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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

New Suburban Veteran’s Hospital for Louisville

On Veterans Day, 11-11-11, the Courier-Journal reported on the status of plans to build a new Veterans Hospital for the region of Louisville Kentucky.   The community has been waiting with decreasing patience for the results of all the promises and hearings.  The update did not, however, announce that a final site had been decided, nor that financing was in hand, nor that a start date was known.  Instead, the big news was that the site selection process had decided against leaving the hospital where it is on Zorn Ave, and against moving to the downtown medical center of metropolitan Louisville.   Subsequent notice of new road work near the intersection of the Watterson Expressway and Route 42 suggested that the new VA would be located there.  On Dec 14, we received further official verification from United States Secretary of Veterans Affairs, Eric Shinseki, that indeed the 4906 Brownsboro Rd  address is the first choice for the new medical center.  The second choice site is the one Factory Lane near the Gene Snyder Expressway.  It was estimated that from the time financing is secured, construction will take a little more than three years.  The letter from the Secretary appears to be in response to a request from Sen. McConnell for a realistic timeline for the project.  The Veterans’ Day update quoted 5 veterans, 4 of whom expressed disappointment and a preference for staying at Zorn, one of whom was relieved that at least it would not go downtown. Continue reading “New Suburban Veteran’s Hospital for Louisville”

Open Letter to Governor Steve Beshear Concerning Acquisition of University of Louisville Hospital

Last week I submitted the following letter to the Governor’s Office.

Governor Steve Beshear
700 Capitol Avenue, Suite 100
Frankfort, Kentucky 40601

Re: Premature approval of hospital acquisition in Louisville.

Dear Governor Beshear,

You have been asked to consider approving a merger/acquisition involving the University of Louisville and University Hospital, Jewish Hospital & St. Mary’s, and the St. Joseph’s Hospital System under the auspices of Catholic Health Initiatives.   Individuals and Organizations (including women’s organizations) in the Louisville Community who have written or spoken about this matter are overwhelmingly against this merger, save for employees of the University, or its business partners.   The opposition continues unabated despite several public and private briefings.  This is in great measure because of the puzzling refusal of the proposal advocates to disclose relevant details supporting the real public or indigent-care need for the merger, or the implementation of its most controversial elements– especially those revolving around church and state issues. Continue reading “Open Letter to Governor Steve Beshear Concerning Acquisition of University of Louisville Hospital”