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Dying Poor People & Jindal’s Priorities

Not sure how this [1] is going to sound to the rest of America when Louisiana Gov. Bobby Jindal runs for president:

Cuts to hospice care announced by state officials last week are deeper than originally portrayed, eliminating hospice treatment for all Medicaid recipients starting in February, the Louisiana Department of Health and Hospitals [2] said Wednesday. In announcing the reductions to hospice care [3], which aims to make dying people more comfortable in the last six months of their lives, Jindal administration [4] officials said the cutbacks would force people on Medicaid to seek the service in a nursing home. But the change actually means the state is eliminating all hospice care – both at home and in nursing facilities — to people covered by Medicaid.

Merry Christmas, Poors! More:

Legislators at a Friday hearing to discuss the $165.5 million in reductions and other budget fixes were especially alarmed by the hospice cuts. The cuts are needed because a revenue shortfall has thrown the the state’s budget out of whack. The budget must be balanced by the time the fiscal year ends on June 30.

If the state doesn’t have the money, it doesn’t have the money — and we in Louisiana are constitutionally required to balance our state budget. But not enough money to pay for hospice care for the poor? Really? What kind of state are we?

We are the kind of state that provides at least $1.79 billion annually [5] in tax breaks and incentives to business. We are the kind of state that won’t cut or scale back those, even a little bit, but will cut $1.1 million annually to provide minimal end-of-life care for 5,800 poor Louisianians.

Such are the priorities of our presidential hopeful Republican governor and our GOP-run state government, it appears. I believe that our governor is sincere when he openly and enthusiastically talks about his Christian faith [6], which makes it all the more frustrating to see that business and industry are the Chosen People in this state. more important to take even more away from the poorest of the poor than to compel the well-off to give up the least tax break. Gov. Jindal said in a 2011 Christianity Today interview:

I think that it’s absolutely critical to get the economy growing without raising taxes or increasing the deficit. I’m also proud to belong to a party that stands for the sanctity of human life and traditional marriage. Those values remain important during good and bad economic times.

“Sanctity of life”? With Medicaid-funded hospice, we’re talking about helping terminally ill poor people die with dignity. What kind of “sanctity of life” ethic values maintaining state tax breaks for wealthy corporations over hospice care for the poor?

Jindal supporters, what am I missing here? Help me out.

[Via The Mighty Favog [7].]

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88 Comments To "Dying Poor People & Jindal’s Priorities"

#1 Comment By Rebecca Trotter On December 22, 2012 @ 12:26 pm

Thank you so much for speaking out like this. I hope many more conservatives start to consider that their faith might ask more of them in the public sphere than voting against abortion.

This reminds me a bit of a story I saw yesterday about healthcare giant UPMC in Pennsylvania. Their non-medical employees are trying to unionize and have been going public over their ridiculously low wages and stingy benefits. So UPMC (and I swear I’m not making this up) put out a statement saying that they have been listening and care about their employees well being so they are opening an on-campus food bank to make it easier for their laborers to access the services they need. There is class warfare going on in this country, but it’s happening top down, not from the bottom up.

#2 Comment By M_Young On December 22, 2012 @ 12:46 pm

@JLF

California, a state dominated by Democrats (with the non-exception of the nominally Republican governator) has an ‘official’ poverty rate of 16.3 versus 19.1 for Louisiana, over the last three years. However, adjusted for living costs and changing ‘market basket’ of goods and relative prices, Democrat California has a 23.6% poverty rate, and Louisiana has a 17% rate. See this pdf, Table 4. Silicon Valley, long a stronghold of Democrats, has also long been a [8], third worldish in its wealth distribution.

Oh, and we don’t even beat out Louisiana on NAEP results.

#3 Comment By Geoff Guth On December 22, 2012 @ 12:55 pm

Bless you, Mr. Dreher! It’s people like you who take the whole pro-life agenda seriously that gives me hope for social conservatism.

#4 Comment By Chris Mallory On December 22, 2012 @ 1:07 pm

Jimmy Swaggart Ministries has a budget of at least $84 million a year. I would guess the Catholic Church in Louisiana has a budget of at least that much. If between the two they can’t fund the $1.1 million that Rod says is cut from hospice care, maybe their tax exempt status needs to be looked at.

