Author: P Hasselbacher

Pediatric Cardiac Surgery in Kentucky Revisited.

University Presidents speak about cooperation.red-blue-heart

A month ago, I wrote about issues concerning the pediatric cardiac surgery program at Kentucky Children’s Hospital in Lexington. That institution, part of the University of Kentucky’s University Hospital programs, was receiving much adverse publicity about allegedly poor mortality rates for cardiac surgery for pediatric congenital heart disorders. The institution temporarily suspended that surgery program and conducted an intensive in-house review emphasizing plans for the future.

My article was seen by Elizabeth Cohen, Senior Medical Correspondent for CNN who had been following the story. She asked me to respond to several questions. Because I believe the matter is relevant to health policy in Kentucky, I present here the responses I offered with some minor edits. Continue reading “Pediatric Cardiac Surgery in Kentucky Revisited.”

QCCT Funding for Indigent Care: Back in Play Again.

Massive Cut Proposed in State’s Biennial Budget for Indigent Care in Jefferson County. Time for a new game-plan?

I knew I was going to have to write something more about the Quality and Charity Care Trust (QCCT) when I saw that the Governor’s budget was slated to decrease the annual appropriation substantially from $21 million to $9.5 and $6.15 million in fiscal years 2015 and 2016 respectively. That represents a 70% reduction and would surely be a body blow to University of Louisville Hospital.

I am unaware of the rationale behind the proposed reduction, but together with the decreasing contributions from the city of Louisville, it is clear that our state and local legislators are rethinking the appropriateness of the QCCT funding mechanism as the principal means to support the care of medically indigent of our community. I have argued that they are correct to do so.

The QCCT fund to support inpatient care at a public University of Louisville Hospital may have made sense in the early 1980’s, but I do not think it does any more.  Much has changed, including the amount of funding and the rules regarding its use.  Our healthcare providers and our community itself have also changed. This was never a funding system that should have been considered to operate in perpetuity. Perhaps the Governor’s Office knows something that we do not. Continue reading “QCCT Funding for Indigent Care: Back in Play Again.”

Reinforcing the Separation of Church and State in Kentucky.

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Judge rules that Kentucky must recognize legal same-sex marriages.

Last week the Commonwealth of Kentucky made headlines all around the country when Federal Judge John G. Heyburn II ruled that Kentucky’s laws and constitutional amendment prohibiting the recognition of legal same-sex marriages performed in other states were unconstitutional. (Bourke v. Beshear) We are not the last state to recognize the wrongs of the past, but sadly we were not the first. In its recent Windsor decision, the US Supreme Court recently came to the same conclusion. Those institutions who currently discriminate against such marriages no longer can use the lame excuse that they are only following the law to cover what for at least some is simple institutional intolerance.

I find it both ironic yet predictable that some folks locally and nationally rail against Judge Heyburn’s decision concerning same-sex marriage as judicial activism and an attack on the Constitution even as they admit to not having read it!  I found in the language of the opinion the most logical, eloquent, and powerful arguments in support of our Constitutions in recent memory. It will be instructive to see how local institutions change their existing policies. I asked KentuckyOne Health how they plan to modify their exclusionary policies for their Kentucky employees, but received no response yet. Perhaps KentuckyOne is waiting for the decision to become final at which time they they will have no choice but to change? Continue reading “Reinforcing the Separation of Church and State in Kentucky.”

D-Day Today for KentuckyOne Health?

Waiting on KentuckyOne Downsizing Day.

By all accounts, today is the day KentuckyOne Health will begin to reveal the first steps of its plan to decrease expenditures by $217 million before the end of Fiscal Year 2015. Specific details were not offered at the time the cuts were announced, but nothing was taken off the table. It seems likely that some hospitals or outpatient facilities will be closed or sold. We should expect to see clinical programs eliminated or consolidated rather than trying to offer everything everywhere. We will surely see terminations and reassignment of staff members.

None of this is in intrinsically inappropriate. KentuckyOne has to balance its books. There is much duplication of clinical services in Kentucky, but unfortunately also many areas with limited resources. The challenge for KentuckyOne is to achieve a balance of downsizing, consolidation, and redistribution of services in a way that does not give the appearance of compromising their goal of providing excellent care to Kentuckians at prices they can afford. I wish KentuckyOne well. One of my principle objections to KentuckyOne’s operations is that it is using its publicly funded healthcare system in public facilities as a vehicle to promote the religious objectives of its owners. It may even be possible that some of KentuckyOne’s financial problems stem from its position on religion-based healthcare. That may be a problem KentuckyOne cannot fix on its own. Continue reading “D-Day Today for KentuckyOne Health?”