Mardi Gras Photo Gallery

Tuesday was Mardi Gras, and I spent part of the day in the French Quarter taking pictures. You can see them here. Perhaps in a show of post-Katrina civic pride, revellers in the Quarter wore more traditional masks and costumes than I can ever remember seeing. Many of the costumes were quite beautiful, and I have included some of my best pictures in the gallery.

Mardi Gras above all is a time of satire, a time for the common folk to make fun of people in high places. There were a few FEMA-themed costumes, a few George W. Bushes, but for the most part the humor was much more playful and good-spirited than last year, with less Katrina bitterness. I was very glad to see that.

Some highlights: A man dressed as George Bush with a Grim Reaper mannequin strapped to his back. The Grim Reaper had a fishing pole, and dangling from the end of the pole was a can of oil. In other words, the Grim Reaper was riding GW Bush's back, baiting him with oil.

Another good one: A man in an excellent Napoleon costume carried a sign offering to buy Louisiana back from the Bushes.

And finally: A man dressed as Rep. William Jefferson, the Louisiana politician currently under investigation after $80,000 in bribe money was found in his freezer. The faux Jefferson, wearing  a striped prisoner's uniform, was wandering the Quarter banquettes handing out fake $100 bills  with Jefferson's face on it. He walked right past me on Royal Street and handed a wad of the counterfeit money to a cop.

C'etait un bon Mardi Gras! 

Endymion and the Ladder People

On Saturday night, my wife and I went to see Endymion, the largest of the Mardi Gras parades. Although we had a good time, our experience was marred by the large number of tents and ladders people put up along the parade route.

The Endymion-ladder controversy is one of those issues that only a true New Orleanian can completely comprehend, but it has been ongoing for the last decade or so. The problem is that Endymion in particular has evolved into such a huge event that some people make a day of it, taking tents, barbecue pits, beer kegs, tables and chairs, and even television sets and stereo systems out to the parade route to enhance the party experience. Something like tailgating at a football game. People also take stepladders with them, sometimes 16 feet tall, and affix plywood seats to the top so they can sit up there and enjoy the parade above the heads of the crowds.

Here is the problem: the ladder and tent people arrive hours early (s0metimes even the night before) to stake out their territories. People who show up at the last minute are confronted with a wall of ladders and tents and can get nowhere near the parade. This is the worst for children. A three foot tall youngster can't see over an crowd of people simply standing up, so how is one supposed to see over a 10 foot ladder?

The ground these ladder people take up is city property. It doesn't belong to them. Yet in this matter they exhibit typical American behavior. They think anything they are not prohibited from doing must be their right. Have you noticed that about Americans? Anything -- whether it be blaring music from a car stereo, driving though a parking lot to avoid a red light, wearing shorts to high class restaurants, allowing children to run out of control in a store, or wearing T-shirts with obscenities inscribed on them -- anything that is legal is therefore a personal right. And the ladder people really do behave as if blocking other people's view is their Constitutional right. If you try to step in front of them, they will stop you and curtly inform you that they were here first and you have no right of passage through their claimed area. Negotiating an area full of ladders can be a sticky social experience.

The ladder people have been multiplying for years. Some people try to blame this phenomenon on tourists, but this is nonsense. Tourists don't know enough about Mardi Gras to think to bring a ladder or a tent to Endymion. I have been to the airport around Carnival season and have never seen a tourist loading a ladder or tent into a taxi cab. This is a local problem. And this is a situation where the rights of the few trump the rights of the many, because the vast majority of parade goers don't bring ladders. It is the doing of ten percent at the most.

Before Hurricane Katrina, the New Orleans police tried confiscating ladders, but this led to such ugliness that they gave up. As a result, the practice has grown and grown, and in my opinion, this year was the worst ever. My wife and I walked seventeen blocks down the parade route Saturday looking for some break in the wall of ladders. There was nothing, not even a four foot interruption along St. Charles Avenue from Napoleon to Washington Avenue. That makes for a tremendous number of ladders.

The strange thing is that the ninety percent of people without ladders put up with this. I think there are a few reasons why. First, many people don't want any trouble, and banning or restricting ladders could cause trouble. Second, a lot of people look at the wall of ladders and, instead of wishing the ladders were gone, wish they had ladders too. This is an interesting line of thinking because it explains a lot about the politics of elitism. Why, for example, does a large population put up with lousy public schools while a minority gets excellent schools? Because it is easier to be envious, and promise yourself the fiction that you will obtain what they have, than it is to demand fairness. The final reason the ladder people exist is that the majority do not know how to change the rules. The majority of people have never looked at an unfair rule, demanded it changed, and then watched as it was changed. People don't believe change is possible, and so the ladder people live on.

