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LSU System President John V. Lombardi has an extensive résumé, a deep expertise in academic matters and a reputation, as chancellor, for speaking his mind—a trait that hasn’t always endeared him with university system presidents and trustees.

Business Report sat down with the former chancellor of the University of Massachusetts Amherst and former president of the University of Florida in hopes that he would do just that: speak his mind. Lombardi had plenty to say.

Question: How’s the transition from university chief to system chief treating you—especially a system like LSU, which has a huge health care component?

I’ve been at places with medical enterprises before. I was at Johns Hopkins as provost, and I was at the University of Florida, which has a large hospital network. So it’s not a totally unique circumstance. On the other hand, Louisiana is always unique in everything it does, so the particular configuration of health care in this state is a challenge for everybody, not just Louisiana State University.

Q: Revamping LSU’s public health care system is a big topic of discussion. What’s LSU’s proper role in health care?

Our job is to try to represent the interests of academic health care, in which we work to train doctors and nurses and other health care professionals in the kind of high-powered hospital setting that is essential for success in that activity. In order to do that right, as has been proved in just about every place around the country, you have to have a network of effective hospitals that are capable of supporting that mission of providing high quality medical education and research for the state.

Q: Some critics knock LSU health care as being inadequate to meeting the needs of the state’s huge uninsured population.

One of the things you learn when you look at the hospitals in this state that we run is that the quality of care delivered there is absolutely superb, but the amount of care we’re able to deliver is limited. It’s limited by funding. It’s limited by the availability of physicians in this state. It’s perhaps limited by organizational issues that we need to resolve. We need to focus on the ability to continue to expand that delivery of high quality care to more and more people.

Q: But statistics show Louisiana to be at or near the bottom in terms of public health.

People assume that’s a function of what the public and private hospitals and doctors are doing. That’s not actually the case. It’s a function of the poverty levels and the rural areas of the state that are poorly served and those kinds of issues, unrelated to the way in which we’re actually delivering health care. It’s important to separate out the various pieces and attack them. And I think we have an opportunity with the new governor and the new legislators to take a clear-eyed look at this. The private sector is not going to be able to do this completely. The public sector can’t do it without collaboration with the private sector, and they don’t do it anywhere (in the country) without collaboration with the private sector. Getting that balance right is going to be the argument. And trying to do it based on fact and experience in other states and other places will be the trick.

Q: Many would like to see the state’s traditional public health system scrapped in favor of insuring everyone and letting the public dollar “follow the patient” to private hospitals, which are inundated by indigent patients as it is.

I don’t think that the status quo is how we’re going to solve this problem, but I don’t think that you can dismantle wholesale a public hospital system that is providing outstanding and quality care and create a new enterprise that will cost a lot less. The difficulty always in health care is the cost. It’s not a question of not knowing how to do it. We know how to do it. If we insured everybody we’d solve this problem overnight. But every time you’ve tried to figure out the mechanics of insuring everybody, it turns out to be much more expensive than any alternative system that we have.

Q: And still the debate rages.

It rages because everybody has an interest in the debate. There are niches in health care that only want to deal with certain kinds of patients and they would like to have public support. Other niches think they can do better than public health care because they will do something that we don’t do. The fact is, when you start doing it, it turns out that nobody’s got it right.

Q: You’re big on metrics: measuring performance and taking appropriate steps to make improvements where needed. Has that process begun?

Yes, we’ve started that conversation. We’ve started out looking at the enrollment of our various institutions to make sure that we are providing enough space and doing enough to educate the people in the state of Louisiana and build our institutions so they’re at the right scale. Second, we’re looking at whether we’re getting the right return on our investment, whether it’s in teaching or research or technology transfer or agriculture or medicine or whatever it is. That requires getting some metrics that measure what we do against the best national practice. And that’s tricky. It’s not easy to do because no state does anything the same way.

Q: There’s been talk of reconfiguring the state’s higher education systems, including streamlining the LSU System by moving some campuses into other systems. Does this make sense?

No, I don’t think that makes a lot of sense. Usually when you start playing musical chairs with institutions, you waste a lot of time and energy and money. You stir up every political hornet’s nest in the state and when you’re done you’re not any better off. Because the game of higher education is not about how they’re arranged in systems. It’s about how each institution does its job. I’m never in favor of major restructurings of higher education systems. My experience has been they waste an enormous amount of political capital and energy and enthusiasm on doing something that simply rearranges the deck chairs.

Q: Does Louisiana have too many colleges and universities?

We have a lot of institutions. You can make a case that if this were a private enterprise world, we would do leveraged buyouts of each other. But this is not that kind of world. This is public higher education world. The public wants units within their geographic district. This is the driver of all public higher education. Every community wants a campus. Because they know that these entities are economic generators for their community.

Q: Do you like the idea of funding universities based on their performance, an idea Gov.-elect Bobby Jindal supports?

