University of Louisville’s Homegrown Soap Opera.

Spoiler Alert: Its not really about African-American representation on the Board of Trustees.dream-lives-on-250

The chaotic goings-on within in the administration and Board of Trustees of the University of Louisville (and therefore also it’s academic medical center) increasingly resemble the plot of a television soap opera.  In the setting of a succession of embarrassing external audits, criminal convictions, and a revolving door of questionable executive and lower-level hiring and firings; the senior executives of both the University itself and the Medical Center are struggling to keep their jobs.  The former wants to manipulate the composition of the University Board of Trustees in his favor, and the latter is under investigation by the FBI and has not been heard of for weeks.  I am not alone calling for resignations.  It appears that the opportunity for face-saving transitions has passed.

Continue reading “University of Louisville’s Homegrown Soap Opera.”

Schnatter and Koch Grants to University of Louisville Revisited.

The John H. Schnatter Center for Free Enterprise at the University of Louisville College of Business is up and running.  Last fall, when the enabling grants to the University of Louisville Foundation by the Charles Koch Foundation and the John H. Schnatter Family Foundation were announced, much concern was expressed by faculty and others in the community about the lack of institutional control that was given up to the funding organizations, the shortcuts taken within University governance to sign the agreements, that the University and Foundation were committing themselves to funding elements of the Center even if the Donors withdrew support, and concerning the general concept that the Donors were seeking to purchase academic legitimization of their far-right political philosophy.  These issues were discussed prominently within the local community including by the Center for Investigative Reporting, Insider Louisville, The Courier-Journal, WFPL, WDRB, Business First, and even the Kentucky Health Policy Institute.  The practice of the Koch Foundation funding similar interests in other colleges and Universities has drawn national attention in The Atlantic, Huffington Post, Center for Public Integrity, and others. Following the rollout of the Center, a series of submissions and letters to local media – some from outside the state – brought the matter to my attention again and prompted this follow-up to my earlier articles. Continue reading “Schnatter and Koch Grants to University of Louisville Revisited.”

Prescription Drug Utilization and Costs for Kentucky Medicaid in 2014.

The jointly managed state and federal Medicaid program has always been an important part of the American patchwork healthcare system. The Medicaid expansion of the Affordable Care Act and other changes to eligibility have not only increased the number and diversity of Medicaid beneficiaries, but also Medicaid’s potential financial and clinical ability to shape other healthcare segments in the same way that the Medicare program has done. However, not all of Medicaid’s structural practices may be worth promulgating. I suggest that the way Medicaid has chosen to select eligible drugs for its formularies nor the way its has paid for them are worthy of emulating. To start a new thread in these pages, I begin with a survey of drugs prescribed to Kentucky Medicaid beneficiaries in 2014. I freely admit that I will be learning along with my readers who I hope will participate in the process of exploration and understanding.

I will demonstrate an overlap in the use of drugs by both federal programs but also illustrate major differences. It will be obvious that many beneficiaries who are excluded from employment-based or ineligible for Medicare coverage are dependent on Medicaid for their health care. You might even become more concerned about recent promises to reverse Medicaid expansion and cut its roles.  I will highlight the extraordinary cost of some new drugs such as those for the curative treatment of hepatitis-C.  I will show that the cost to the system of every-day commonly used drugs overshadows that of the high-flying cancer drugs that are frequently featured in our news reports. You may be surprised to see how frequently opioid narcotics are prescribed. You should be concerned about the exploding costs of necessary and successful medically assisted drug treatment for opioid addiction. You will be as surprised as I at the personal and financial burden of depression and other mental disorders. Finally, you will probably be disappointed and maybe even a little angry about how little our public policy seems to be guided by the prevalence of the illnesses that most frequently affect us. Continue reading “Prescription Drug Utilization and Costs for Kentucky Medicaid in 2014.”

Introducing hasselblogger.com

I have enjoyed preparing this series of articles relating to healthcare and medical education over the past few years. I find the research and analysis of data lying beneath many of the articles to be intellectually satisfying. People tell me that I am making a difference and encourage me to keep it up. In truth, I also found that the actual process of writing itself, and the sharing of my ideas or opinions to be personally rewarding. I am neither the first nor the last to be enthralled by the ability to self-publish – or less elegantly stated, to blog!

There have been occasions where I recognized that the subject of some of my offerings strayed from the main theme of health policy, but I could usually justify that, at least to myself. However, I increasingly feel the urge to write about things that even I cannot warp into the world of healthcare. Thus, to feed this imperative, I launched this week a second unabashed blog — hasselblogger.com     There are a couple of timely things there now.  Take a look from time to time and help me turn it into something interesting and useful.  I will place a link to the site in the sidebar of this one to remind you.

Thanks,
Peter