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Study: County health system nearing crisis

Tuesday, August 08, 2006
Daily Herald

In case this year's gaping $54 million shortfall in patient revenues at the County Health Bureau wasn't enough of a sign something is wrong, an independent group released a study Monday urging an overhaul of the trouble-plagued system.
"With the president's office as the sole hiring authority, there is a clear opportunity to use the system for political hiring at the expense of best qualified health management leadership," was one of the conclusions reached by the study, conducted by Northwestern University's Institute for Health Studies.
"And while this report did not directly explore the issue of patronage, most interviewed for this report perceived patronage was engaged by the President's Office to staff a number of key positions within the bureau."
The timing of the report could not be worse for the bureau, which was short $54 million in collecting patient fees as of the end of June and the major contributor to the county's $40 million shortfall. The patient fees deficit may even balloon to $90 million by the end of July, said Gregg Goslin, a Glenview Republican on the county board.
The report pulled few punches, laying much of the blame at the foot of the office of the former County Board president, John H. Stroger. Stroger has retired since suffering a stroke in March, and his son Todd Stroger is running in November, seeking to replace him.
In addition to the alleged patronage, the report cites a host of inefficiencies at the hospital that could be done away with, including having the president's office as an integral top of the chain of command. Direct governance, the report said, "is a model that nearly every other major urban community in the United States has abandoned."
There were some pluses, however. The county's relatively new facilities are the envy of other hospitals, as are its full-time doctors. But without better attention, the report noted, it could lose those assets as well.
"Health care for the underinsured in America is in crisis. It is hardly surprising that the Cook County bureau of health services, with a long history as one of the most comprehensive and overburdened health care safety net systems in America, is dramatically affected by this crisis," said the health bureau's chief, Daniel H. Winship through a county spokeswoman. He did not address the criticisms specific to the county.
The six-month study was funded by the Otho S.A. Sprague Memorial Institute, a Chicago-based foundation started in 1911 with the mission of being dedicated to "the investigation of the cause of disease and the prevention and relief of human suffering in the city of Chicago, county of Cook, state of Illinois."

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