Month: December 2011

Faculty Letter to UofL President Ramsey & Provost Willihnganz About Hospital Merger

I have not heard much public criticism of the proposed acquisition of University of Louisville Hospital by Catholic Health Initiatives from UofL faculty members.  Not surprisingly there has been support by the University-dominated boards of the hospital, the Cancer Center, and the like.  The individual response of the retired faculty member of the Brandeis School of Law and widely respected constitutional law scholar, Professor Robert Stenger, could not have been more critical of the proposal.  I asked an old friend on the Medical School Faculty how his colleagues felt about the acquisition.  I was told that they were unsettled.

There are legitimate reasons of self-protection why individual current faculty members might hesitate to express their honest opinions.  Such a move could be a career-limiting event.  I confess to being a little surprised but immensely proud when I was given the following letter sent by the most senior faculty of the School of Arts and Sciences to President James Ramsey and Provost Shirley Willihnganz.  Their letter is in the finest tradition of higher education and citizenship.  I do not believe it has been published before, or a least I have not seen it referenced in the current debate.  There is little I can add to it.  Here it is. Continue reading “Faculty Letter to UofL President Ramsey & Provost Willihnganz About Hospital Merger”

Questions Unasked at Recent Louisville Forum on Hospital Mergers

Last Wednesday, Dec 14, I appeared on a Louisville Forum panel with two other individuals with serious concerns about the proposed acquisition: Ms. Beverly Glascock, a nurse and attorney; and Dr. Ken Zegart, a prominent Ob/Gyn physician.  It turned out to be a spirited affair.  The house was packed with UofL supporters.  There was not much time for many of the questions submitted in writing from the audience.  I was disappointed in the spectrum of questions asked.  I had prepared a list of questions that I hoped would be asked of the supporters, and in fairness, a list of questions I half-expected would be asked of us.

How would you answer these questions?  I will take a stab at them one-by-one in subsequent entries in this Policy Blog.  If you indicate a favorite, I will tackle that one first.  I numbered the questions in each section for that purpose although they are not in any particular order.  Look also at the many questions I posed in the first major entry in this Hospital Acquisition Series.  What questions would you have asked?  Ask them here!  Perhaps the acquisition proponents will respond respond as well.  Read on to see the questions.

Continue reading “Questions Unasked at Recent Louisville Forum on Hospital Mergers”

Dust-Up Over Disbursement of QCCT Funding to University Hospital

There was a little excitement this week in the Louisville Metro Council over whether or not to continue the next installment of the $7 million indigent care payments to University of Louisville Hospital from the QCCT funds. The City of Louisville and Kentucky provide many millions of dollars annually against which University Hospital can bill for eligible indigent patients.

There were a number of issues that caused the Budget Committee to put the brakes on the city’s payments as of January 1. One was that that in the post-Passport scandal era the Hospital had not provided the requested and expected accountability. It is puzzling to me that the Council expressed the same transparency concerns last July but had still not been satisfied. Is the council giving too much deference to the university?  The procedural move also signaled that there are deep concerns about the proposed acquisition of University of Louisville Hospital by the hospital chain Catholic Health Initiatives out of Denver. Would the same services be provided, and would it even be legal to give public funds to a private religious organization.

Two days later the Council as a whole voted to release additional installments of the remaining $4.8 million funding until March, pending the apparently delinquent reports by the Hospital. Councilman Downard said that, “the hammer is still there” concerning their demands for information, but I thought the hammer had already been cocked! So much for transparency from this self-declared private institution. Amendments were offered to make the continuation dependent on providing the same range of services after as before any take-over but they were defeated. The protest of the committee hold was overridden, but its point was made. The University of Louisville made some of its documents available publicly the very next day. The University seems to realize that it has lost its public relations war against the citizens of Louisville. I sent the Council an open letter the day of their main meeting. It gives additional details and outlines my thoughts about whether the QCCT mechanism is still an appropriate way to fund indigent care in our city, or whether it has had unexpected and undesirable consequences. What do you think?

Continue reading “Dust-Up Over Disbursement of QCCT Funding to University Hospital”

Health Care Reform: Vision or Hallucination?

Has anything in health care improved for the better for us patients… for anyone?

Over 10 years ago as we approached the new millennium I was finishing an intensive Health Policy Fellowship.  As a synthesis of all I had seen and learned from an insider’s perspective, I penned a vision of what I thought healthcare should look like in the next century.  It was more a statement of some twenty principles and directions rather than specifics. We are now more than a full decade into the 21st century so it seems a good time to take a look at my old roadmap.   Perhaps it is a measure of my current pessimistic state of mind, but I am not immediately able to declare progress towards any of the goals I envisioned.  In fact, it seems at first blush that despite all the money and best efforts of public and private interests, that most of the items on my wish list are getting worse.

What do you think?  Please prove me wrong.  Help me indentify something good that has happened to us as collective patients.  Is anyone better off?   If so, who?    Convince me that we are not irreversibly lost in a status quo of decreasing access to healthcare of uncontrollable cost, and of unknowable quality.

Add a comment below.  I will not spam you, I promise.

Peter Hasselbacher