Why Is A Bishop Even In The Room?

I was plowing through my unread pile of newspapers and came to the report by Patrick Howington of October 17; “Hospital Merger- Altered Catholic rules pose problems.”  A subtitle asserted that “Hospital officials say fears of church interference are overblown.”  Really!   In point of fact, they are not overblown at all.  A number of  examples of church and secular hospital mergers were listed for which the winks and nods and work-a-rounds that were approved by a local bishop were overturned later by higher authorities or changes in rules.  We are not talking about a theoretical problem.

By coincidence (or perhaps as a sign) as I read this article today, the leadoff report on the CBS Sunday Morning Show focused on a Catholic hospital in Phoenix.  A woman who was 11 weeks pregnant developed severe pulmonary hypertension as a complication of her pregnancy.  The result for both her and her fetus would have been fatal.  The local hospital Ethics Committee considered her case and gave its approval for an emergency abortion to save the life of the mother.  That decision was shared by the nun who sat on the committee.  The woman’s life was saved but her pregnancy was sadly but predictably lost. Continue reading “Why Is A Bishop Even In The Room?”

Still Another Hospital “Merger” in Louisville Kentucky

Potential Questions and Issues Related to the Proposed  Acquisition or Merger of University of Louisville Hospital with Catholic Health Initiatives.

I am very troubled with the way this vaguely defined proposal has been revealed to the public.  I cannot avoid the impression that important elements of the deal have been intentionally hidden.  There is a lot to cover and these initial thoughts just scratch the surface.  If I had an opportunity to ask clarifying questions, I would start with these.  I ask them from my perspective as a life-long medical educator, physician to both the rich and poor, and a lobbyist for higher education.  What do you think?

Nature of the Proposed Arrangement:
Is a true merger of hospitals planned, or simply an acquisition by another hospital chain?  For example, will the new entity have a single Medicare Provider number?  If a true full merger is not planned, why not?  Which, if any, hospitals will be truly merged, or is University Hospital just being put in play once again by another hospital chain?  What will be new?  For what is the University of Louisville, its Hospital, and the Commonwealth of Kentucky giving up precious independence and control?

University Hospital has been managed by at least 5 outside corporate chains or partnerships of hospitals in the last 25 years.  All failed.  Other existing or contemplated partnerships, programs, or mergers with Louisville Hospitals have also failed.   What were the reasons for those failures?  What plans have been made to ensure a better outcome?  Where can we see those plans?  Why not? Continue reading “Still Another Hospital “Merger” in Louisville Kentucky”

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

New Public Health Director for Louisville: Follow-up (or lack thereof).

On June 24, I sent a copy of the June 18  Blog entry below to Louisville’s Mayor Greg Fischer, and to Mr. William Altman, Chairman of Louisville’s Department of Public Health. I repeated my request to reconsider the employment structure of Dr. LaQuandra S. Nesbitt, the new Director of Public Health and Wellness. (Cover letter here.)  The letter contains the mission statements of the Louisville Board of Health emphasizing its independence.

I have not had a response, nor am I aware of any new information.  What do you know, and what do you think?  Add your two bits.

[Addendum Dec 14, 2011:  When I wrote the above letter to the Board of Health and the Mayor’s office, I somehow thought that the Louisville Metro Department of Public Health and Wellness  reported to the Louisville Board of Health– imagine that!   While the details of accountability still elude me, it seems that the LMPHW Department is a branch of Louisville Government, reports to the Mayor, and is only “advised by the Board of Health. The Board of Health is “independent,” and is appointed by the Mayor.  Its Chairman was on the search committee for the new Director, Dr. Nesbitt.  If anyone can straighten me out about this, please do so.  The details of the organizational chart do not affect the substance of my letter nor my concerns.  I still think her dual employment it is a bad idea. The absence of her counsel in the current debate over the acquisition of University Hospital is appropriate given her conflict of interest, but missed.

Peter Hasselbacher, MD