My Way or the Highway! UofL Takes Hostages.

Governor Beshear, with consultation from the Attorney General’s office, again rejected “suggestions” offered by James Ramsey and Jim Tayor that were intended to make more acceptable the addition of the University of Louisville and its Hospital to the newly merged Catholic Health Care Initiatives entity in Kentucky.  The Governor thought not!

The substance of the suggestions was not initially made public.  Even the Governor’s office curiously called them “private and proprietary.”  However, President Ramsey has given his version of them to the UofL community in a broadside that continues this matter with some open threats.  (Read his message here.)  In fact, President Ramsey seems openly  to have picked a fight with the Governor and Attorney General by claiming an alternate version of reality. “We began our in depth merger conversations with the governor 18 months ago.  He has never expressed any concerns to us about the governance structure of the proposed merged entity.”  I do not have a feeling that this is going to end well for Dr. Ramsey and the University!

I am surprised at the continuing secrecy, especially since this whole merger-matter has been widely criticized for inappropriate secrecy and private dealings.  Dr. Taylor did not initially reveal this new Plan-B,  telling us that the University wanted the Governor to have a chance to reflect on it.  I maintain because now that President Ramsey has released his own obviously self-serving version of the suggestions, we of the public have a right to hear it all.  I believe the University has already waived its “privacy” with regard to its amended merger propositions, if indeed it was ever entitled to such special treatment.

Summarizing President Ramsey’s message to the University Community, he gives a two-choice ultimatum to the Governor:  accept our new (and undefined) terms for merger; or give us $550 million now and $50 million yearly thereafter for a variety of activities in which research seems to be the most prominent item.  Ramsey ends his broadside with an unveiled threat: now that we can’t  have our way, we will reduce clinical services soon.  Nice!  I feel compelled to ask again, what does the University’s commercial research enterprise have to do with funding for Louisville’s safety net hospital?  Why should research suck money out of the hospital and indigent care finding?  Shouldn’t it be the other way around?

The Governor tells us again in his second rejection, that the University has strengths and record profits.  Surely the University would not mind the rest of us hearing about them.  I have been trying to gain a better understanding of the University’s financial relationship with its hospital and related clinical activities through public documents such as its tax filings.  I do not have the clout to get sufficient understandable or verifiable information.  I propose that the Commonwealth help the rest of us citizens and taxpayers evaluate the competing versions of University Hospital’s future.  Is Governor Beshear unfairly limiting the University’s options?  Is the University fearful of loosing another clinical shush fund?  Is the truth neither– or both?    We should not to have to ask such questions.  I call for a state audit of the University Hospital and its financial relationship with the University of Louisville, the Quality and Charity Care Trust (QCCT), and the related University of Louisville Research Foundation.   My suspicion is that the University will resist such examination with the same vigor it has resisted all previous attempts to lift the curtain on its internal management.  It should not.  Recent state audits of public agencies has allowed cleansing light to purify corrupt or badly managed entities.  I respectfully assert that such examination of the University of Louisville and its faculty organizations is long overdue.

Peter Haselbacher, MD