Wednesday, July 14, 2010
by Chicago Tribune editorial staff
The symptoms are troubling: Thousands of impoverished patients rely
for their health care on Cook County facilities that don't match their
needs and that cost more than taxpayers can sustain.
prognosis, though, has brightened. Apply the right treatments and
everyone could win — the county health system's patients, the underused
infrastructure and the taxpayers who pay for it all.
members of a Cook
County Board committee will begin discussing that prognosis, which
comes in the form of a consultant's dramatic plan to reform the county's
health system. The report proposes:
•Scaling back inpatient
services at Provident Hospital, which uses relatively few of its beds.
An emergency room and some short-stay beds would remain open.
•Closing inpatient services at
Oak Forest Hospital and creating a regional outpatient center that would
provide a range of primary care services.
strengthening services at Stroger Hospital.
Health Center, an outpatient clinic on the Stroger campus.
the independent health panel that now runs the county system with a
smart, gutsy plan that should promote efficiency and deliver better
The problem here isn't lackadaisical doctors or a
lack of will to serve a disadvantaged clientele. The problem is that
decades of county politics geared toward patronage hiring created three
hospitals, and three big work forces, that a shrinking patient load no
longer justifies. The hospitals gobble dollars better suited to supply
basic outpatient care.
The challenge is to redeploy those dollars —
away from some too-empty inpatient wards and toward decentralized
primary care clinics in neighborhoods where patients live. This plan,
which the County Board should approve, does just that. Why hasn't that
happened before? Because it has been in the interests of politicians to
build large pools of patronage employees at the hospitals.
thing tempers our enthusiasm: The plan projects that when the changes
are complete, the system will run deficits similar to today's: The plan
envisions a $332 million infusion of cash from county taxpayers in 2015,
about the same as in 2010. An overhaul this ambitious should produce
Health panel officials advise us not to put
much stock in those projections. But ignoring the numbers wouldn't be
healthy. We think health officials are on the right track, but they've
got to control expenses. As reimbursement collections improve and
hospital costs ease, the system should need fewer dollars from
cash-strapped Cook County.
One way to save: Coordinate with city
clinics in Chicago
to eliminate redundancies. County system CEO Bill Foley says officials
have had "preliminary discussions" and "we definitely want to look at
opportunities to collaborate with them." That's a must.
card in all this is the rollout of new national health care reforms over
the next few years. It is unclear what that will mean for public health
providers. But here's what we do know: Hundreds of thousands of poor
uninsured adults — the core clients of the county health system — will
gain insurance coverage and more choices about where to get treatment.
They'll choose medical competence and convenience, just like everyone
else. They won't choose a county system if it can't compete for quality
of care and ease of service.
Bottom line: We urge the Cook County
Board to quickly approve this plan, because it moves the system in the
right direction. But that's not the end of it.
The board rightly
handed control of the health system to the panel to get things done. The
panel has delivered so far. But the board shouldn't relinquish its
responsibility to county taxpayers, to make sure that they, too, get
maximum bang for every health care dollar.