Two hours of explanation did not silence the critics and skeptics of a pending hospital merger, though many new issues and complications have been revealed.
The Louisville Metro Board of Health brought representatives from University of Louisville Hospital, Jewish Hospital and Catholic Health Initiatives to a public forum Wednesday evening. The partners took questions from the public and explained how procedures currently banned by the Catholic Church would or would not be performed at a merged University Hospital.
If the merger is approved, University Hospital will not entirely follow Catholic care directives, according to the partners’ attorney Jennifer Elliott. Rather, only certain procedures frowned upon by the Catholic Church will be banned. Namely, tubal ligations will be moved to Baptist Hospital East.
U of L Chair for Obstetrics, Gynecology and Women’s Health Sharmila Makhija explained how other reproductive services would be handled:
- Miscarriage management will not change
- Elective abortions are not performed at University Hospital and will not be performed after the merger
- Medically indicated abortions (when the life of mother is threatened or the fetus has a lethal anomaly) will be performed at University Hospital
- Emergency contraception (the morning after pill) will still be offered. “At this point in time it will remain the same,” said Dr. Makhija.
- Family Planning is usually done in outpatient centers and will not change.
- Vasectomies are out of office procedures and will not change
- In vitro fertilization will remain an out of office procedure
- Contraception counseling and prescriptions will be available, but the hospital will no longer fill prescriptions for contraceptives.
For end of life care, patients and families will be informed of all their options. Euthanasia is not allowed, but officials say it is often not done at hospitals, but at long-term care facilities. Living wills will be honored.
After merger, University Hospital will also honor the visitation rights of same-sex or unmarried partners of patients.
Full audio of the merger (mp3 download):
After the forum, Elliott said not all the details about care have been worked out, but a specific list of banned and allowed procedures is forthcoming and will be available before the merger is finalized. Some procedures not allowed at CHI hospitals could still be done at University Hospital, since the statewide network will not necessarily be a faith-based institution.
U of L officials have long said banned procedures could be performed by the School of Medicine, which is not part of the merger.
“As the dean of a tax-supported medical school that serves the people of the community, we will provide a full range of services to our patients,” said U of L School of Medicine Dean Edward Halperin. “And if that means a full range of services sometimes under a different roof, we will do it like most other cities in the United States. We will not back away from our commitment to a full range of healthcare for all our patients.”
There were several questions about how health insurance for employees of merging facilities will change. Many questions concerned whether the employee health plan will cover reproductive services or other procedures banned by the Catholic Church. The officials said they’re working on a solution to the conflict in this area and declined to discuss the details. However, the federal healthcare law (the Affordable Care Act) could require employers to cover certain procedures. The merged network will follow all state and federal healthcare laws.
The Affordable Care Act was also cited as a reason why the merger is necessary. The partners say the law will require greater efficiencies and create thousands of new patients, which only a merged entity will be able to handle. U of L officials painted a dire financial picture, saying they do not have the funds to continue current care or to attract or retain top talent.
U of L School of Medicine Dean Edward Halperin suggested the merger would stop the “brain drain” caused when talented students leave the state to practice medicine by giving them more and better-funded facilities to work in. CHI has promised to invest hundreds of millions of dollars in the network.
When asked whether the merger would create redundancies and require layoffs, the partners were mostly silent. They instead touted the potential job-creating aspects of the merger. They hope it will create more high-paying medical jobs, though many administrative jobs could be lost.
Throughout the forum, audience members called for simplified answers to cut through lengthy and complication explanations. The most jeers came during a discussion of whether the merger violates the separation of church and state, since Attorney General Jack Conway recently ruled that University Hospital is a public institution, despite U of L’s claims to the contrary. The partners haven’t yet decided whether to appeal the decision. Attorney Jennifer Elliott says she does not think the merger represents an unlawful entanglement of religion and state.
“We’re going to monitor the situation,” says merger critic Honi Goldman. “We’re going to see what comes up next. Our big concern has never been about the merger itself. We’ve always been in favor of the merger. Our problem has been with the stipulations.”
Board of Health chair William Altman said he was pleased with the forum and will continue the dialogue to ensure community involvement. The unanswered questions from the forum will be sent to the merging partners. Further, the Board of Health will continue to take questions from the public and pass them on to the partners. Several questions have already been answered in writing.
State approval for the deal is still pending.
The African American Think Tank will hold a forum on the merger Thursday at 5:30 at the African American Heritage Center.