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Enough to make you sick

Tuesday, August 08, 2006
Chicago Tribune

Political patronage is crippling public health care in Cook County. Good doctors are kept from doing their best work because of incompetence at the top of the system. And the Cook County commissioners who are supposed to oversee the nearly $1-billion-a-year health-care system don't have a clue about how to fix it. Not a clue.

That's what you can draw from a stunning assessment by health-care professionals who spent the last six months evaluating public health in the county.

It's rare to get such a frank, independent assessment of the chaos called Cook County government.

The evaluation of the county health system revealed Monday was conducted by the Institute for Healthcare Studies at Northwestern University's Feinberg School of Medicine. It was performed in association with Health Management Associates, a national consulting firm.

These aren't politicians. These are health-care professionals.

Their conclusion: The health-care system faces a crisis. Demand and costs are rising but revenues are not. And Cook County is in a terrible position to handle such a crisis.

No other health-care system in the country is so infested with politics as the Cook County system, according to the leaders of this study.

Who's going to fix that? The county commissioners in charge of health care?

"They don't know what to do. They've always been told what to do" by former President John Stroger, said Patricia Terrell of Health Management Associates. Terrell was deputy chief of the Cook County Bureau of Health Services from 1991 to 2002.

"We talked to the commissioners," she said. "They're really good people. They just don't have a clue how to run a health-care system."

Can it be fixed by the people who are in charge of Stroger Hospital and the rest of the health-care system? They wouldn't even cooperate when the professionals from Northwestern sought their help to do this analysis.

What a shame. The Northwestern report found that the county has physicians "of extremely high quality," but they have to work in a management system that is "archaic."

And who pays for that? The patients and the taxpayers.

The health-care system "is like a big fuel gauge," Dr. Kevin Weiss, director of the Institute for Healthcare Studies, told the Tribune editorial board. "At the end of the year they say, `Do we need to fill it up with more tax dollars?' There's no accountability. No transparency."

Weiss, Terrell and the others who conducted this research are pleading for the larger community, particularly the business community, to step in. They are on the right track. Public health care in Cook County needs the kind of crisis intervention the Chicago schools received a few years ago.

The Cook County Board is allowing one of its most precious resources, the public health-care system, to go to rot.

The county commissioners need to get out of the way. They have no business running a health-care system. They need to allow a broad assessment of the failings of this system. They need to bring in new management--either a private health-care firm or an independent board of health-care professionals.

Like everything else in Cook County government, the health-care system has been designed for the benefit of politicians and their cronies. It's enough to make you sick.

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