#5 Comment By Lee Penn On December 22, 2012 @ 1:49 pm

Link this story – cruel budget cuts and tax cuts for business – with the story above, the marketing of more-explicit sex stories to the teenage audience.

This is why Apocalypse can seem appealing.

What this country is living now is an anti-Magnificat. The proud are secure in the imagination of their hearts. The mighty are secure on their thrones, for the National Security State is with them. Those of low degree are abased even further. The crumbs of the hungry (and the indigent dying) are snatched away, and the rich are filled with bailouts and tax privileges.

Remember Ezekiel 16:48-50:

[48] As I live, says the Lord GOD, your sister Sodom and her daughters have not done as you and your daughters have done.
[49] Behold, this was the guilt of your sister Sodom: she and her daughters had pride, surfeit of food, and prosperous ease, but did not aid the poor and needy.
[50] They were haughty, and did abominable things before me; therefore I removed them, when I saw it.

By this standard, Jindal and his allies share “the guilt of your sister Sodom.”

Lee

#6 Comment By Richard Johnson On December 22, 2012 @ 2:04 pm

“Richard, I can’t speak for anybody else but a partial answer to “what’s stopping me” can be found in the example of abuses–actually, the outright fraud–of the Catholic Campaign for Human Development.”

Well, that gives the Catholic’s a convenient excuse. I suppose the evangelical drive to have the largest, most modern houses of worship give them an excuse.

Meanwhile the sick and poor suffer, and Bobby J. gives tax money away to corporations.

Gotta love it!

#7 Comment By rr On December 22, 2012 @ 2:16 pm

Rod,

I live in Georgia and work for the state university system. As with Louisiana, the Republicans who control the state government have ensured that the state tax code has all sorts of loopholes and give aways to business interests. While some of these may attract businesses to the state and create jobs, many are quiet questionable and are detrimental to the budget.

That said, it isn’t fair to blame all of this on Republicans. The one thing that you seem to be missing in this post is that the cost of medical care, including hospice care, goes up and up each year, with no end in sight. The result of this has been deep cuts to other government services. For instance, in Georgia’s university system, we have had budget cuts for several years in a row. They have also raised our health insurance premiums several times. When I asked my dean about the latest round of cuts, he said it was due to increased state Medicare/Medicaid expenses.

I’m sorry, but this sort of thing can’t continue forever. State governments can’t spend infinitely on medical expenses. I’m sick and tired of cuts to education, both to K-12 and higher education. In the next round of budget battles in my state, I say cut the medical expenses before education. I’m sure many other state agencies (fish and game, parks, transportation, prisons, etc.) are likewise tired of this annual ritual of budget cuts while medical expenses go up each year.

You may question Jindal’s priorities regarding hospice care. But the bigger problem in all of this is the insatiable appetite of the health care industry for more money.

#8 Comment By Polichinello On December 22, 2012 @ 3:07 pm

There’s usually a lot more to these subjects than what appears to be an “OMYGAWD I CAN’T BELIEVE THIS!!1!!!!” situation. Since this revolves around Medicaid, it could have a lot to do with the way the money is budgeted, and the federal strings that come with it.

A lot of the tax breaks are usually designed to encourage companies to take risks in the state. The state has, in effect, signed on as a co-investor in a project. This is particularly true of natural resources. Some times oil and gas projects don’t pan out, so you need to offer companies some inducement to take a risk to offset the costs for personnel, material and time. Unlike a lot of tech ventures, oil and manufacturing are very capital intensive up front. You can’t just start a factory with some code in hand. Sometimes these are good deals for the state, some times, not so much.

Also, these are taking place in “hearings”, so the bill might very well be amended. It’s very unlikely that Bobby Jindal is sitting somewhere in the Capitol rubbing his hands in glee at the thought of kicking dying poors to the streets.

#9 Comment By JLF On December 22, 2012 @ 3:38 pm

@ M_Young.

Pravada? Really? The same guys who say: “In my opinion, the fall of Soviet Union, more than twenty years ago, was bad news for many, at least for anyone who ruminates on the matter.” or “The USA doesn’t even value the lives of its own citizens. Witness the numerous testing of weapons, drugs, medications, pesticides and what have you on the population. This has been well documented in this space.”? Not to say your statistics are not accurate, but consider your source.

