The Coalition of Leaders for Louisiana Health Care on Tuesday proposed a plan to divert federal funds from the New Orleans' charity hospital system to a free-market model that would provide residents with insurance cards to the physician of their choice, the New Orleans Times-Picayune reports. The coalition suggested redirecting about half of the "federal disproportionate share hospitals" payments to create insurance vouchers for adults with incomes below 200% of the federal poverty level. Under the plan, doctors would be reimbursed at 90% of Medicare rates for their services.

According to analysts from the Lewin Group, monthly premiums for the plan would be about $194. The program would cost $208 million, the analysts said -- a little more than half of the $370 million in federal disproportionate share hospital payments available for New Orleans charity care. The remaining federal funding would serve as a safety net to cover care for prison inmates, residents with acute mental illnesses and others, according to the plan proposed by the coalition.

Since Hurricane Katrina, and the subsequent closing of Charity Hospital, uninsured residents have been forced to seek care in emergency departments or "far-flung corners of the state," the Times-Picayune reports. According to Coalition Chair Mark Peters, CEO of East Jefferson General Hospital, the voucher program would provide payments to physicians who have been receiving no reimbursement for treating the uninsured since Katrina. In addition, he said allowing patients to choose their providers would force area hospitals to improve.

Gov.-elect Bobby Jindal (R) has said he supports using the disproportionate share funding to support clinic-based care, rather than exclusively hospital-based care. His press secretary, Melissa Sellers in an e-mail wrote that Jindal "looks forward to working with this group along with other key health care stakeholders to ensure Louisiana patients have access to the best health care possible" (Moran, New Orleans Times-Picayune, 12/5).

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