By some measures, Louisiana already attracts a fair amount of medical tourism despite the absence of a big name-brand attraction like Houston’s MD Anderson Cancer Center or the multistate Mayo Clinic. Officials touting the Louisiana Medifund want to further develop the “destination health care” business.
Lawmakers created the Medifund last year but didn’t actually fund it. On paper, the Medifund is an independent grant-making body meant to create “medical centers of excellence” and boost the economic impact of the state’s health care sector.
But at the moment, the fund is basically an empty bucket.
“How do we fill it up?” Michael Hecht, president of GNO Inc. and an early champion of the concept, wondered aloud at the second Medifund board meeting in September. “And how do we distribute it, monitor its distribution, and measure what we’ve distributed?”
Hecht thinks $100 million is a pretty good number to shoot for to get the fund started. Individual grants likely would need to be in the $10 million to $20 million range to make a measurable difference.
“We can’t do everything,” notes Sidhir Sinha, CEO of InnoGenomics Technologies and a Medifund board member. “If you get scattered requests, we may do a little bit everywhere but not have a big impact.”
Medifund grants would go to nonprofits, with an emphasis on public-private partnerships. But which partnerships? It’s a tricky question, partly because other states and regions are way ahead of the game.
There’s lots of money in cancer treatment, for example, but trying to compete with an internationally known giant like MD Anderson on its own turf may be futile. Conversely, a Louisiana group could focus on some niche disease that isn’t already associated with a prominent facility, but then they (and the Medifund) risk investing in a limited market.
Some board members suggest betting on a growing specialty—diabetes treatment, perhaps—and trying to become a leader. But is it really practical, or politically advisable, for the Medifund board to pick those specialties?
Hecht says the board should create general criteria for a winning proposal, including a growing global market, existing local expertise, lack of significant competition, and high economic potential. Under this approach, the grant seekers would have to demonstrate how their proposal fits into the matrix.
“We let the criteria drive the outcome, as opposed to the committee,” Hecht says.
A national foundation might provide some of the grant money if it approves of whatever selection process the board comes up with. But there’s still a chance the Legislature might decide to actually fund its creation.
Hecht suggests looking at cigarette taxes, which in Louisiana are well below average. An extra buck a pack could raise more than $300 million in a year, he says; surely some of that new money could go to the Medifund? Gov. Bobby Jindal, who has thwarted efforts to raise cigarette taxes, might be succeeded by a governor open to the proposal.
Some Medifund board members say funded projects might be difficult to sustain as long as health care and higher education are always first on the state budget’s chopping block. Dr. Donna Ryan, a former professor and executive with the Pennington Biomedical Research Center and a Medifund board member, says the successes of Houston’s Texas Medical Center and the medical district in Birmingham, Alabama, were built on decades of steady financial support for their academic anchors.
“Higher education [in Louisiana] has been squeezed forever,” Ryan says. “It’s futile to try to do this [without] stable funding for your academic institutions.”
Hecht says several prominent good-government groups are looking for possible solutions to the state budget’s structural issues, which could be a point of discussion during next year’s elections. But as things stand now, even if there’s a short-term tax allocation, the state’s recurring budget crises could limit the Medifund’s success or doom its efforts altogether.