#10 Comment By Wesley On December 22, 2012 @ 3:57 pm

Remember when Jindal said that the Republican Party has to end “dumbed-down conservatism.” Well this is one example from Rod Dreher’s link:

” While cutting hospice care is slated to trim the state portion of the Medicaid budget by $1.1 million, Boudreaux predicted it wouldn’t actually result in savings. This is because many dying people will end up at hospitals, where Medicaid will pay for at least a portion of their care.

“I predict they will spend at least four times that amount in emergency room visits and hospitalization of those type of folks,” Boudreaux said.
STUPID is one thing. Despicable is another. But when a state can combine stupid and despicable in a single public-policy debacle, it may be onto something.”

#11 Comment By Wesley On December 22, 2012 @ 4:29 pm

PM,

The Medicaid hospice funds are only $1.1 million dollars for only 5,800 people. Most people in hospice in LA will still get their hospice care paid for by Medicare.

#12 Comment By Lord Karth On December 22, 2012 @ 4:30 pm

It would be interesting to see a breakdown of the Louisiana provincial budget. How much of its spending is for Medicaid and similar programs, and how much is for “tax breaks for business” ? Post the link, let’s all take a look at this, and THEN we can see just how much of a twist we have to get our knickers in.

Also……when thinking about these matters, it is well to remember this one thing, from which all else will follow:

Math always wins.

Your servant,

Lord Karth

#13 Comment By Lord Karth On December 22, 2012 @ 4:33 pm

Linda writes:

I have never been able to understand why all Christians do not support helping people in need. I am not talking about free handouts for those that able. I have seen many unbelievable heartless comments from people claiming to be Christians against helping the poor. “

I have no qualms whatsoever about helping the poor.

I do, however, have quite a few qualms about being forced to do so at the point of a gun. Charity that is compulsory is not charity.

Your servant,

Lord Karth

#14 Comment By 98rsd On December 22, 2012 @ 4:34 pm

Does anyone really think the teachings of Jesus bear any relation to the actions of the Christian Right?

He rode a donkey, not a private jet or an elephant.

#15 Comment By Lord Karth On December 22, 2012 @ 4:39 pm

Bryan writes: “In a less Ebenezer-ish development than Jindal’s decision, my state recently re-wrote the tax code, literally, for Nike Inc. at Nike’s insistence, in return for the promise of 500 new jobs. I don’t know the details but on reading that story it struck me that such an acquiescence to corporate demands, no matter how seemingly benign or even sensible, really ought to violate some basic principle of governance.

I’ve got you beat, Bryan. My province (New York) is planning on increasing spending and taxes, the better to satisfy public-employee unions, while thousands of jobs are leaving the province every year. Nobody is saying much about it, and what is actually being done (moving to ban hydrofracking, for example) actually encourages and reiterates an impression of NY as an anti-business province.

Your servant,

Lord Karth

#16 Comment By pjsmoov On December 22, 2012 @ 5:39 pm

M.Young wrote:

“Oh, and we don’t even beat out Louisiana on NAEP results.”

Regarding education, we used to say thank God for Mississippi. I had no idea I’d be able to say “thank God for California.” Of course it brings me no joy to write that. Is California still a bellwether?? Yikes.

#17 Comment By Bakehouse On December 22, 2012 @ 5:42 pm

I remember hearing several times over the last few years that most of the spending in Louisiana is somehow protected from budget cuts by the state constitution. The only two areas that are unprotected and available for cuts are health care and education. I haven’t checked this out lately, but this may be part of the problem.

#18 Comment By EB On December 22, 2012 @ 7:54 pm

Hmmm. Jindal is saving money for Louisiana on the backs of poor people who are dying; he’s putting them in nursing homes because Medicaid funding comes partly from the federal government. So, he’s feeding the beast of big government, but just not in his state.

#19 Comment By PM On December 22, 2012 @ 9:05 pm

AB, if I understand you, you think that LA cutting state government hospice funding means that a) poor people b) who went bankrupt c) due to medial bills d) are now going to be booted out of hospitals to die alone e) without painkillers?! Please, please tell me you don’t actually believe this.