This is a job for an economist. Though I am not always pleased with the way economists explain human behavior, I think in this case an economist would offer the best solution. Economists believe that when people engage in undesirable behavior, the solution is not to ban the behavior, but to tax it. Following this line of logic, instead of banning ladders, the City of New Orleans should issue ladder permits. The permits needn't be expensive -- maybe $25 to $50. With the permit comes a large colored tag. Before the parade, city officials will canvass the parade route. Anyone with a ladder without a tag will have a choice, a ticket for $150 or they can buy the $50 tag with a $50 late fee tacked on.

One of two things will happen. Either the number of tents and ladders will dramatically decrease, or the city will make a ton of money. A win-win situation, I would think.

Note: If you look closely at the last photograph, you can see what I am talking about. The entire foreground of the photo is comprised of a row of ladders, shoulder to shoulder, all the way across. There is no way through it. And we picked a spot where the ladders were shorter, so we would at least have a chance to see something! 

Here's Johnny

Mardi Gras is just around the corner, and to celebrate I like to queue up my collection of New Orleans music on my iPod. Just as carols lend Christmas its distinctive sound, a large group of Louisiana artists give Mardi Gras its own unique soundtrack. I would like to introduce you to one of my Mardi Gras favorites.

Johnny Adams was a blues singer, and one of the finest vocalists ever to come out of New Orleans. He is best known for his remarkable range, his ability to effortlessly soar over the gritty backing of his blues bands. Many male vocalists can sing high, but Adams had the unusual ability to hit very high notes and without losing his masculine vocal timbre. The only other singer that comes to my mind who could do that as well as Adams was Roy Orbison, but Johnny's voice was raspier, more streetwise, and yet equally passionate. Adams could groove along, then suddenly explode with emotion. In these days of the American Idol, where young singers are coached to elevate to maximum energy from the very first note, it is refreshing to listen to a singer who knows how to hold back until precisely the right moment.

About a year ago, I bought a very nice blues album called Night Train To Nashville, a compilation of blues and R & B songs from Nashville in the 1950s and 60s. The point of the album was to showcase the R & B talent recording in Nashville at the very time Country-Western was swallowing that city's music scene. Something of a retrospective look at Nashville's lost sound. As I listened to the CD for the first time in my car, I heard a familiar voice. I had to pull off to the side of the road to look at the CD case. Could it be? Yes, it was Johnny Adams! I was surprised because Adams had spent almost his entire career in New Orleans, and I had never thought of him as anything but a New Orleans musician. But apparently Adams had gone up to Nashville in the 1960s a few times to cut records. In the brief time he was there, he impressed the establishment so well that the producers of Night Train chose to include him among Nashville's all-time best bluesmen.

That says a lot. A singer who can briefly flit through a town as musically sophisticated as Nashville and make such an impression that he is still remembered 40 years later must have been nothing less than a monumental talent. And he was. Adams died in a Baton Rouge hospital in 1998, but he is not forgotten. I play him every year come Mardi Gras. Some of my favorite Johnny Adams tunes include the unearthly "I Won't Cry," "Reconsider Me," and one of the best song titles I have ever heard, "Hell Yes, I Cheated."

The Ugly Stepchild

The 2007-08 Federal budget has been submitted to Congress. It includes an 11% increase in defense spending, which is no surprise. Nor is it surprising that this spending increase will be financed in part through cuts in health care. One hundred billion dollars will be excised from Medicare and Medicaid, and there will be deep cuts in funding to medical training programs. (I had to borrow $130,000 to get through medical school. I guess this means future doctors will be borrowing even more.)

These budget cuts will mean serious pain for the U.S. government's two largest healthcare programs. Healthcare costs continue to rise much more rapidly than inflation, and the Bush administration is looking to cut funding at a time when demand is increasing. Medicare, the larger of the two programs, insures almost all Americans over 65 and many people on disability. Medicaid is America's idea of healthcare for the poor. It is so underfunded that in most states it excludes anyone with a job, even a part-time minimum-wage job, meaning that a lot of  Americans are forced to choose between working for $5.15 an hour and having health insurance.

