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`Painful' health cuts are seen for county

Wednesday, January 10, 2007
Chicago Tribune
by Mickey Ciokajlo

Patients using Cook County's health-care system can expect fewer services and longer lines as a result of budget cuts mandated by County Board President Todd Stroger, the county's health chief said Tuesday.

Dr. Robert Simon said he will propose closing a number of community health clinics, many of them underused, and transferring their patients to other locations. He will also propose cutting entire departments that provide non-critical services in the system's three public hospitals as part of the effort to cut $140 million.
"There's going to be longer lines until we're restructured," Simon told reporters. "But in the end, over a period of a year, maybe a year and a half, 18 months, we will restructure. We will restructure, and we will be able to recapture most of those essential services that we need."

Simon offered hints of his proposed cuts while standing with Stroger, who next week is expected to release his proposal for closing a projected $500 million hole in the county budget without raising taxes.

"It's going to be very painful," Stroger said. "How can you cut into any health-care system and not feel some pain? But we are going to keep the essential services, and that's the most important thing."

While trying to justify the pain of the budget cuts he is seeking, Stroger also defended his recent decisions to hire and promote friends and family members. In the latest example, Stroger has hired his sister-in-law, Monique Martin, to be his personal secretary for $64,983 per year.

"I am working with people who I know are qualified," Stroger said. "And why would I go out and hire somebody I don't know when there's people I do know who can do the job?"

Stroger's budget plan will go to the County Board's Finance Committee for public hearings and by law must be approved by Feb. 28.

A bipartisan group of 10 commissioners stood together Tuesday to support Stroger's directive to cut spending by 17 percent across the board.

"It is a cut that is long overdue," said John Daley, Finance Committee chairman. "This financial situation of the county should not be a surprise to any members before this board."

Tony Peraica, Stroger's Republican opponent in the November election, said he supported Stroger's effort to cut the budget without raising taxes.

"This particular budget year is going to be the most difficult one, because it is the day of reckoning," Peraica said. "We're going to get this done. It's not going to be easy, it's not going to be painless. But sometimes, when all else fails and there is no medication that you can give anymore, you have to engage in electroshock treatment."

But Commissioner Jerry Butler said he was concerned that Stroger's cuts will "do more harm than good."

"I don't see how you can do it," said Butler, who supports Stroger politically but did not join the 10 other commissioners. "I don't know what clinics he's talking about, I don't know what services he's talking about, and that's why I'm not standing with them up there until I find out what they're going to do."

Dr. Peter Orris, senior attending physician at Stroger Hospital and a past president of the medical staff, said if services are cut, many patients will lose their preventative care, leading to more serious illnesses.

"It will cause an ultimate rise in hospitalization for severe diseases at all Chicago hospitals," Orris said.

The county's Bureau of Health Services employs nearly 8,000 workers and has an annual budget of $830 million. The county expanded its system of community clinics in the 1990s from nine to about 30 as it took advantage of additional federal Medicaid dollars that have since tapered off.

The system now has 26 clinics, but Simon said Tuesday that up to 90 percent of the patients are seen at 10 to 12 of those locations.

"A lot of those sites see seven, maybe 10, maybe 12 patients a day," Simon said. "Now when you and I go to a doctor, remember a doctor has scheduled four patients an hour in a primary-care clinic. Calculate that out. Should that clinic be funded and open? No."

Simon said the plan that he is working on keeps "probably about 10" high-volume clinics open. He said he is working with his team on ways to direct patients to new clinics and having doctors work in shifts.

Simon did not identify the targeted "non-essential" services that will be cut at hospitals but said there are "good services, good departments, that we no longer can afford."

- - -

What's next

Cook County Board President Todd Stroger's budget plan will go to the board's Finance Committee for public hearings and must be approved by Feb. 28. ----------



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