The funny thing about your accusation that I’m heartless is that people like me prevent the collapse of the welfare state. And people like me are about gone from this nation…note the last election, where voters (statistically) from broken or nonexistent families elected their first president for more cash and prizes. As a poor person, I would personally much rather live in a solvent, hard-nosed state that requires personal responsibility and helps those who are truly in need than a welfare state going bust. The state I currently live is isn’t going bust…but then, it’s conservative…

#20 Comment By Delmonico On December 22, 2012 @ 11:04 pm

Based on reading the entire article, I think that the administrators may have thought that, since those on Medicaid would be housed and cared for by nursing homes and hospitals and given appropriate pain medicine, that this meant they would have continuing hospice care. Apparently though, the reality is that they will not be provided “emotional support” by professional hospice workers. So, while technically true that “all hospice care” is being eliminated, the practical result is only the elimination of state employed professional emotional counselors.
You may be correct that Jindal may be made to look heartless and mean when the story is conveyed in a sound bite manner. And it may even be that it is lousy policy, but to make it into an attack on the morality of Jindal with a tired tax exemption vs services chestnut (all states exempt some income from tax for many reasons; all states have to make decisions to end services at some level. No matter what the levels are of each, one can always take the most unfortunate individuals who are not covered and make an entirely specious comparison against an unpopular recipient of some tax break. One can do so, but not necessarily honestly)
So, assuming the Jindal administration had to come up with some sort of equivalent cut in the state Medicaid system, maybe the least destructive was to cut a service (emotional support) that can effectively be provided by family, clergy or non-professionals. Or maybe the services would not need to be cut anywhere if some state employees’ benefits were brought closer into line with the rest of the country.

#21 Comment By Richard M On December 23, 2012 @ 12:15 am

“Richard, I can’t speak for anybody else but a partial answer to “what’s stopping me” can be found in the example of abuses–actually, the outright fraud–of the Catholic Campaign for Human Development.”

No Catholic with any sense should ever give a dime to Catholic Campaign for Human Development.

#22 Comment By M_Young On December 23, 2012 @ 1:17 am

” the fall of Soviet Union, more than twenty years ago, was bad news for many, at least for anyone who ruminates on the matter.” ”

It was — that’s unarguable. In the long run it was a good deal for the younger generations — to the extent there are any — but it was really bad during the Yeltsin/Chicago Boyz years.

#23 Comment By Clint On December 23, 2012 @ 3:53 am

@Chris Mallory:

Do your homework before you badmouth Catholic Charities, Sport.

“Together with the local, diocesan-associated Catholic Charities, it is the second largest social service provider in the United States, surpassed only by the federal government.”

#24 Comment By Linda On December 23, 2012 @ 6:07 am

Lord Karth said, “I have no qualms whatsoever about helping the poor. I do, however, have quite a few qualms about being forced to do so at the point of a gun. Charity that is compulsory is not charity.”

The above comment is a typical ideological conservative statement that provides no solution for the problem.

Matthew 17: 24-26; Romans 13:1-7; Proverbs 20:3

Government treatment/mistreatment of the poor is included in the Bible. I have never seen a Bible verse that says only individuals, not governments, should help the poor – another excuse I have seen many times by Christians for not using tax money to help the poor – a no solution statement.

Peter H said: “I think it’s in the Gospel of Luke that Jesus tells his followers that poor businesses in need of tax breaks will always be with us.”

The above sarcastic statement is typical of what I have frequently seen on conservative Christian sites. It is an excuse to not help the poor by using a verse out of context while ignore all of Christ’s teachings on helping the poor.

#25 Comment By Blairburton On December 23, 2012 @ 7:43 am

“I have no qualms whatsoever about helping the poor.

I do, however, have quite a few qualms about being forced to do so at the point of a gun. Charity that is compulsory is not charity.” – Lord Karth

“If men were angels, no government would be necessary. ” – James Madison, The Federalist Papers

#26 Comment By Turmarion On December 23, 2012 @ 8:47 am

A slightly off-topic but relevant quote from Chesterton’s The Eternal Revolution, my emphasis:

