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.
Who should she serve?
Compared to the tumultuous search for a new school system superintendent, the announcement of the appointment of a new Director of the Louisville Metro Department of Public Health and Wellness seemed to come out of nowhere. Since the departure of the previous Director, Dr. Adewale Troutman, the announcement in the Courier Journal on June 14 was the first indication of progress of which I was aware. Did I miss something– like a public hearing? Was there any public input into the process? Perhaps the search became invisible in the shadow of the school superintendent search. Yet both searches are equally critical for our future. As our failing private health system continues to eject middle income Americans (employed or otherwise), a new form of systemic health disparity is growing rapidly. The widening income gap in America is causing a pernicious denial of access to affordable health care within a system that is tailored for the well-employed and the wealthy. In a health system where even the “haves have not,” I predict that our public health departments will become increasingly important. They will likely be incubators for whatever our future system of health care looks like. As a society, we are only as healthy as the sickest among us.
Dr. LaQuandra S. Nesbitt, MD, our new Director, looks like a great catch. She has impeccable credentials of training and experience. She most recently held a senior public health role in the cauldron of Washington, DC. The challenges she faced there provide relevant experience for our needs. I wish her well. I hope I can help.
As far as I know, Dr. Nesbitt’s successful candidacy was without controversy. Therefore, let me introduce some! One sentence in the C-Js reporting positively gave me the shivers. It was reported that half her salary of $180,000 and half her benefits will be paid by the University of Louisville. I think this is a bad idea: a very bad idea. No doubt the fiscally-strained city was glad to have someone else pick up part of the tab, but I think this is bad public policy. This is not simply the customary gratis faculty appointment that honors Dr. Nesbitt, allows her to teach, and otherwise participate in the academic life of the University. Hundreds of other physicians in Louisville have such privileges. The current arrangement makes her an employee of the University of Louisville. By placing her in a position of having two very different employers, she will start on day one with conflicts of interest. Continue reading “New Director for Public Health in Louisville:”