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Cook County's health system needs major overhaul: study
Northwestern University study warns of 'clear and growing crisis'

Monday, August 07, 2006
Crain's Chicago Business
by Mike Colias

(Crain’s) — Cook County’s public health system is in need of a massive financial
and operational overhaul in order to avert “a clear and growing crisis in the
health care safety net in Cook County,” according to a study released Monday by
Northwestern University researchers. 
The report calls for independent oversight of the Cook County Bureau of Health
Services, which now is under control of the 17-member Cook County Board of
Commissioners and interim President Bobbie Steele. The governance structure
presents “a clear opportunity to use the system for political hiring at the
expense of best qualified health management leadership” and does not provide the
expertise needed to oversee a large health system, the study says. 
“The system is being managed by people who may be good public policy figures,
but have no experience in the complexities of modern health care,” said Dr.
Kevin Weiss, the study’s lead author and member of Northwestern’s Institute for
Healthcare Studies. “We need professionals running this system, not
politicians,” 
A Cook County spokeswoman said she could not immediately comment on the report,
but officials planned to release a statement later Monday. 
The three-hospital system includes the 464-bed Stroger Hospital and faces
dwindling revenue from Medicaid, the health care program for the poor that is
funded by the state and federal governments. The county had to tap reserves to
plug a $70 million shortfall last year and faces another budget gap this year
due largely to a shortfall in Medicaid funding. 
Laurence Msall, president of the Civic Federation of Chicago, said business and
civic leaders have for years pressed for independent oversight of the health
system – particularly after the county moved ahead with its plans for the
$630-million, John H. Stroger Jr. Hospital, which opened in 2002. 
“There is certainly a need for Cook County board members to really examine their
ability to effectively manage the hospital, especially in light of the continued
failure to implement some of the more basic efficiencies at the hospital,” Mr.
Msall said.  
The Northwestern study calls for creation of a commission of county officials
and civic leaders to recommend ways to revamp the health system’s governance and
set benchmarks to measure clinical quality and patient satisfaction. It also
calls for an analysis of the health system’s fiscal strategy and ways to boost
Medicaid revenues and county subsidies. 


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