Written by Jack Davis
New Orleanians meeting with President Obama Thursday will be asking, as usual, for more federal money – for hurricane protection, to keep Louisiana’s wetlands from vanishing, to make housing affordable. This fragile city, in its fifth year of recovery from Hurricane Katrina, has no shortage of urgent needs.
But one critical need already has ample federal money – more than $1 billion to support the construction of two major hospitals. The problem is that state and city officials are planning the hospitals so ineptly that patients, especially the poor patients who need them most, might not get inside for five or seven more years.
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At well over $2 billion, the hospitals are the city’s single biggest Katrina recovery project, other than regional levee upgrades, and the largest New Orleans project ever, equal in cost to 13 Superdomes.
The delays result from a growing backlash against the closed-door decisions to bulldoze a 25-block residential and business neighborhood for a teaching hospital for Louisiana State University’s medical school and for a Department of Veterans Affairs hospital. Both are intended as replacements for hospitals closed after the flood, including the state’s huge and sturdy Charity Hospital, a landmark of the Huey Long regime.
State government hasn’t yet realized it will have difficulty financing its share of the LSU hospital, the larger of the two, because the university’s pre-Obama business plan counts on federal payments for uninsured patients to retire its bonds. Healthcare reform would reduce or eliminate those uninsured patients, who could take their new insurance cards to other hospitals years before LSU can open for business. A recession-driven push for the state to operate less expensively is attracting more attention to lower-cost ways of creating a first-class hospital: Louisiana Treasurer John Kennedy this month suggested building a state-of-the-art hospital in the gutted shell of the old Charity building.
But other state officials have declined to evaluate this option. For a year they have tried to dismiss a study by the architecture firm RMJM, one of the world’s leading designers of new hospitals. The architects established that reusing old Charity would produce as advanced a hospital as new construction, but for $283 million less and with a completion date at least two years sooner.
Such a radical departure from the state/city push for brand-new suburban-sprawl hospitals would also spare scores of camelback and shotgun houses to be seized and demolished for VA to build its own hospital in the century-old Lower Mid-City neighborhood, much of which is included in a National Register Historic District.
It would also avoid another urban-design disaster: moving the two hospitals and their thousands of workers and patients from the traditional medical district in the downtown core, which is already suffering from post-Katrina business flight.
State and city officials will not deviate from their plan, even in the face of clear public sentiment against them. A July poll by political scientist Edward Renwick found that New Orleans voters favored building the new LSU hospital inside old Charity building, by a 2-to-1 margin over the alternative. Candidates considering races for New Orleans mayor or City Council have seen similar pro-Charity results in their polling, and may challenge the state/city plan in the campaign leading up to the February election.
The Obama team has the opportunity to move this vital hospital initiative from stasis and controversy. They can step in to demonstrate that their new healthcare system and their new urban-revitalization strategy can work together to bring effective healthcare recovery to New Orleans while protecting the downtown and saving a neighborhood that can supply badly needed, sustainable, workforce housing.
The President can ask Housing and Urban Development Secretary Shaun Donovan to find a better use for $79 million of his department’s grants to the City of New Orleans than to pay for the seizure and demolition of housing, including some repaired after Katrina with other federal money. He can ask Homeland Security Secretary Janet Napolitano to find a way encourage LSU to rethink its site and design when FEMA pays $150 million or more for Katrina damage to the old Charity building. He can ask Veterans Affairs Secretary Eric Shinseki to move his $900 million hospital to a more compact location nearer the business core.
The President can empower any one of the secretaries, or perhaps Senior Advisor Valerie Jarrett, to bring the federal players together with Gov. Bobby Jindal and Mayor Ray Nagin, along with community representatives, to find a way to make this investment so that it does less destruction and more good.
Jack Davis is a New Orleans resident and a trustee of the National Trust for Historic Preservation.