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Bad medicine

Monday, November 05, 2007
Chicago Sun-Times
Editorial

The ailing Cook County health system needs to be run by someone up to the challenge -- like a board made up of health professionals -- instead of the elected officials who are now in charge. That's what a panel of experts concluded more than a year ago, and that's what a different group of experts concluded last month.
But instead of quickly handing over the job to people who know what they're doing, President Todd Stroger and the County Board decided to ask yet another group of experts for its advice.


Most local governments in the United States already have assigned the running of their hospitals to people who are trained administrators and doctors who know the difference between a stethoscope and an otoscope. Cook County is one of two major systems that is still run the old-fashioned -- and we would argue inefficient -- way, by elected officials. To give just one example of that inefficiency, the system's billing process, by one estimate, misses out on up to $120 million a year in Medicaid and other payments.
There's also a perception, if not a reality, that patronage and politics are more important than sound management. Things have to change.
"The archaic approaches to health care governance and administration require attention now," a report by Northwestern University concluded in July 2006. Then last month, a committee formed by Stroger at the behest of Sen. Dick Durbin came to the same conclusion. "It is unlikely that the president and County Board will (or possibly can) streamline the current bureaucracy and modify the system of current oversight sufficiently to adequately address this crisis," the committee wrote.
That ad-hoc committee advised creating an independent board to run the county hospitals. Stroger said he's open to the idea, and the board voted for a task force to study the proposal. What seems to be missing, however, is any sense of urgency.
There's no doubt there is a crisis. The federal government has cut back on Medicaid. Health care costs keep rising. So do the number of uninsured and underinsured patients. Other area hospitals can't take up the slack. The county hospitals -- Stroger, Oak Forest and Provident -- are the last resort for the poor. Massive cuts last year demoralized the staff that remains. Many noted doctors have left. The public has lost faith in the system, making it difficult if not impossible to rally support for new money the system will need to continue operating.
So what should be done now? Commissioner Larry Suffredin suggests creating an interim board of health care experts to run things for the next three years, to provide time to reach a more permanent solution. As long as the board and Stroger don't meddle with them, the experts should be able do things more competently and efficiently, and maybe restore some public confidence.
Suffredin still is working to gather support for the idea. We urge Stroger and the rest of the board to sign on. We can't wait for yet another study. The county health system needs new leadership, and it needs it now.



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