Health Care and Recovery of New Orleans: Where We Are, Where We are Going

The flooding associated with Hurricane Katrina destroyed the health care infrastructure in Greater New Orleans. After evacuation of health care facilities, the city was left with no 911, no outpatient facilities and only 3 of 22 hospitals open. In the 18 months since the storm, leadership from the public and private sectors have restored basic public health services and reassembled a shell of the health care system. Reconstituted services include 60% of hospital beds and 70% of physicians for a population that is 70% of its pre-storm numbers but there are serious deficits in mental health services, specialty care and surgical care. The uninsured wait in long lines to receive basic services and often access to care through clogged emergency rooms. Though active planning has occurred since the storm, there remains no agreement on whether the rebuilt system will mirror the ineffectual pre-storm system or be reformed to one that can serve as a model for other states. A concept paper conceived by a State appointed board describes an innovative health care system that creates a financial safety net to largely replace the antiquated state public hospital system with each patient linked to a medical home. This health care system would be supported by a robust, state-of-the-art information technology and driven by a transparent system of quality. While the policy debate continues about this newly conceived system, grass roots representing inspiring models of successful public private partnerships are struggling to meet the urgent health care needs of the uninsured.