Category: Politics

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”

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”

New Director for Public Health in Louisville:

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:”