On Wednesday of last week, Health and Human Resources Secretary Mike Leavitt went to Capitol Hill to defend the President's budget before the Energy and Commerce Committee. When Mr. Leavitt was asked if the budget cuts would result in hundreds of thousands of children being kicked off of Medicaid, he answered cryptically, "That it is dependent completely on the state rules." In a mealymouthed, roundabout way, what he was saying is that the states can continue to insure children on Medicaid if they change their policies and pay more of their share of the bill (i.e., raise taxes). Hardly an unqualified commitment to the future of Medicaid.

Many people think of Medicaid as welfare, as a government handout for the poor. While this is to some degree true, Medicaid is also one of the largest insurers of children in America. One in five American children is enrolled in Medicaid in any given year. According to the U.S. Department of Health and Human Services, 59 million people enrolled in Medicaid in 2004, 29 million of them children. Cutting this program will hurt millions of people, most of them poor, and most of them children. And the reason? To finance a war.

It is not possible to lay the full blame of this sad situation on the White House, however. I was greatly disappointed to read the American Medical Association's press release on the proposed budget:

The AMA is deeply disappointed that President Bush has once again ignored an opportunity to right the wrongs in the current Medicare physician payment system by failing to call on Congress to stop the cuts and provide payments in line with practice costs. Current average Medicare payments to physicians are about the same as in 2001, and next year’s reimbursement will be cut 10 percent – unless Congress intervenes.

What is missing from this statement? The word Medicaid. The AMA is all over Medicare, and rightfully so, but in this, and in virtually all other missives I get from them, Medicaid is nowhere to be found. It is the ugly stepchild of healthcare policy. Since most Medicaid recipients are poor and under 18, they do not vote and do not contribute money to political campaigns. It is easy for us to pretend they don't exist.

The AMA has been a strong supporter of Republican healthcare policy for many years. It is hard to see why. What have the Republicans done to improve healthcare in the United States? George W. Bush ran for president in 2004 on the vague promise that he would reform medical malpractice law. He has done nothing of the sort. Nor has Republican leadership offered any revision to our healthcare system other than tax cuts and tax credits. I do not pretend to know everything about health insurance policy, but one thing I can promise is that we will not fix what is wrong with the U.S. healthcare system by jiggling the tax code.

I do not have a problem with the AMA fighting the good fight to keep up Medicare funding. But I am not worried about Medicare. Medicare is healthcare insurance for the elderly. The over-65 demographic group is the fastest-growing segment of the American population, and people over 65 vote. It is unthinkable that Congress would allow Medicare cuts to pass. Any politician who supported such cuts would be signing his own suicide note.

The AMA throws its considerable funding and prestige behind efforts to restore Medicare funding because increasing Medicare funding is both popular and financially beneficial to doctors. Medicaid, however, is a different matter. Most doctors don't see Medicaid patients. While 75% of doctors accept patients with Medicare, less than 25% accept Medicaid. Since doctors rarely depend on Medicaid for their income, and since most Medicaid patients are very poor and have no real political power, there is a real possibility that, while the Medicare cuts get restored, the Medicaid cuts could stick. If they do stick, hundreds of thousands of people will move into the ranks of the uninsured, and many of them will be children.

One way to get a feel for how well the government funds Medicaid is to look at the ratio between what Medicaid and Medicare pay for the same services. In other words, if Medicare pays $100 for a particular service, such as a new patient office visit, how much does Medicaid pay? This ratio varies from state to state, but overall, in 2003 it was 0.63 for primary care doctors. That is, on average, Medicaid only paid doctors 63 cents for services that Medicare would pay a dollar for. In Louisiana, the percentage was 0.73, which is pretty good. California paid 0.51, New Jersey paid 0.35, and New York paid 0.45. Now, if you were a doctor in New Jersey, how would you feel about getting only 35% of the payment would get if you saw the same patient under Medicare? Would you consider not seeing Medicaid patients at all? And the Bush administration wants to cut Medicaid funding even further.

When I was in Louisiana, I got about $28 in reimbursement for each Medicaid patient I saw for a typical office sick visit. If I saw 4 patients an hour, that would come to $112 an hour. In a typical doctor's office, after factoring in the nurse's salary, the receptionist's salary, rent, heat, light, phone, and insurance costs, it costs more than $100 an hour just to stay open. For a specialist, who may require high tech equipment such as ultrasound machines (OB/gyn, cardiology), lasers (dermatology), Xrays and casting equipment (orthopedics), the cost can be much, much more. It is very difficult to see a Medicaid patient without losing money.

