The funding is less, but the same!

Just minutes ago, the mayor released his budget to the Metro Council and the rest of us.  Relevant to recent discussions on these pages, Mayor Greg Fischer recommended funding the Quality and Community Care Trust for 2012-2013 at $7.0 million which actually keeps it at the 2012 level.  Here is what the Mayor had to say about the QCCT:

“This budget continues to fund external charitable agencies at the same rate I proposed last year and the same rate since merger and continues to fund, also at the same level, indigent healthcare at University Hospital. We are committed to indigent care and to being an active participantin finding solutions to the long term needs of indigent care and the challenges that University Hospital faces.”

This may appear to be a decrease, but in prior years, the University was returning $2.6 million of a larger budgeted amount of $9.6 million.  This is not a decrease in the net amount provided to University Hospital for care of those it deems eligible.  Rather it provides a more honest accounting and avoids the dysfunctional and vaguely dishonest appearance of the earlier shell game.  I think the State Auditor’s recent audit would favor this accounting change and I commend the Mayor.

What remains to be seen is how the Kentucky State Legislature will view this honest accounting.  Some in the legislature have promised that if Metro Government reduces its contribution to the QCCT fund,  that they would push for the state to reduce its own contribution dollar-for-dollar.  The Mayor’s budget does not change the net amount contributed and should not be used as an excuse to reduce the states share.  Indeed, the report from Auditor Edelen’s office tells us that the Commonwealth has been playing a little $5 million shell game of its own with the University.

None of these necessary budgetary preparations alter the demands of these pages that before additional public money is poured into the improperly managed and overpriced creature that the QCCT has become, that the University of Louisville abandon its claim that University Hospital is a private entity, that the University abandon its secret-books policies, and that we stop thinking as if the QCCT fund and University Hospital represent the total solution to our shared responsibility of financing and providing medical care to the disadvantaged.  By way of perspective, the Mayor’s budget allots $1.88 million to the city’s Family Health Centers.  I would say, why so little?  To rebut my question is to open the doors to the conversation we should be having now, not next budget time, about how to fund indigent care in Louisville and Kentucky.

Peter Hasselbacher, MD
24 May 2012