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The Empire Strikes Back!

Someone forwarded to me a reply by President Ramsey and the CEOs of the three hospital systems to last Sunday’s editorial in the Courier-Journal.  These are the hospitals that would become the “Network Entity” with the acquisition of three large Louisville hospitals by the 7 or so smaller ones of CHI. (It is hard for me to count up these latter because not all of the CHI hospitals seem to be recognized by or eligible for Medicare.)    The rebuttal acknowledges the problem of picking a fight with a party that buys ink by the barrel, but I do not think it rises above sounding arrogant, self-serving, and whiney. The three complain about being characterized as having acted in a “secretive and contorted fashion.”  It is a matter of settled fact that few of the pubic knew that anything had been going on until the announcement last summer that the entities were going to merge.  I certainly believe they are still keeping secrets about their plans and what they propose to do with their money.  It has only been in the last week that any documents were released at all.  Two or three weeks ago a caller to the WFPL radio interview told the merger representatives that he was disappointed in the way they were proceeding, and that “they were losing the public relations war.”  The University did not take that advice until forced to by a judge.

[Addendum Jan 4:  I take some affirmative consolation that the Attorney General of Kentucky in his report of Dec 29 also scolded the University and its Board of Trustees for proceeding so far without informing the Commonwealth!] Continue reading “The Empire Strikes Back!”

Is the University of Louisville a Scofflaw? Or Just Ethically Confused?

I have been unsettled by the University of Louisville’s unseemly rush to have its own takeover by Catholic Health Initiatives approved before the overriding issue of whether it is a private hospital or not works its way through the courts.  My discomfort is amplified because I have seen the University do this kind of thing before.  For example, it was reported publicly that the University plans for finance the construction of a new instructional building  for its medical school with tuition increases, especially for non-resident students.  (Most of us think that medical students already graduate with exorbitant debt that distorts their career choices.)  The University plans to increase its proportion of out-of-state medical students to leverage this unconstrained source of income.  I was surprised to see the Medical School admit that it already has 25% non-resident students despite a Kentucky state law that specifically limits such students to 15%.   If the University does not like a law, it has the right to try to change it, but not a right to ignore it.  Because I believe this pattern of behavior is relevant to the current merger-mania, I wrote to the Attorney General of Kentucky about the matter.  The text of my personal letter is below, and its supporting documents are available here. Continue reading “Is the University of Louisville a Scofflaw? Or Just Ethically Confused?”

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”