Open Letter to Metro Louisville Council Concerning QCCT Fund for Indigent Care

The Status Quo is Not an Option.

In an earlier article, I urged all readers to make their opinions known to Metro Louisville leadership about how to handle the University of Louisville’s request to maintain the status quo for how public money for indigent care is funneled to University of Louisville control.  In that spirit, I sent the following letter to each of the Metro Council members and to the Mayor.  Given that the University’s own internal review process is unlikely to produce detailed financial information relevant to its use of QCCT funds, and that it is not yet known if the Kentucky State Auditor’s office will have adequate access to the University’s books to do its job, how the Metro Council decides to act becomes even more important.

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Dear Metro Council Member,
You are being pressed hard to maintain the status quo regarding the QCCT fund used to support indigent care at University Hospital. I believe that those who provide medical care to the uninsured and under-insured on behalf of the rest of us should receive necessary public support for that responsibility. I also believe that we now have a historic opportunity to review and restructure the way we provide medical assistance to the disadvantaged. I do not believe that the QCCT fund as it exists now is either the fairest nor the most efficient way to provide such support. Rather, I think it has gotten in the way of a just use of public resources and created an expensive second-class system of medical care. I also believe that the University of Louisville is in a position where it must regain the public trust it has squandered before it can be entrusted with additional public support.

I have attached a position paper that includes some recommendations on how the public interest might be served. Its major recommendation is that the University must become more transparent in its uses of public money it has already received, and that if it wishes to be treated as a public hospital, it must abandon its ill-conceived claim that its hospital is a private institution not subject to public inspection.

I wrote this article in response to the massive lobbying effort launched by the University and its President and I have posted it on the website of the Institute. I know that my position is not an isolated one, and I request that in fairness, you consider my response to President Ramsey’s direct lobbying effort to reach you through your friends at Derby events. Alas, I was unable to attend Derby this year to rebut his arguments, but neither would I have wanted to spoil your day with business!

Because I believe these issues overlap with those surrounding the University’s unsettled efforts to find a partner to help it with its basic academic and clinical responsibilities, I have prepared a list of suggestions of what such a new partnership agreement should look like. Most of its recommendations are relevant to the QCCT matter.

Respectfully,
Peter Hasselbacher, MD
May 11, 2012

President,
Kentucky Health Policy Institute.
Emeritus Professor of Medicine,
University of Louisville.