Jindal promised to “oppose and veto all efforts to increase taxes.” This was part of the bargain he agreed to when he took the pledge—the shorthand description of the Tax Protection Pledge hawked by Americans for Tax Reform, the group headed by anti-tax zealot Grover Norquist. As governor, he has taken the “no tax” commitment to such lengths that in 2011 he vetoed legislation supported by dozens of Republicans that sought renewal of a 4-cent portion of the state’s 36-cent-per-pack cigarette tax, the country’s third lowest. “His only reason is that he’d taken the crazy position that if you renew a tax or suspend an exemption it was a tax increase,” said state Rep. Harold Ritchie, a Democrat and smoker who sponsored the measure. Lawmakers found a way to approve it without Jindal being able to exercise a veto.

    …. Jindal has plenty of defenders in Louisiana. “The majority of voters think they pay enough taxes,” said state Rep. Lenar Whitney, a Republican from south Louisiana who is also the party’s national committeewoman. “I’d rather cut the size of government than raise taxes.” The conservative Tax Foundation ranked Louisiana as having the 46th lowest tax burden as a share of state income. Louisiana also scores at the bottom in education and health care.

    The pledge wasn’t an issue when Jindal became governor in 2008 and the state had a healthy budget surplus thanks to the taxes produced by massive federal government and private insurance spending following Hurricane Katrina and Hurricane Rita. The state legislature cut income taxes for higher-end earners by a total of about $700 million per year. Jindal was not an initial supporter, perhaps because of warnings that the surplus would not last as the outside spending tapered off. He went along with the plan, though, and now takes credit for it.

    Read more:

  72. 72
    Elizabelle says:

    More from same Politico magazine article: Bobby Jindal’s Troubles at Home

    In December, Jindal had a 41 percent approval rating, according to SMOR Louisiana Report, an independent state poll. Analysts say voters think he has cut too much and been inattentive to the state’s needs while pursuing his national political ambitions. On a per-student basis, Jindal’s cuts to the public colleges and universities have been the deepest of any state over the past eight years, according to the Center on Budget & Policy Priorities. Raising tuition—which does not count as a tax increase, although the effect is the same—has filled most of the gap. Tuition at the public institutions will be 90 percent higher in 2015 than when Jindal took office.

    Read more:

    About the Politico writer: not the usual hack:

    Tyler Bridges, a freelance writer based in New Orleans, is a former Nieman Fellow and reporter for The Miami Herald and The Times-Picayune. He is the author of The Rise of David Duke and Bad Bet on the Bayou: The Rise of Gambling in Louisiana and the Fall of Governor Edwin Edwards.

  73. 73
    Elizabelle says:

    Last from Tyler Hicks’ excellent article:

    Bobby Jindal is even balancing the budget on the backs of cats and dogs.

    A $25 payment to get an Animal Friendly license plate, for example, hasn’t gone to spay cats and dogs—as many people believe—but instead has provided a total of $30,000 for the budget.

    Read more:

  74. 74
    Punchy says:

    @RSA: Didn’t know they could fire profs for budget issues. So I learned something today. From Balloon-Juice, of all places.

  75. 75
    kilgore trout says:

    @Schlemazel: A blue font is used to denote sarcasm,I have to assume you meant to use it as only a fool could believe that
    Health insurance encourages people to get sick….

  76. 76
    dp says:

    @Face: The problem with that is that the football team makes a profit, which is being used to subsidize academics to the tune of $7,000,000 a year or so.

  77. 77
    dp says:

    @Bobby B.: He beats the hell out of the one we’ve got, and the ones we’ve had for the last fifty years or so.

    He has been a voice in the wilderness opposing Jindal, until the effects of Jindal’s policies started becoming apparent and his popularity went through the floor.

  78. 78
    Richard Mayhew says:

    @Fred Dickinson: Ok, tell me how to get there given how the US is full of multi-veto positions, neither political party supports a nationalization of healthcare, and the exisiting providers would either need to be bought out or completely replaced.

