The Closure of New Orleans' Charity Hospital After Hurricane Katrina: a Case of Disaster Capitalism
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University of New Orleans ScholarWorks@UNO University of New Orleans Theses and Dissertations Dissertations and Theses Spring 5-18-2012 The Closure of New Orleans' Charity Hospital After Hurricane Katrina: A Case of Disaster Capitalism Kenneth Brad Ott University of New Orleans, [email protected] Follow this and additional works at: https://scholarworks.uno.edu/td Part of the American Politics Commons, Bioethics and Medical Ethics Commons, Community-Based Research Commons, Emergency Medicine Commons, Health and Medical Administration Commons, Health Economics Commons, Health Policy Commons, Health Services Administration Commons, History of Science, Technology, and Medicine Commons, Medical Education Commons, Medicine and Health Commons, Policy History, Theory, and Methods Commons, Political Economy Commons, Politics and Social Change Commons, Primary Care Commons, Psychiatric and Mental Health Commons, Public Policy Commons, Race and Ethnicity Commons, Social History Commons, Social Welfare Commons, Urban Studies Commons, and the Urban Studies and Planning Commons Recommended Citation Ott, Kenneth Brad, "The Closure of New Orleans' Charity Hospital After Hurricane Katrina: A Case of Disaster Capitalism" (2012). University of New Orleans Theses and Dissertations. 1472. https://scholarworks.uno.edu/td/1472 This Thesis is protected by copyright and/or related rights. It has been brought to you by ScholarWorks@UNO with permission from the rights-holder(s). You are free to use this Thesis in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights- holder(s) directly, unless additional rights are indicated by a Creative Commons license in the record and/or on the work itself. This Thesis has been accepted for inclusion in University of New Orleans Theses and Dissertations by an authorized administrator of ScholarWorks@UNO. For more information, please contact [email protected]. The Closure of New Orleans’ Charity Hospital after Hurricane Katrina: A Case of Disaster Capitalism A Thesis Submitted to the Graduate Faculty of the University of New Orleans in partial fulfillment of the requirements for the degree of Master of Arts in Sociology By Kenneth Brad Ott (K. Brad Ott) B.A. University of New Orleans, 2007 May 2012 Copyright 2011, Kenneth Brad Ott (K. Brad Ott) ii Acknowledgements This thesis would not have reached its completion without the support of my University of New Orleans (UNO) academic community. Special thanks to my major professor and thesis committee chair Dr. Vern Baxter, and thesis committee members Dr. Shirley Laska and Dr. Rachel Luft. The Center for Hazards Assessment, Response and Technology (CHART) also provided me with vital logistical and emotional support. Special thanks to CHART’s Director Dr. Monica Farris and Office Administrator Joyce Broden-Douglas; as well as Maggie Olivier, Erin P. Merrick, Carrie Beth Lasley, Corey Miller, Dr. Kris Peterson, Dick Krajeski, Dr. Earthea Nance and Reddy Avula. Thanks also to the UNO Department of Sociology, especially Dr. Jean Ait Belkhir, Dr. Christiane Charlemaine, Dr. Phyllis Raabe, Michelle Gremillion, Delilah Hall, Dr. Pam Jenkins, Dr. David Allen, Dr. Susan Mann, Dr. D’Lane Compton and Dr. Francis Adeola; The UNO Student Support Services’ Nora Chapuis and Daniel Braud; The UNO Department of History’ s Dr. Michael Mizell-Nelson, Dr. Connie Atkinson, Dr. Raphael Cassimere, Jr., and Dr. James Mokhiber; and other UNO faculty and staff especially Dr. Chris Day, Amy King, Dr. Barbara Mitchell, Amanda Athey, Connie Phelps, Denise Perez, Dr. Tomas Mulleady, Henry Gueringer, Tom Harrington and Ella Coleman. This thesis would not have been completed without support of my friends and loved ones. Special thanks to Kit Senter, Caroline Senter, Lila Dunlap, Anna Sudie Dunlap, Blaine Dunlap, George & Maria Andrews, Carey Dupuis, Ben Gordon, Anne Lovell, Lance Hill, Sandra Stokes, Derrick Morrison, Janet Hayes, Jacques Morial, Tracie Washington, Stephen Rosenfeld, James Moises, Shannan Cvitanovic, Bill Dwyer, Kathy Kennedy, Kent Mathewson, Tim Vining, Stephen Donahue, Mimi Yahn, Vern Cope, D’Ann Penner, Dorian Hastings, the Gillespie Memorial Community Breakfast and many others who gave me support and well wishes. iii TABLE OF CONTENTS Abstract and Keywords ..................................................................................................... vii Introduction .........................................................................................................................1 Theoretical Foundation ......................................................................................................3 Narrative Structure