I know that the most modern manufacture has been really occupied in trying to produce an abnormally large needle. I know that the most recent biologists have been chiefly anxious to discover a very small camel. But if we diminish the camel to his smallest, or open the eye of the needle to its largest — if, in short, we assume the words of Christ to have meant the very least that they could mean, His words must at the very least mean this — that rich men are not very likely to be morally trustworthy. Christianity even when watered down is hot enough to boil all modern society to rags. The mere minimum of the Church would be a deadly ultimatum to the world. For the whole modern world is absolutely based on the assumption, not that the rich are necessary (which is tenable), but that the rich are trustworthy, which (for a Christian) is not tenable. You will hear everlastingly, in all discussions about newspapers, companies, aristocracies, or party politics, this argument that the rich man cannot be bribed. The fact is, of course, that the rich man is bribed; he has been bribed already. That is why he is a rich man. The whole case for Christianity is that a man who is dependent upon the luxuries of this life is a corrupt man, spiritually corrupt, politically corrupt, financially corrupt. There is one thing that Christ and all the Christian saints have said with a sort of savage monotony. They have said simply that to be rich is to be in peculiar danger of moral wreck. It is not demonstrably un-Christian to kill the rich as violators of definable justice. It is not demonstrably un-Christian to crown the rich as convenient rulers of society. It is not certainly un-Christian to rebel against the rich or to submit to the rich. But it is quite certainly un-Christian to trust the rich, to regard the rich as more morally safe than the poor.

#27 Comment By Caregiver On December 23, 2012 @ 9:39 am

Delmonico has hit on a really important point; “hospice” care comes with the baggage of counselors whose job it is to convince the family to “make Grandma comfortable”, i.e., to hasten her demise in any way possible. I have cared for two family members, in my home, who were totally disabled – over a period of 12 years. One of the worst aspect of the home care was the constant pressure from “emotional counselors” to terminate this treatment or that treatment.

Hospice lures you with the carrot that there will be all sorts of extra support but the support made things worse, not better, for my family. For part of the dying process of my mother, we had hospice in the nursing home and had to dismiss hospice because the right hand never knew what the left hand was doing. If something wasn’t done, hospice would blame the home and say it was the home’s responsibility while meanwhile the home would blame hospice.

The bottom line is, we’d all be better to get out of the health care system any way we can.

#28 Comment By Andrew Garland On December 23, 2012 @ 9:59 am

“Will cut $1.1 million annually to provide minimal end-of-life care for 5,800 poor Louisianians.”

That is about $200 per patient. That can’t be all hospice care, or even much care. It seems they are saving some money for marginal services. Why the condemnation?

#29 Comment By Richard Johnson On December 23, 2012 @ 10:02 am

“No Catholic with any sense should ever give a dime to Catholic Campaign for Human Development.”

Then why not start a different organization to minister to the poor? One that conforms to your church’s teachings?

If you truly want the government out of the business of caring for the poor, then make it so. Face it, we know conservative Christians have money. Just put together an initiative to ban gay marriage and it starts raining like manna from heaven.

If the CCHD is unfit, then find a fit way to deal with the problem. What is stopping you?

#30 Comment By Lance Kinzer On December 23, 2012 @ 11:17 am

Rod: It would take a much more detailed treatment of tax and spending policy in LA than is provided in your post in order to determine if the policies you discuss are prudent. That said I am a bit taken aback that you of the Benedictine option and the little way (about which much good can and should be said), would posit a situation in which the only alternatives seem to be the bureaucratization of social services in the hands of the state vs. a Hobbesian world of solitary isolation in which each individual is on his own. Is there no civil society outside the care of a benevolent leviathan? I have no qualms with asking what the proper role of the state might be in providing care for the population in question, but are there not more basic questions that we should be asking about who, in a healthy society, should bear the primary responsibility of the hard privilege of care for the dying?

#31 Comment By Rod Dreher On December 23, 2012 @ 5:54 pm

Lance, you make a reasonable point. The reason I ended the post by inviting those who think Jindal is right on this issue to tell me what I’m not seeing. I don’t think Jindal is a bad guy, but I can’t figure out why hospice care for the poor is on the chopping block here (as opposed to ending a tax break or two for business).

I know people who have helped their family members through fatal illness, but who have felt compelled to turn to hospice for assistance at the very end. It wasn’t an either/or situation, but one in which these people, who had poured themselves out for their family members throughout a long illness, didn’t feel able to give their dying kinsman what he needed in his final days and weeks.

