Why UofL Can’t Say No to the Kochs or Papa John.

A Former UofL Lobbyist’s Perspective.

A few months ago, someone anonymously sent me preliminary news reports about the University of Louisville’s engagement with politically conservative donors over the establishment of a new University Center.  A fair amount has been written since about the UofL’s willingness, if not eagerness, to accept a grant from the John H. Schnatter Family to fund a new John. H. Schnatter Center for Free Enterprise within, but effectively independent of the School of Business.  Insider Louisville and the Kentucky Center for Investigative Reporting have followed the matter closely.  The grant itself is contingent on the University’s also accepting a grant from and sharing controlling interest with the Charles Koch Foundation.  Most community concern stems from attached strings that restrict the academic viewpoints that can be addressed by the funding, and which give inordinate and inappropriate academic control to outside political and business interests. Read the Grant Contract yourself (6MB).  As I lifetime member of the Academy, it made me shudder— and I am not alone. Alas, I do not think the University felt it was in a position to say no.  Even as a non-University person, would you have agreed to all the provisions in this contract?  If so, tell us why in your own name in the comments section. What parts of the contract do you believe are inappropriate? I don’t have enough room to do so here. Continue reading

Another Major Data Breach for a Health Insurer.

Hackers breached whatever firewalls and security measures were present at Premera Blue Cross based in Washington state.   The personal, financial, and now even medical information of some 11 million past- and present customers were accessed. The breach may have occurred last May, was detected on January 29, but not disclosed to either the public or regulators until a few days ago.  Nice job on the accountability front.

I recently wrote about an even larger breach of security at Anthem where the personal information of almost 80 million people was penetrated.  It was not thought that medical information was compromised then, but how can one know for sure?    I predicted we would be seeing more attacks on medical record and insurance databases but it is disappointing to see them coming on so rapidly.  There are at least two driving forces or enablers.  The first follows from Willie Sutton’s law explaining his reason for robbing banks—because that is where the money is.  Some 18% of our gross national product fuels the healthcare industry— that is where the real money is.  Medical fraud is part of that big business. Continue reading

Was Kentucky Spared from CHI Layoffs?

Is there still a nursing shortage in Kentucky?

Earlier this year, and following a disappointing report for the first quarter of FY 2015, Catholic Health Initiatives announced that it would cut 1500 jobs nationally by the end of January.  The positions targeted were administrative and support staff representing some 1.7% of CHI’s total 90,500-person workforce.  KentuckyOne Health (CHI’s operation in the Commonwealth) had already absorbed an previous layoff of 500 employees one year ago but remains the weakest sister financially among CHI’s regions.  Locally, concerns were shared that we might take another hit this round. Has that happened?

To be fair, CHI is not the only big system to be laying off people.  A nationwide shift from inpatient to outpatient services has even the prestigious Cleveland and Mayo clinics trimming their staffs.  Frankly, I have not heard much of anything about layoffs in Kentucky– at least in the Louisville market. Even a usually productive Google search did not reveal much for me.  The most notable activity is in Omaha where CHI’s hospital and clinical system have no current network contract with Blue Cross/Blue Shield.  The drop in patient volume there is said to have sparked layoffs of at least 156 people including physicians! Additional job cuts were anticipated through attrition and by not filling open positions.  There have been layoffs reported in Oregon too. Otherwise things seem to be quiet. Is that what happens when administrative jobs get cut?

In fact, in the usual on-line places, KentuckyOne is advertising to fill quite a few clinical positions in Louisville. I am informed that some modest hiring of clinical-support people is also occurring. I do not know what is happening in the rest of the state.  Good! Lets face it– you can’t run a hospital or medical office without doctors, nurses, and technicians.  If you terminate too many of these, people tend to notice, including accreditors and regulators.  I asked KentuckyOne how much and in what way Kentucky might have shared in CHI’s nationwide job-reduction program but did not receive a reply. Continue reading

You Can’t Always Get [What You Pay For]

But if you try real hard— you might do better than Venezuela!