It would be one thing if Medicaid simply paid badly. Perhaps doctors would take it anyway, just as an act of charity. Many would, I believe, except that Medicaid, besides being the cheapest payor in healthcare, is also the most annoying. Here is a concrete example. In both Louisiana and Mississippi, Medicaid has a drug formulary -- a list of medications it covers as part of its plan. In this way Medicaid is no different from most other drug plans. But in most drug plans, the drug formulary is composed of tiers. First tier drugs are the cheapest -- usually generics -- and the insurance  pays for the majority of the cost with a small co-pay of maybe $10. Second tier drugs are more expensive, and the drug plan usually pays for them also but requires a higher co-pay of, say, $30. Drugs on the highest tier have the highest co-pay, and the plan will often only pay about 50% of the cost or less.

Medicaid is different. Medicaid is the only insurance plan I know of in which the plan has no second tier. Medicaid pays all the cost of its first-tier drugs except for a small copay of $2. For everything else, it pays nothing. This forces doctors to write for formulary medications. Patients with Medicaid are by definition poor, and they cannot afford non-formulary drugs. The only way around this rule is to apply for an override, known as a Prior Authorization, or PA. In my experience, Mississippi Medicaid rarely approves PAs, and PA forms take time to fill out and file.

So instead I have to memorize the Medicaid formulary and work only with it, even if I feel my patients would be better served with non-formulary drugs. To make matters worse, the state of Mississippi changes the formulary every 3 months and never, ever sends me a list of their changes. I may have a patient on a particular medication for months or even years, and then suddenly the medication is dropped and I start getting phone calls from pharmacies on behalf of patients stuck with huge drug bills. I find out what is now covered, and I rewrite the prescriptions. This is easier than signing a hundred PAs and waiting for the rejections.

This agonizing bureaucracy is typical of Medicaid, and to my knowledge, occurs in some equivalent manner in every state.

To sum up, there are no benefits to taking Medicaid patients. The reimbursement is lousy, the drug formulary is difficult and annoying, there are severe restrictions on services providers are allowed to bill for, and, on top of all that, the program makes no effort whatsoever to accommodate doctors who are trying to work with the system out of concern for patients. One would think that a program in which nearly 80% of doctors refuse to participate would be eager to work with the 20% who do. One would think.

What we have is this orphaned program, a program that provides a critical service to some of the sickest and poorest patients around. The federal government wants to slice it up, the AMA has forgotten about it, and most doctors want nothing to do with it. If there were not real lives at stake here, we might even think this is funny.

Most people with private insurance give Medicaid no thought. All I can do is invite you the reader, next time you pick up a paycheck, to look at that check and consider a possibility. If you were to lose your job and then contract a serious medical illness, that forsaken program may be all the medical care you can hope to get. Don't laugh. I can name a dozen patients of mine who have found themselves in exactly this predicament.

Think it over. Then go out and vote accordingly.

Scandal

Add one more misery, one more scandal to all the miseries and scandals that have plagued the Gulf Coast since Hurricane Katrina. Of course, there haven't been enough. This one, which only started to emerge in the national media this week, concerns the rate at which recovery money has been distributed to the people who most need it.

In a word, slow. Very, very, very slow. Scandalously slow.

In the months after Katrina, Congress rapidly authorized an emergency recovery package. Though less than what people down here were hoping for, it was nonetheless substantial, allegedly $110 billion. A year and a half later, a little over $50 billion of that has been spent, meaning that there is about $60 billion of approved money sitting in the Federal Reserve while hundreds of thousands of people still live in trailers.

And this ratio of 45% is much worse than it appears. When government officials tallied up the $110 billion figure, they included in that total $20-25 billion in payments made to policyholders under the federal flood insurance program. Allow me to clarify that. The federal government considers $20 billion paid to people who paid insurance premiums to be recovery money. When Katrina hit, I had a flood insurance policy in place on my home which covered its entire value. I paid premiums on this policy for four years. According to the government's own figures, by redeeming my insurance policy according to its terms I am in receipt of "recovery money." I am on the dole.

Strip away that $20 billion as any truly honest person would, and the real recovery figure stands at more like $90 billion. Still a lot of money, right?

