Issues of Quality and Safety at University and Other Hospitals.

Is Rome Burning While Nero Fiddles?

Screen Shot 2016-06-07 at 10.24.46 PMKentucky’s Hospitals have not done well in the past on national Hospital Rankings including the Leapfrog Hospital Safety Score.  Things seem to be getting worse. In the most recent iteration last month, once again Kentucky had fewer ‘A’-rated hospitals than the national median and more hospitals rated near the bottom with increasing numbers of ‘D’s.  More troublesome is the observation that 5 of the 6 hospitals receiving a ‘D’ are in the same hospital system. Three of these are in Louisville including two of our major teaching hospitals. Continue reading “Issues of Quality and Safety at University and Other Hospitals.”

More Fireworks Over Executive Salaries at UofL.

The matter of compensation to UofL President James Ramsey that tipped public opinion of the University in a more critical direction is back in the news.  Both Chris Otts of WDRB and Andrew Wolfson of the Courier-Journal reported yesterday on the release by the University of Louisville Foundation of its Form 990 Federal Tax Return for 2014.  The University knew it would not be pretty and began to prepare the way with letters to supporters and posts to various social media.  Pretty it was not– except for Dr. Ramsey and his senior supportive staff.  Numbers taken directly from the compensation pages of the return listed President Ramsey’s salary from the Foundation alone as $2,428,886 with additional benefits of $362,500.  His compensation included tax “gross-ups” to make up for any personal income tax he would have to pay.  A great deal if you can get it, but not offered to most faculty or staff!

Even before the ink hit the page, Foundation Chairman and former UofL Trustee Chairman Robert Hughes broadcast an email to the UofL world at large highly critical of Mr. Otts.  He accused Mr. Otts him of missing the point, vastly overstating Dr. Ramsey’s salary, having an agenda, and misleading the public with fairy tales.  (I am accused of much of the same by the University’s internet trolls.) In my experience,  Mr. Otts and Mr. Wolfson are both knowledgeable and careful reporters.  If they have an agenda, it is in providing accurate and relevant information to their public. Continue reading “More Fireworks Over Executive Salaries at UofL.”

No Progress in Reconstituting Functioning UofL Board of Trustees.

I was traveling out of the country the first part of this month.  When I returned, I expected, or more perhaps accurately hoped that some progress has been made in restoring the governance and oversight responsibilities of the University of Louisville Board of Trustees.  Unfortunately, last week the Board was forced to meet once again for “informational” purposes only.  Alas, as far as I am able to determine, nothing has come out of the Governor’s Office or the newly constituted Governor’s Postsecondary Education Nominating Committee indicating an intention to resolve in a timely manner the deadlock that has placed the Board in limbo.  I can find no required public notice that a meeting of the Nominating Committee has been scheduled.  An email inquiry yesterday morning to the Governor’s office has not been answered, nor was a phone message earlier in the month requesting notice of a date.

Based on what I have observed, I must assume Governor Bevin’s higher priority is to protect an embattled and increasingly desperate-appearing President James Ramsey.  By delaying the appointment of an African-American trustee further, Governor Bevin will have an opportunity to appoint a larger and controlling block of additional trustees as existing terms of office expire thus effecting political capture and control of the University.  Surely such a potential goal must not be perceived as delaying the resolution of a matter of social justice which is in my opinion now being used as an excuse to sideline the current Board of Trustees.  In my 36 years at the University, now is the worst possible time to allow the University to flap ineffectively in the breeze. Continue reading “No Progress in Reconstituting Functioning UofL Board of Trustees.”

Update On The Rising Prices of Insulin Between 2013 and 2016.

Earlier this month I published a survey of the cost of insulin to the Medicaid and Medicare programs of Kentucky and the nation.  Fully 9.1% of the total cost of Kentucky’s outpatient Medicaid drug program went to pay for the several brands of Insulin still available. It was obvious that some brands cost a lot more per prescription or claim than others and that the most expensive brands were prescribed most often!  I used this critically important drug as an example of how the market for prescription drugs in America is badly broken.  Since then I stumbled on two additional federal databases that provide additional insight into how much these drugs cost at the local pharmacy counter where the rubber hits the road. These are federal surveys that determine the National Average Retail Prices paid by the consumer (NARP), and the National Average Drug Acquisition Cost (NADAC) for the pharmacy.  Both these programs provide data at the cost per milliliter level, and otherwise facilitate apple-to-apple comparisons of the different brands.  In brief, the additional data confirm that in 2013, for the same size bottle, the newer insulin analogs cost 71% more than the older “human” insulins.  By 2015, all prices had increased; some substantially.  Valuable information about the retail prices of drugs is being kept from public inspection. Continue reading “Update On The Rising Prices of Insulin Between 2013 and 2016.”