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Patronage killing health hope for poor

Tuesday, September 11, 2007
Chicago Tribune
by Forrest Claypool (D-Chicago)

The American Cancer Society recently announced it will devote its entire advertising budget to the tragedies caused by inadequate health insurance.

The uninsured are the least likely to have money for regular screenings such as mammograms and prostate exams. Yet preventive care is the most effective way to stop cancer in its tracks, averting costly treatment later. This is also true of diabetes, high blood pressure and other deadly ailments.

Cook County Board President Todd Stroger, though, has slashed preventive care in county hospitals and clinics. Eight neighborhood clinics have been shuttered, along with a wing of the $551 million Stroger Hospital. Mammogram screenings have been eliminated, and specialty clinics devoted to treating high blood pressure and preventing heart disease and colon cancer have been shut down.
I don't mean to suggest that Stroger is insensitive to cancer-sufferers. As a decent man and a victim of prostate cancer, I'm sure he cares deeply about fighting that disease. But his policies have consequences for tens of thousands of Cook County residents who rely on the county for preventive health care. Stroger's interim health chief, Dr. Robert Simon, admitted to the Cook County Board earlier this year that residents will suffer from less access to basic care, longer wait times, less preventive care and a

potential increase in cancer deaths.

That's the price poor patients pay for a hospital system dominated by politics. The county has been a patronage dumping ground for years. Incompetent management has cost the county hundreds of millions of dollars that were never collected from Medicare and insurance companies.

With layoffs of doctors, nurses and medical technicians, it is increasingly difficult for professionals to care for their patients. The chief of internal medicine at Stroger Hospital, Dr. Avery Hart, warned in a July memo to Simon of an "impending collapse of general medicine at Stroger Hospital" due to the rapid loss of internists who were laid off or quit.

We can save this unique public asset if we finally remove politics from medicine.

Last year, I joined a majority of the County Board to sponsor an alternative budget that would have averted health-care cuts by slicing redundant layers of management. But several sponsors of our measure switched sides, providing the margin of victory for Stroger's deep service cuts.

The county will soon take up its 2008 budget. The choice will be the same: politics or health care. We will have another chance to attack the wasteful, patronage-laden bureaucracy. New and effective leadership for the county health bureau will be even more important.

Earlier this year, we replaced unqualified leaders of the county's Juvenile Detention Center with a nationally recognized expert. After years of neglect and abuse, the young residents of this facility now have hope for fair treatment, rehabilitation and a brighter future. That change was the result of continual pressure from members of the County Board, legal advocates, newspapers and citizens who were outraged that patronage and politics trumped real leadership.

Saving Cook County's vital health-care safety net will require a similar effort. If elected officials stand up, if church and neighborhood leaders come forward, if civic and business groups speak out, we can apply the pressure necessary for change. We have to act before the safety net is frayed beyond repair. Cook County's historical commitment to health care is worth preserving, for those who need it today and for generations to come.



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