Greg Fischer – City funding and University Hospital

The Sunday editorial about University Hospital and Metro government’s commitment to pay health care expenses for the poor and uninsured omits a significant fact.

The city is not cutting its annual contribution to the Quality Care and Charity Trust, the fund established more than 30 years ago to help pay for indigent care at University Hospital. For the past five years, the city has contributed $7 million toward that fund annually, and the budget I proposed for the new fiscal year starting July 1 keeps that funding at the exact same level.

My administration thought it important to keep the funding consistent for another year while University Hospital charts a course for the future. There are many important questions that need to be answered as the city further evaluates the future funding of QCCT. Those questions include:

• How will the university respond to concerns raised by the state auditor, who discovered inadequate oversight of the trust?

• How will health care reform — and the pending decision from the U.S. Supreme Court — affect University Hospital?

• Will the hospital find another merger partner? What role will that play in indigent care in our city?

• How will the state’s decision regarding the status of Passport Health Plan, the Medicaid provider for Jefferson County, impact indigent care services?

• Does the flow of funds from the city to the QCCT through University Hospital and then to the medical school impact indigent care?

• Why is Louisville the only city government in the state that pays into an indigent care trust fund?

Ensuring that the poor continue to receive quality health care is important for our city and it remains a priority of my administration, demonstrated by the $7 million commitment in the city budget, which Metro Council will vote on Thursday.

Metro government spends a total of $17 million in local dollars (excluding federal money and grants) each year on paying for health care for the poor, from QCCT to services at the Family Health Center and the Department of Public Health and Wellness, among others. In addition, the city spends another $8 million in other forms of indigent care beyond the health care system — for a total of $25 million, which translates to 6 percent of our general fund providing a safety net for our most vulnerable citizens.

Despite these tough economic times when city budgets are stretched thin — and despite the outstanding questions regarding the most effective way to manage and provide indigent care — city government is committed to the poor and uninsured in this community by maintaining its same financial commitment of the past five years.

However, with limited city dollars we will continue to annually evaluate all city services and programs. QCCT will remain a viable part of such examination and discussion.


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