- Associated Press - Wednesday, August 12, 2015

Recent editorials from Louisiana newspapers:

Aug. 12

The Advocate, Baton Rouge, Louisiana, on state’s managed care plan:

It’s not clear just how willing candidates for governor are to take on a powerful State Capitol lobbying force, the nursing home industry, which has balked at the managed-care model that Gov. Bobby Jindal has imposed on other providers in the Medicaid program.

Unfortunately, as so often with Jindal’s administration, the facts are in dispute about whether managed care has saved the state money and boosted health care outcomes for Medicaid recipients. What is certain is that the providers don’t like it.

Gubernatorial candidate Scott Angelle on Thursday backed off the original Jindal plan to extend managed care to nursing homes. “Certainly, it’s saving money, but it’s not just about money,” Angelle said of managed care. While just about everyone can agree with the sentiment, it’s not a dreadfully courageous stand.

“I want to see some of the outcomes of the program” before making a commitment to expand it to include long-term care for the elderly and developmentally disabled, Angelle said, deeming this “a vulnerable population.” Just about everybody can agree with that, too, but is this a case of tending to the interest of the taxpayer or tending to the interest of provider groups?

Angelle’s backing away from a Jindal program - he was a key aide to the sitting governor - came as he and two other candidates participated in a forum on issues facing the elderly. Lt. Gov. Jay Dardenne and state Rep. John Bel Edwards also spoke, but U.S. Sen. David Vitter did not participate, citing a scheduling conflict in Washington. Edwards is a Democrat. The remainder are Republicans.

Jindal already has turned over to private insurance companies management of medical and behavioral health components of the state’s $8 billion-plus Medicaid program. The companies are charged with managing the care of Medicaid recipients.

Many middle-class families don’t think of themselves as Medicaid recipients, but their elderly relatives often are. Long-term care for the elderly and developmentally disabled was supposed to be the final part of the Jindal initiative where private companies manage the care of Medicaid recipients. But the administration said Wednesday it will leave the move to the next governor, who takes office in January.

A question about the candidates’ positions on the issue was first up at the forum sponsored by AARP Louisiana, the Councils on Aging and the Louisiana Aging Network Association.

“If we have managed care, it needs to be across the continuum of services,” Dardenne said. “It’s the last of three areas and it needs to be applied to everybody consistently.”

That makes sense, and Edwards somewhat more broadly agreed. “We also need to transition to nursing homes when necessary,” he said. “It is my goal that we sit at the table and work this out.”

We can’t help but agree with Angelle as well, though, that this managed care initiative should also stress improved care as well as curbing costs. And one of the problems with Jindal’s administration is its yawning credibility gap with legislators and the public. The ultimate fate of managed care for nursing homes and other providers will depend on whether projected cost savings, as well as service improvements, can be trusted in the existing Medicaid contracts.

That may take, after Jindal’s phony figures of recent years, a raft of auditors and the blessing of the pope. But even then, the new governor will have to be willing to take on influential State Capitol lobbyists to make things happen.




Aug. 11

The Advertiser, Lafayette, Louisiana, on state’s “revenge porn” law:

Louisiana’s newly enacted law that criminalizes “revenge porn” - unauthorized sharing of nude images without permission, usually on the Internet - puts this state in the forward-thinking half of those that have taken steps to halt this cruel practice.

State Rep. Julie Stokes, R-Kenner, passed House Bill 489 in the Legislature and Gov. Bobby Jindal signed it as Act 231, which would penalize offenders with fines of up to $10,000 and jail time up to two years for intentionally publishing images of people “whose intimate parts are exposed.” Those are serious consequences, but not as serious as the damages - mental and emotional - that victims can bear.

For a guilty verdict, the culprit must know the person does not want his or her image distributed and does not consent for the image to be published. For successful prosecution, the accused also must have the intention to harass or cause emotional damage to the person whose image is distributed.

That’s a lot to prove, especially in regard to the accused person’s intent, but ours is not a subtle age. Accused people have been known to send nude images to the victim’s family members. Such intent is hardly masked.

“Revenge porn” laws have developed in at least 20 states in the past few years and usually for the same reason: An ex-boyfriend or ex-spouse takes revenge by posting nude pictures, oftentimes taken on a cellphone, that were shot in more felicitous times.

That’s not the sole scenario - folks have been photographed unaware, their images published - and on rare occasion the accused is a woman. Technology and social media have created a strange world.

Yet consequences to victims can be severe. Victims have talked about being terrified to apply for jobs - many companies conduct thorough Internet searches on prospective job candidates - and the results would provide more information to a potential employer than most job hopefuls would be willing to share. Stakes are high.

At least one criminal defense attorney in Louisiana, Craig Mordock, has written that the new state law criminalizes speech that is constitutionally protected. He contends in a blog that “content based restrictions criminalizing speech are presumed invalid,” but that accused offenders might have a tough task in defending themselves, especially in state court. One might hope so.

In his blog, Mordock takes exception to Stokes’ stated reason for drafting her legislation: “It is not your right to cause someone, sometimes, irreparable emotional harm just because you’re mad at them, or want to get back at them, or want to cyber bully them. I just think you have to draw a line somewhere.”

That line may cross the First Amendment - it would not be the first - but in a way that most Louisianans can accept - or even demand.




Aug. 11

The Town Talk, Alexandria, Louisiana, on military budget concerns:

When the top U.S. Army officer says he’s worried the nation doesn’t have enough soldiers, we think it’s time to listen.

“If we get small enough where some of these (world) leaders don’t believe the Army can respond or deter them, if you can’t … deter them from believing they can accomplish something … that increases the threats and danger to the United States,” Gen. Raymond T. Odierno said in an exclusive interview with Gannett’s Army Times. “And I don’t know what that level is, but I think we’re getting dangerously close to that level now.”

It’s not a new idea. In President Theodore Roosevelt’s day, the strategy was described as walk softly and carry a big stick.

For decades, the United States has had the biggest stick around. But, with budget concerns and other factors, the military started whittling away at that stick. Now, they’re taking ax chops to it.

Some trimming was needed. Everyone has heard stories of military excesses, particularly when it came to spending related to military contracts. Reports of $900 hammers got people looking more closely at the budget. The military is spending our money, and as such they should be held accountable to act as good stewards of that money. Items to keep soldiers safe shouldn’t be bought from the discount bin, but ancillary items can be. We expect and should get sound fiscal judgment.

It’s also valid to note that for too long the United States has shouldered more than its fair share of the global policing load. The reductions in manpower and supplies have forced us to partner with other nations and for those other countries to step up and shoulder more of the responsibility. That’s not a bad thing.

So, while acknowledging the need for increased fiscal responsibility, as we have noted here before, we believe troop strength numbers should be determined by top military officials, not Congressional budget planners. “There are a lot of things boiling in a lot of different places,” Odierno said. “What you don’t know is when something boils over. You have to have the capability to respond, and that’s the issue.” For example, just two years ago there was no such thing as ISIL. More than 177,000 soldiers were deployed, forward stationed or assigned to more than 150 countries on at least five continents as of the end of July, and new threats - including an increasingly aggressive Russia - are on the horizon. Now is not the time to reduce our strength.

“I worry about our capability to meet all these different challenges as we move forward,” he said. “And I worry about the long-term impact increased requirements and reduced resources are going to have our soldiers.”

We’re worried too, and we hope our nation’s leaders heed Gen. Odierno’s warning.



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