#32 Comment By Richard M On December 24, 2012 @ 10:50 am

Hello Richard Johnson,

“Then why not start a different organization to minister to the poor? One that conforms to your church’s teachings?”

Because – with respect – there are plenty already.

There are the soup kitchens and charities run by individual dioceses and parishes.

There is the Society of St. Vincent de Paul.

I could go on and on…

If you want to help the poor – cut out the middle man. Go local. Chances are, near you there’s a local SSVP or Catholic shelter that can use your help. And you’ll know exactly where your money and time is going – and that it’s not going to entities that work to undermine the Church’s teaching.

#33 Comment By Lance Kinzer On December 24, 2012 @ 11:07 am

Rod: Thank you for your response. No question that in many cases even the most committed and self-sacrificing family will need help from the community in these situations. My vision of where that help should come from and how it should be financed may be a bit romanticized given the realities of modern life. I do worry that the more we view such matters as someone else’s responsibility, the less likely it is for true community to flourish. The way in which we care for the dying and commemorate the dead is deeply important and subcontracting out that function (so to speak) seems to me part of our capitulation to dispossession. As our mutual friend Caleb has written so beautifully: “Repossession requires love above all—I have said this before—and no amount of anger or stumbling about trying to recover a lost identity will forge a lasting “localism” if it has not love.” In this struggle toward repossession, love of our own at the end of life has an important role to play. Of course I doubt the policy choice in LA was driven by a desire to reinvigorate traditional practices of care for the dying out of a desire to strengthen local communities. But one can always dream…
Have a most blessed and merry Christmas.

#34 Comment By Gaither Pope On December 24, 2012 @ 2:35 pm

I shudder to think of what my father’s last days may have been like without hospice.

#35 Comment By BillCC On December 25, 2012 @ 6:51 am

About half of the fatalities from Hurricane Katrina were individuals 75 years and older.
The universal prescription for future hurricanes: more government intervention!
Apparently in Louisiana everything that was once the province of family (as in evacuating the elderly) is now deemed the responsibility of government.
No wonder they’re broke.

#36 Comment By Siarlys Jenkins On December 26, 2012 @ 7:32 am

I have no qualms whatsoever about helping the poor.

I do, however, have quite a few qualms about being forced to do so at the point of a gun. Charity that is compulsory is not charity.

I just can’t refrain from kicking a dead horse, even though its already been done at least once.

Lord Karth makes the obvious error of equating tax-supported government services with “charity.” Obviously its not, but it isn’t meant to be either. It is a rational policy that the nation as a whole will run better, be a safer place for everyone, if certain public policies and programs are in place.

Once upon a time, people with serious physical or cognitive disabilities were left to their families to take care of, because there was no alternative. Since in most families, adults had a lot of hard work to deal with (even women in patriarchal families, who had to haul water from the creek to fill wash tubs to get laundry done, scrub floors and walls with primitive equipment, make up fires to cook, haul firewood…), these relatives, some of them stark raving mad, others with milder conditions, got darn little attention from anyone. Aunt Susy might even be chained to the wall in the basement for her own safety. Thus, enlightened legislators got the notion that such individuals should be cared for in state sponsored asylums (originally a word with a positive spin), by trained medical staff. If wasn’t always good, but it was better. It wasn’t charity, it was a tax supported program for the general welfare.

Without Medicare, some number of elderly people were cared for by doctors who considered it part of their ethical and professional duty, regardless of ability to pay. But far from all. Ditto for Medicaid, as to the non-elderly indigent. Charities never took up the slack. That was luck of the draw. The public policy decision was, don’t rely on charity, take a more comprehensive approach than charity ever has done or can do.

If Lord Karth has to kick in his tuppence like all the rest of us, so be it.

#37 Comment By DS On December 28, 2012 @ 12:31 pm

Back from Christmas vacation, catching up on stale posts, and glad to see you on the Jindal-is-Overrated bus after just a year back home.

#38 Comment By Steve On January 21, 2013 @ 10:52 pm

It just seems like a bad idea not to help someone out when they’re preparing to die. Louisiana took in ~$42.7 billion in 2011, so if it really costs the state $1.1 million annually to help the poor pay for hospice care like this article says, then Bobby Jindal needs to get his priorities straight if he ever hopes to run for president.