Political Horizons for July 22, 2012

One of the prevailing themes coursing through a five-hour informational legislative committee hearing on budget cuts to LSU hospitals was “Where’s Waldo?”.

The children’s puzzle book — called “Ou est Charlie” in French — invites readers to locate a specific fellow dressed in a candy-striped sweater amongst thousands of other people on the page images.

For both Republican and Democratic state legislators, Fred Cerise, LSU’s health care chief, played the role of Waldo as they sorted through Gov. Bobby Jindal’s plan to balance the state Medicaid budget. In late June, U.S. House Republicans had put into motion a rules change that decreased federal government contributions to the state’s program providing health care for low income, disabled and uninsured Louisiana residents for the fiscal year that began July 1.

The Jindal administration decided that the public hospitals run by LSU would bear the brunt of the cuts: $329 million or about 25 percent of the public health care system’s nearly $1.3 billion budget. A former secretary for the state Department Health and Hospitals, Cerise oversees 10 public hospitals and two medical schools in New Orleans and Shreveport.

“We have been done a disservice today that Dr. Cerise is not here,” said state Rep. Jon Bel Edwards, of Amite, and head of the House Democratic caucus.

“There’s a demonstrated history of folks from the administration coming to committee to muddy the water,” Edwards said.

Undeniably, one of Jindal’s greatest accomplishments is what political pros call “message discipline,” that is, adherence to the description of an issue that the governor wants everyone to accept, usually called the “narrative.” In the case of LSU hospitals, the narrative appears to be gallant governor turns a tough but not catastrophic budget scenario into an opportunity to “transform” the LSU hospital system.

State Rep. Patricia Smith, D-Baton Rouge, sees it differently. “We’re basically starving the LSU system and forcing them into new models,” she said at the committee meeting on Thursday.

Louisiana Health and Hospitals Secretary Bruce Greenstein replied that the “take away” is that LSU leaders can use the lack of funding as an impetus for modernization, for developing new ways to provide services. “The LSU hospital system as it’s run today is unsustainable,” Greenstein said.

LSU Board Chairman-elect Bobby Yarborough said LSU is looking for ideas for the “new and improved model.”

As late as three weeks ago, Cerise had been LSU’s public face for protecting from budget cuts the charity hospital system, which provides medical care for the poor and provides training for the up-and-coming physicians. In May, when the state Senate was projecting a 10 percent reduction scenario, Cerise again warned of elimination of “many essential services.”

Back in February, Greenstein and Cerise squared off over LSU reaction to proposed Jindal budget cuts. Greenstein characterized threats of layoffs as “inflammatory” and aimed at mobilizing support for LSU.

In June, for the first time since Jindal took office in 2008, his selections became the majority of the 16-member LSU Board of Supervisors.

A one-time Jindal campaign treasurer and maximum donor, Yarborough said he and interim LSU System President William Jenkins would handle this issue. Jenkins came out of retirement after the Jindal-dominated board fired a Jindal opponent, John Lombardi, from the position.

At last week’s informational hearing, Yarborough, a Baton Rouge sausage-maker, got a small taste of how laws are made.

Republican state Rep. Cameron Henry, of New Orleans, and other legislators repeatedly quizzed the chief executive officer of Manda Fine Meats on why Cerise hadn’t come to address the committee hearing on issues that could impact finances, such as how the LSU hospitals operate.

Yes, allowed Yarborough, Cerise could answer operational questions. But nobody could “take to the bank” any of Cerise’s other answers, Yaborough told state Rep. Ted James, D-Baton Rouge. “He’s not speaking with any decision-making authority. That will be the board and the president of the LSU System,” Yarborough said.

Yarborough couldn’t say how many people are employed by LSU hospitals.

Cerise was added to the agenda of the Joint Legislative Committee on the Budget and will testify Monday.

Mark Ballard is editor of The Advocate Capitol news bureau. His email address is mballard@theadvocate.com.