of this Case Study ..............................................................................8 Methods .............................................................................................................................11 Study Validity and Reliability ...........................................................................................13 Standpoint of the Researcher ...........................................................................................14 Chapter One From Charity Hospital’s founding through Medicare and Medicaid ........................16 Charity Hospital’s First 200 Years: Yielding Modern Medicine.......................................17 Huey Long launches LSU Medical School, ‘Big Charity’ and a statewide hospital armada..................................................................20 Charity Hospital and its inspired safety net system faced competitive pressure because of the 1946 Hospital Survey and Construction (Hill-Burton) Act .......................28 Medicare and Medicaid undermined “special categories” like Charity Hospital .............31 Chapter Two From Medicare and Medicaid until Hurricane Katrina ..............................................36 The Louisiana Health Care Authority (LHCA) oversees Charity Hospitals; proposes the end of the name ‘Charity’ and to close New Orleans’ Charity Hospital ......37 Disproportionate Share Hospital funds (DSH) enrich private providers at Charity expense.......................................................................43 Facing an end to the golden egg era of DSH funds, Gov. Edwards proposes a Charity HMO ...........................................................................46 Bobby Jindal saves Louisiana Medicaid by shrinking it; Jindal leaves unaddressed the continued diversion of millions of dollars in DSH funds from Charity hospitals ..................................................50 iv LSU assumes administration of Charity hospitals; and faced the continued loss of DSH funds.......................................................................53 The fate of Charity hospitals were a deciding factor in the 2003 LA. Governor’s race....62 Governor Blanco’s reform panel grapples with Charity’s centrality in state healthcare...63 LSU proposes building a new hospital – and closing Charity...........................................67 Chapter Three Hurricane Katrina and Charity Hospital’s forced closure ..........................................70 Charity Hospital’s patients, staff and families weather Hurricane Katrina; LSU left all hospitals to fend for themselves; Federal health response compounds LSU’s failure ...........................................................71 The attempt to reopen Charity Hospital by its workers and the U.S. military is thwarted................................................................75 Louisiana returns $340 million in emergency FEMA aid meant to repair Charity Hospital......................................................................80 The healthcare consequences of Charity Hospital’s forced closure ..................................82 Senator Coburn and others demand that Charity be reopened and independently evaluated ...........................................................89 Despite LSU’s proclamation of closure, Charity’s workers make a last public stand for reopening; FEMA disputes LSU’s amount of Charity’s storm damage reimbursement .....................91 LSU overcomes FEMA through the political intervention of Cao, Landrieu and Obama ........................................................................97 Discussion Was Charity Hospital’s closure a case of “Disaster Capitalism?” ............................105 Charity was closed when New Orleans was virtually emptied of its populace; Its patients were the heart of the Katrina Diaspora; Fears of exclusion from recovery decisions ....................................................................106 The Bring New Orleans Back Commission attempts to capitalize on the Katrina Diaspora ...............................................................108 v Considering Charity Hospital’s closure as a human rights violation of the internally displaced........................................................111 LA. Health Care Redesign Collaborative also attempted to capitalize on Charity’s closure....................................................................116 Continuity or Rupture? Comparing LSU’s pre-storm plans to close Charity Hospital with its disaster capitalized closure following Hurricane Katrina .......120 Findings ..........................................................................................................................132 Epilogue Conflict between LSU and the Jindal administration over LSU-HCSD state budget