Yes, but even that number is misleading. The federal government owns a lot of property damaged by Katrina, including a destroyed interstate link over eastern Lake Ponchartrain, Keesler Air Force base in Biloxi, Jackson Barracks in the Ninth Ward New Orleans, and Post Office and federal offices throughout the area. These federal properties are the responsibility of the national government, and the feds would be fixing these properties even if they refused to spend a penny on the citizens of the Gulf Coast. It is dishonest to advertise money spent to fix your own roof as charity. So we ask: Are the billions appropriated to fix the U.S. government's own property added into that $110 billion figure? Oh, yes.

Here is the worst part. Most of the government's obligations as the guarantor of the Federal Flood Insurance Program have been paid out. The government has also been pretty good about paying out money to fix its own properties. This means that the vast majority of funds already paid out are for obligations the government would have had to meet, no matter what.

What hasn't been paid out? In Louisiana, of $7.5 billion slated to help uninsured people who lost everything, $14.4 million, or less than one third of one percent, has been paid out. Money for damaged local government property still sits in the banks. Money to help public schools to recover, to rebuild the shattered health care system in the city, has yet to be spent.

In other words, the money that would make the most difference in the lives of the poor, of those rendered destitute by the storm, comprises the majority of the unspent money. Fine, the Feds have approved and are spending $2 billion to fix the span of Interstate 10 over Lake Ponchartrain. But it has only spent $1.3 billion of the $5.8 billion appropriated for levee repair.

Yes, you read that line right. After Hurricane Katrina, a disaster in which most of the damage was caused by levee failure, the government has only spent about 20% of the money it has to fix levees.

FEMA has only spent $25 billion of the $42 billion given it. The E in FEMA stands for emergency. I always thought there was something about the term emergency that implied hurry up. Perhaps not.

I will site a specific example to show how the delay is not only costing money, but human lives. The city of New Orleans (which has so far received only 14% of the funds promised it) has been experiencing a surge in its murder rate recently. This surge is supposedly a result of turf wars as drug dealers return to the city and attempt to re-establish themselves post-Katrina. New Orleans, in the midst of this crime wave, lacks the resources to properly investigate and arrest suspects in murder cases. The police force is headquartered in a trailer park. By itself, the organizational problems of shuffling arrested individuals, witnesses, and paperwork through a maze of trailers is greatly impeding police work. But there is another problem. The NOPD has lost its crime lab, and this makes prosecution difficult because all evidence in criminal cases has to be farmed out at great expense to other crime labs. This has created an overwhelming case backlog, and unprosecuted criminals end up being released after brief detentions to walk the streets because evidence has not been processed.

New Orleans could really use its money to rebuild its crime lab. But Uncle Sam drags his feet, the city remains broke, and the bodies pile up in the old slum neighborhoods.

Why can't the federal government spend the funds already budgeted? Off the record, officials say it is because we are a bunch of crooks. Fearful that the money will be wasted, the White House drags its feet through endless tangles of red tape, refusing to pay out a dime until every penny is justified in triplicate forms. Louisiana politics is corrupt they say, and the government has to be careful. In a letter written to former Speaker of the House Dennis Hastert and quoted in the Wall Street Journal this past week, Rep. Tom Tancredo of Colorado summed it up this way: "The question is not whether Congress should provide for those in need, but whether state and local officials who have been derelict in their duty should be trusted with that money . . . . Their record during Hurricane Katrina and the long history of public corruption in Louisiana convinces me that they should not."

Taylor Beery, the director of policy for Donald Powell (the Bush-appointed recovery czar) told the Wall Street Journal in a written statement: "Some people see [the regulations that delay disbursement of funds] . . . as overly cumbersome, but . . . there is a reason, and that reason is to ensure that the taxpayer money is spent properly."

I want the money spent properly, too. But spent properly in this case means a whole lot faster. Donald Powell is supposed to be in charge of the recovery effort. That means he needs to be an advocate for the people he is trying to help, not a shameless apologist for the sorry excuse for an executive branch we have in Washington. Not to overly generalize, but this has been G.W. Bush's problem from the start. His appointees do nothing but make excuses for him. No one wants to stand up and admit a mistake, no matter how much suffering or how many dead bodies are involved.

However, it is not just the Bush people who have labeled Louisiana as a nest of crooks. We got a lot of that after the storm. Basically, the argument amounts to: Your local government is corrupt, so we have no intention of helping you. Which I guess would be perfectly fine if the federal government had a check box on the 1040 tax form that allowed us to skip paying taxes when we feel the federal government is too corrupt. After all, if they don't have to help us because they think we are corrupt, it seems only fair that we should not have to help them should we happen to adopt the the same opinion about them.