What you have to do is figure out what performance you’re talking about. The theory is great, and I’m a firm believer you do need to fund on performance, but you need to say what is it that we want. We don’t want the same thing from every institution. When I’m talking to LSU at Eunice, I don’t say what we need you to do is get NSF grants. It’s not the performance indicator for LSU at Eunice. What are the appropriate productivity measures of the institutions we have? As they succeed in improving on that productivity measure there should be a reward for that. If you do more, you should get more. If you do less, you should get less. If you’re doing badly, you shouldn’t get money.

Q: Is tuition too low at LSU?

Tuition needs to be structured so that those who can’t afford to pay are fully funded. And those who can afford to pay aren’t necessarily fully subsidized. TOPS has been a terrific program in motivating people to study hard and come to schools and so forth. On the other hand, when it becomes a generic program that covers everybody, and there isn’t enough state money to do everything we need to do in higher education, then you begin to say, “Well let’s see if this is the right distribution of support to achieve the goal.”

Q: With TOPS, do you feel like you’re roughing up a sacred cow?

I don’t know that that’s the case. I think everybody knows that TOPS is wonderful. Nobody wants to give it up and rightly so. I don’t want to give it up, either. But I’ve only been here two months, and I’ve had a lot of whispering in my ear about the problems that TOPS creates that are unanticipated consequences. All I’m trying to say is—since I’m new, I can get with this stuff for a while—at least let’s put it on the table and talk about can it be calibrated to achieve the same objectives but in a more effective way and it doesn’t paralyze the state the way it is now. The state’s paralyzed on tuition, because if you raise tuition they have to pay for it. These are not decisions for me to make. These are decisions for other people to make, but you need to talk about all parts of them. People get the idea that if you have a good program and you want to make it better, somehow it’s an attack on the program.

Q: LSU has made fundraising a big priority with the Forever LSU campaign. Are you happy with the scope and direction of the campaign?

They have put together a very professional, well-constructed fundraising organization. The defect is that it should have been done 25 years ago when other public universities began building these enterprises. We’re starting later than everyone else, so it will take a little more time to build up the kind of momentum that you see in places like Illinois and Wisconsin and Michigan. But I think we’re well on track to getting where we want to be on that. And we have a very good group of alumni and friends who have a capacity to invest in the institution.

Lombardi on sports

As president of the University of Florida, Lombardi hired football coach Steve Spurrier (who left the Gators in 2003, citing Lombardi’s earlier departure as a reason, and currently coaches at South Carolina), basketball coach Billy Donovan and athletics director Jeremy Foley. Lombardi shares a few thoughts on LSU athletics.

Question: LSU will soon embark on a search to replace athletics director Skip Bertman. How involved will you be in that search?

In the athletic world, it’s the chancellor who is in charge of athletics. It’s the campus chancellor’s job to hire and fire the athletic director, to supervise the process of hiring high-profile coaches and so on. At the same time, the university has the responsibility in the end to approve the recommendations of the chancellor. The chancellor will conduct a search for an athletic director, and there’ll be a big committee and a lot of commotion and noise and everybody will have an opinion, none of which will be the same. When the chancellor receives the recommendations from the search committee, he’ll consult with a wide variety of people. Then he’ll make a recommendation to the president (Lombardi), who will then determine that’s a good idea presumably and make a recommendation to the board, which by that time will surely be persuaded it’s a good idea and everybody will cheer. That’s kind of how it works.

Q: O’Keefe says he intends to seek out your counsel.

I’ve been through this more than once. I’ve hired now in different places three athletic directors I guess: one at Florida and two at Massachusetts. It’s actually not rocket science, but there’s a lot of noise associated with athletic directors because they’re high profile. I’ll just help him set up the structure that will make this process move smoothly. I think we’re going to get a lot of first-rate opportunities here because this is a premier program. It’d be hard to imagine a much better spot for an athletic director who is ambitious and capable, and that’s what we want.

Q: Bertman leaves big shoes to fill, doesn’t he?

There’s no question that Skip did a wonderful job here and has a left a legacy that somebody’s really going to have to be first rate to move where we need it to go in the next cycle.

Q: What’s your opinion of football coach Les Miles?

I think everybody gets excited about college football, but good coaches are good coaches. They build good teams, and they pull it out when it gets complicated. Everybody forgets these student-athletes aren’t big time professionals. They’re often very young, and although they’re supremely skilled they get pumped up, and when they get pumped up they make mistakes, because they’re not pros. The coach has to settle them down and say no we’re not doing that again. I think they’re doing very well. I think he’s a great coach. LSU’s done very well this season, so we hope they’re going to keep right on doing it.

Q: If rumors about Les Miles replacing Lloyd Carr at Michigan turn out to be fact, what would you think about Steve Spurrier taking his place?

First of all, I don’t think it makes any sense at all to speculate on coaches or anybody else who aren’t leaving and we don’t want to leave. But what I would say, if there were a coaching position in college football available anywhere I would be delighted to recommend Steve Spurrier for that position. Steve is a first-rate coach. He has demonstrated in many places that he can produce a winning program. Who wouldn’t want a coach like that?