HJBR May/Jun 2026

DIALOGUE 14 MAY / JUN 2026 I  HEALTHCARE JOURNAL OF BATON ROUGE unlikely to get done. Editor Certainly seems that way. I want to switch to the environment for a moment. In our very first issue in 2007, we ran an article by an attorney who referred to the section of Louisiana with heavy petrochemical concentration as “Cancer Alley.” We received a call from Dan Borné, then the voice of the LSU Tigers and spokesman for the Louisiana Chemical Association, and he told us how disappointed he was that we ran it, but more disappointed that there was something called freedom of the press because otherwise he would have sued our ass off. Why have our states lowered standards compared to others and allowed our land to become what many consider sacrifice zones? Carville So I grew up in Carville, Louisiana. I’m 81 years old. If I would have spent my life in Carville, I would be dead right now. I mean, I can’t say that for a certainty, but I suspect that Carville has some of the highest — the epicenter of high pollution–induced disease. I would bet anybody. I can’t tell you if it’d be more than Garyville or more than Vacherie, but really high, really high. And we do have lax regulations. I think there’s so many natural resources at the river. We didn’t even need to do all that, but we did. And it's a terrible thing that’s happened. Editor And they say, “Oh, but we give you good jobs.” Carville Well, you know what? To some extent they do give pretty good [jobs]. I mean, they pay. And when you hadn’t had anything before — I mean, look at the damage that was done to our coastline — but people that were trappers and fishermen were all of a sudden working in the oil industry and making a good living don’t want it to go away. Editor Do you think we’ll ever get it back? Should we fight to get it back or just let it go and say it’s a “sacrifice zone” for the country? Carville I’ve always been passionate about the coastal issues, particularly because I grew up close to the coast. I went to high school and I played sports in Golden Meadow, in Houma, in Cut Off, in Larose and every place that you can think of. And frankly, I’m not sure this place is going to exist in the relatively near future. I mean, I see these stories about Terrebonne Parish. It’s gut-wrenching. It’s really gut-wrenching. Editor Do you have a solution? Carville Well, my solution would be the Dutch solution. The Dutch, I think like 1953, almost lost the country to a North Sea storm and they spent about, I don’t know, three times the GDP and built the finest system of water management and flood protection in the world. Why don’t we do that?And what’s happened, of course, they’ve made money because they’ve exported the expertise in technology. According to public health and security experts, the greatest problem that the world faces going forward is the replacement of people that live in delta areas because of rising sea level. So if we figured a way to engineer that to the benefit of society, we could take that and export our expertise all around the world, the way that the Dutch have exported their expertise in water management. We could be the greatest water management exper- tise area in the entire world, but we don’t want the fossil fuel companies and their dif- ferent interests, sometimes efficient inter- ests. I mean, if you look at what we did in Plaquemines Parish, we had the Barataria diversion, people almost lost their minds. And the truth of that is you’re not going to be able to address this problem. Some people are going to get harmed, but more people are going to be harmed by the status quo. And now I think the official [policy] of our state is, there’s no such thing as coastal erosion. In 1972 or ’73, there was a graduate student at LSU by the name of Woody Gagliano. Woody died not very long ago. He was liv- ing in Lakeview. I always wanted to go see him and I never got around to do it. He did calculations as a graduate student on coastal [land] loss and they were 39%. I mean, everybody knew what was happen- ing. It wasn’t any kind of secret. The people in Houston knew exactly what was going on and they just didn’t want to deal with it. And when I was a kid — it was true — [they’d say] the Texaco flag flies over [the] Louisi- ana State capital. It’s true. Editor Let’s switch gears to private health insurance. Insurers are driven by profit. The public reaction to the UnitedHealthcare CEO’s killing — bullets reportedly engraved with “delay,” “deny,” and “depose” — surprised many who don’t understand the frustration people feel with insurance companies. These companies are doing what they are designed to do: generate returns for shareholders. But being on the receiving end of a denied procedure — even if it’s later overturned — can be agonizing. Healthcare feels different than selling widgets for maximum profit. It feels like we’ve lost the humanity in the system and brushed past the word “care.” When a person first encounters someone asking how they will pay, it signals a priority. This isn’t done in most service settings. Do you think we’ve lost our humanity in healthcare? Carville Yeah, of course we have. Of course. Suppose you were driving down the interstate and you saw a billboard and it says, “We insure everybody. Buy our stock.” Well, there’s no such thing. All right? I mean, yes. And the truth of that is a lot of places around the world don’t do it that way, but we’ve done it. The thing I guess I keep coming back to is I’m afraid we’ve already set our course here. All right? And it’s very difficult for me to see how it changes. I would love to be proven wrong.