This "you are too corrupt to merit help" argument is tantamount to my saying, in my capacity as a doctor, that I will not treat a child with leukemia because I did not approve of the behavior of the child's parents. The local government's failure, lamentable as it was, does not mean the people of Louisiana, American citizens every one of them, should be punished for the actions of their leaders. No one votes for corruption. Voters get to choose among the scoundrels on the ballot. As for me, I did not vote for governor Blanco. I did not vote for New Orleans mayor Ray Nagin. I did not vote for the fool that passes for President of St. Bernard Parish, the place I used to live in. For that matter, I didn't vote for George W. Bush either. As a citizen, I did everything I could in the voting booth to keep the current situation from happening. What else am I supposed to do, besides turn assassin?

Yes it is true that Louisiana has a distinguished history of political corruption. But I refuse to believe our history is really all that much worse than anywhere else.  The difference is that in Louisiana (and Mississippi also) there is very little big business. We are poor states. In a poor economy, the crooks gravitate towards the money, and the money is in government.

Compare New Orleans to New York. Why would a self-respecting crook go into government in New York City while Wall Street beckons? Is anyone really going to argue that a politician in Louisiana who gives a $3 million contract to his cousin is less honest than a CEO who pays himself $250 million in a year his company loses money?

It defies credulity that the leaders of the federal government, in their little world ringed with lobbyists, political action committees and "think tanks," and in a city crammed with government consulting businesses everyone refers to as "beltway bandits," have the nerve to tell a state with a $26 billion annual budget it is inefficient and corrupt. Congress spends $26 billion every 72 hours. And it spends $110 billion, the entire amount of the Katrina recovery effort, every two weeks.

Why is it that when a Louisiana politician gives a job to his son that is considered a corruption, but when President of the United States decides on his own that the writ of habeus corpus is optional in terrorist court cases, when a company the Vice President used to be the CEO of wins billions in no-bid contracts in Iraq, that is considered honest politics?

I would appreciate it if Louisiana's and Mississippi's critics would just get over themselves and admit that they don't give a damn. If you have to be a heartless scum-bag, so be it. No need to complicate the picture with hypocrisy.

The procedural explanation for the slow rate at which the funds are being paid out is the Stafford Act. Passed 30 years ago to prevent the misuse of federal funds, the Stafford Act is a set of regulations that tightly controls the way federal money is paid out. According to federal officials, the problem is that local officials are slow to comply with the Stafford regulations. Local officials say the rules are so complex and onerous that getting funds is extremely difficult.

Having filled out my tax forms a few times, I find it very easy to believe that federal regulations are excessively complex. It is also hard to forget that, in the days right after Katrina when people were dying as they waited for help to show up, the feds had the same excuse then. Remember? It's not our fault we can't get there. It's those darned local officials. There is nothing for us to do but sit here and watch people die on their rooftops on TV like everyone else.

Recovery money has an expiration date. People can't afford to keep their lives on hold forever. If the federal government promises a business a $50,000 grant and then takes two years to come up with a check, that business is not going to survive. A business owner can't afford to ask his employees and his clients that to wait for a couple of years until the company gets the money to reopen its doors. At some indeterminate point, each business owner will give up and leave.

Yesterday a drug representative came into my office and told me a very sad story about friends of his. These friends lived in Lakeview, an upper class but hard-hit neighborhood in New Orleans. They wanted to rebuild, tried hard to rebuild, but time and time again ran up against red tape. Their insurance wouldn't settle with them, and the government would not approve their grant application. Eventually they gave up, abandoning their home, and don't plan to return.

Here is the cruelest blow of all: the Bush administration has the power to suspend the Stafford Act. This was done after Hurricane Andrew in 1993. It was also done in Manhattan after the 9/11 attacks. It hardly seems fair that an area that suffered even greater devastation than these two and with less financial resources is saddled with the highest administrative burden of all.

It has been 18 months since Katrina, and New Orleans is nearing a crisis stage. Either the federal government is going to step in and do what it said it would do, namely, bring New Orleans back, or the city is going to die. How the richest country in the world, the richest country that has ever been, could allow something like this to happen is beyond me.

All I can honestly say is that, if New Orleans dies, my faith in America dies with it.

Note: I relied on the article "In Katrina's Wake: Where Is the Money?" in the Wall Street Journal Saturday, January 27, 2007 for many of the facts quoted in this essay.