  79. 79
    NonyNony says:

    @Richard Mayhew:

    If anyone knows the location of a lamp that will provide three wishes, I am willing to chip in to pay for the services of a plucky young thief with a heart of gold to go retrieve it.

  80. 80
    Berial says:

    I haven’t read the other responses but I just have to add:

    If it is not, the Southern poor are fucked.

    This is technically correct but should read:

    If it is not, the Southern poor are even MORE fucked.

    You can’t look at the way Southern poor are treated and think it’s unintentional by the way.

  81. 81
    Sister Rail Gun of Warm Humanitarianism says:

    @kilgore trout: Perhaps you don’t realize that this blog doesn’t allow font tags in comments?

  82. 82
    Berial says:

    @Face: MUCH TRUTH in your post. WAY too much.

  83. 83
    Woodrowfan says:

    the Southern poor are fucked.

    and this is a change from the way things have been since 1607 how????

  84. 84


    I think you’re missing WereBear’s point — she’s talking about how Southern culture fucks over poor WHITE people and keeps them as oppressed and ignorant as possible. And the way they do it is by telling poor whites that they may be poor, and their lives may suck, and they may die of preventable causes, but at least they’re not niggers. And poor whites buy into it every. single. time.

  85. 85


    Meanwhile, Californa is on track to have a $4 billion surplus:

  86. 86
    Stanton Fink says:

    @Richard Mayhew: Effectively, Governor Boobie Jindall is cutting other people’s noses off to spite Obama. That this will result in a body count is beyond Governor Boobie’s concerns, which lie squarely and solely with pleasing the Christian plutocrats who finance him.

  87. 87
    seefleur says:

    And based on LePlague’s insistence that state income taxes MUST be cut or he’ll have a(nother) temper tantrum, Maine is going to end up like KS with a huge deficit. So much for “as Maine goes” – we seem to be following the Koch playbook to a T. I cannot fathom what the hell the voters were thinking when they re-elected this bombastic bozo… at this rate, by the time I can retire, I won’t be able to.

  88. 88
    RSA says:


    I think you mean by cutting down the colleges of art & design, humanities & social sciences, and music & dramatic arts. They won’t scrap their engineering or agriculture colleges because those are going to be bringing in far more in grant money, student tuition dollars, and alumni donations than the others.

    Yeah, my suggestion was somewhat tongue in cheek. At my public university we’ve had a long series of annual cuts or freezes in funding from the state. After one cut was announced a couple of years ago, one of my colleagues suggested that the administration should announce they were shutting down the colleges that bring in the most external funding, attract the most interest ($) from alumni, and are the main driver for the university’s reputation. All for leverage. But yeah, all of the alternatives you suggest are much more likely targets, even though they’re typically less expensive to run than STEM departments and colleges, I think.

  89. 89
    Tenar Darell says:

    @Richard Mayhew: I just keep thinking, “it’s an Emergency Room!” I am now wondering how many people with gold plated employee sponsored coverage will have treatable accidents, CVA’s, brain tumors, and heart attacks yet die, because there are no nearby emergency rooms in a city! /shock shock shock

  90. 90
    Tenar Darell says:

    @Richard Mayhew: Addendum:
    Everyone is effected when an Emergency Room closes. Doesn’t matter if you’re rich or poor, if you’re not close enough to emergency care for some things you are dead dead dead. Why is this so difficult to explain?

  91. 91
    Davis X. Machina says:

    Doesn’t matter if you’re rich or poor, if you’re not close enough to emergency care for some things you are dead dead dead

    No revolution without martyrs.

  92. 92

    […] Richard Mayhew: "A major hospital in Baton Rouge, Louisiana is closing its emergency room because it is hemorrhaging money…" […]

  93. 93
    Procopius says:

    @WereBear: Not all of them were so willing to put their lives on the line. Look up “the Free State of Jones.” I’ve seen something about Texas at the time, too, but don’t remember the area. There was a reason the South had to institute conscription. Also the Income Tax.

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