Providing healthcare to [some] Americans is the best economic development bonanza going. Alas, here in the exceptional USA, many people do not have access to mainstream healthcare.  Worse however, as pointed out in today’s Wall Street Journal [yes, I do subscribe], nearly all Venezuelans needing even standard medical or surgical care are plum out of luck— unless they can find and then afford to buy their own medical supplies from insulin to heart valves.  It sounds awful. Hyperinflation makes already overpriced medical devices and drugs impossible to afford. An exodus of physicians, including those whom were loaned by Cuba, makes matters worse. The situation is beyond frustrating for both patients and physicians alike.  At least our feared but imaginary American death panels would have actual choices to make!   Venezuelans are in very real death-spirals of the flesh, not the death-spirals health insurance companies face when they are left holding the bag for sick people when healthy and less ill people fail to enroll in their plans.

The disheartening article included the following graphic showing Venezuela at the bottom of the list of Latin American countries, spending in 2012 only 1.6% of its gross national product on healthcare (and that was 2 years ago). The numbers from the World Bank are only slightly different.  If fact, according to that source, its healthcare spending in 2012 puts Venezuela at the bottom of the list of every other ranked country in the world, occupying a healthcare category all of its own.  That country is suffering the melt-down that apocalyptic American alarmists either warn of, or alternatively fantasize about as a starting point from which to rebuild from the ashes. Continue reading

UofL Faculty Senate Voices Harsh Criticism of Executive Bonuses.

Andrew Wolfson of the Courier-Journal has already reported on Wednesday’s meeting of UofL’s Faculty Senate. I was there to as a member of the Executive Faculty and want to add my comments. The Faculty Senate has elected members from every school and college and is the faculty body of highest jurisdiction. I represented the School of Medicine on the Senate for a number of years.

The principal item on the agenda of interest to me was a discussion item labeled “Foundation compensation.” Although the intention of the Senate Chairperson was to limit discussion to the deferred compensation of the President, Provost, and the President’s Chief of Staff; subsequent discussion by the faculty expanded that focus to include the separation payments made last year to at least three other senior University officers and vice-presidents that were accompanied by controversial agreements of nondisclosure. The discussion opened an obvious can of worms. Mr. Wolfson by no means overstated the degree of faculty concern. Not a single faculty member expressed support for what the University and the University of Louisville Foundation were doing. Continue reading

Major Shift in Scope of Litigation in Norton Healthcare v. Univ. of Louisville

Some major demands appear to be dropped… at least for now.

I made the pilgrimage to Frankfort this afternoon. A lot has happened since my last dip into the legal documents of this case. There were thousands of pages to review but at 25 cents per copy, I had to fall back on taking photographs of the most recent 1600 pages. There was a court hearing only yesterday! A summary of that session is attached. It looks like the otherwise short hearing was interrupted by some off-the-record discussion between the parties. The index to the video of the court proceedings attributes to Judge Wingate that “what remains in this case is the issue of the amount of the reimbursement that needs to be paid from Norton. This should be able to be taken care of through mediation.” Additionally, “The hearing on the 18th is not needed. The parties should continue in the discovery process.” Continue reading

Next Round in Norton Healthcare v. UofL.

Only Superficially About Cooperation with UK?both-logos-150

The lawsuit stemming from UofL’s claim that Norton had violated its land-lease agreement with the Commonwealth, and the initiation of a process by the University to wrest physical ownership of Kosair Children’s Hospital from Norton is on the docket for Franklin County Circuit Court on March 18. Norton is asking for a judicial determination that its non-binding Letter of Intent (LOI) to cooperate more closely with the University of Kentucky over children’s health does not violate is ground lease with the Commonwealth or any other agreement with UofL. Because the Commonwealth actually holds the lease, the Finance and Administration Cabinet intervened as a defendant on the side of UofL. Continue reading

Family and Medical Leave Act Provisions Extended to All Same-Sex Married Couples.

Regardless of what the U.S. Supreme Court decides in resolving the lower court differences over whether individuals of the same sex can marry in all states, the tidal wave of change in both public opinion and law sweeping over the country only gets higher. The U.S. Supreme Court recently found in U.S. v. Windsor that gay and lesbian couples that were legally married could not be denied the ability to file their federal income taxes jointly from other states, even those which refused to recognize that marriage. To do so for federal tax purposes was found to be a denial of equal protection under the law and therefore unconstitutional. Since marriage status is relevant to a multitude of other civil matters, it is not surprising that other regulations or laws might be revised. So it came to pass last week when the U.S. Department of Labor (DOL) published its final rule on eligibility to take advantage of the Family and Medical Leave Act (FMLA). The rule goes into effect March 27, 2015.  A Fact Sheet and Frequently Asked Questions are available on the DOL website. Continue reading