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?”
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”
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.
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?