Category: Health Care Reform

UofL President Ramsey Calls for Evaluation of Indigent Care Fund

How do we provide the best health care to the underserved?

A few days after this Policy Blog, County Attorney Mike O’Connell, the Courier-Journal and others called for an audit of the Quality & Community Care Trust (QCCT) that funds indigent care at University Hospital, President Ramsey responded in acquiescence.  He had no other reasonable choice.  Given increasing criticism over its habit of secrecy, any dragging of feet would have had a devastating effect on the University’s tarnishing reputation.  The “Unsubstantiated C**p Defense” is no longer feasible.  A better course for the University would have been to be out in front with such an offer weeks ago when it was becoming clear that the Louisville Metro Council and others were having concerns about how this particular package of public money was being used.  Now we know that there was a good reason for that concern.  Nonetheless, better late to the table than never.

To their credit, the University is not using its “Private Organization” defense to limit scrutiny, despite the fact that the initial results of outside scrutiny were not good.  Board meetings have not been held for several years, and required records were not kept even as the University complained that it needed more money.  The University of Louisville has given away its best defense against criticisms of acting secretly or even irresponsibly.  The fact that this University-led Board was so careless in its management of such an important public function adds urgency to the many other calls for the University of Louisville to stop the secret internal shell game it plays with its many component foundations, corporations, institutes, and other entities. Continue reading “UofL President Ramsey Calls for Evaluation of Indigent Care Fund”

Not One Public Penny More for Lipitor®

It is often said facetiously that the true measure of the success of an advertising campaign is that it compels its target to buy something that is not needed.  By this measure, the pharmaceutical industry is the true master of the craft.  What else explains the high proportion of the industry’s budget that goes to advertising and marketing spending more for ads than research!  But that is a subject for some future blog or comment below.  What I will highlight today is the stunningly successful campaign of the industry to induce us to pay $billions for overpriced brand-name drugs when the exact same drug (or one that is as or more safe and effective) is available for a small fraction of the price as a generic product.

What got me going today is the latest of a long series of full page ads in my local newspaper urging me to apply for Pfizer’s $4-CoPay Card that allows me to begin or continue to take brand-name Lipitor® to lower my cholesterol.  The CoPay Card promises an out-of-pocket cost to me of from $4 to $50 per month for perhaps one year.  The savings depends on whether or not I have prescription drug coverage as part of my health insurance, and how low my co-pays are.  As usual, those without any health insurance pay the highest prices.  Those of our neighbors do not have anyone negotiating discounts for them are stuck being billed for the full amount of whatever the healthcare industry thinks it can get away with. Continue reading “Not One Public Penny More for Lipitor®”

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

Lots of Health Policy Still in Play!

I had the good fortune to be able to travel abroad and at home for most of the fall.  I confess I still have a foot-high pile of newspapers to look through.  It is immediately clear that a number of things have happened related to items I have been commenting upon in these pages.  Among these items:

  • The state legislature, not surprisingly, followed through with its support for a new concept of optometry by approving new regulations.
  •  The Veterans Administration listened to the overwhelming resistance by veterans and others to placing a new Veterans Hospital in downtown Louisville but also, reasonably in my opinion, felt that remaining on the existing Zorn Avenue site was impractical.   This decision has not disarmed the proponents of another downtown hospital who will no doubt continue to bring political pressure to bear against the remaining suburban locations.
  •  Drug companies continue to behave like tobacco companies.
  •  Everyone agrees our healthcare system is in big trouble but almost no one agrees with what to do about it.   My prediction: it will get worse before it gets better.)
  •  For sheer volume of public concern however, nothing comes close to the resistance against a vaguely revealed merger or acquisition of University of Louisville Hospital by the religious organization, Catholic Healthcare Initiatives.  In some as yet undisclosed way, University of Louisville Hospital will combine with Jewish Hospital & St. Mary’s Healthcare.

I will try to comment on these and other issues.  Please join me.

Peter Hasselbacher