• Editorial
  • Is this the right cure for what ails County Health?

    If Toni Preckwinkle wants to control the response to the county health system's financial woes, then she ought to assure her constituents that she knows what the response should be.

    John R. Boehm

    79彩票注册网址Toni Preckwinkle

    79彩票注册网址

    While insisting the move is "not a power grab," members of the Cook County Board are backing legislation introduced by Board President Toni Preckwinkle that will allow the board to retake control of Cook County Health, the $2.8 billion collection of hospitals and clinics that is one of the largest public health systems in the nation.

    That system's finances have come under scrutiny from the county's independent inspector general, and the move to reorganize the independent board that has overseen the system since 2008 comes on the heels of the departures of CFO Ekerete Akpan and CEO Jay Shannon, exits that have left system leadership in flux. Meanwhile, the health system is grappling with an unexpected increase in the amount of charity care it is expected to deliver—recently estimated to reach $590 million for fiscal 2020.

    A situation like that would seem to a casual observer like a good time to tighten up oversight of the county health system. The question is whether the prescription recommended by Preckwinkle is the cure the system really needs. Would Cook County residents rather have an independent board of knowledgeable and committed volunteers provide oversight of an increasingly complex health system, or would they prefer to place the system more firmly in the grip of political players? If residents knew the history that led to the creation of the independent oversight board in the first place, they would very likely be skeptical of any plan that would put pols more fully back in charge.

    As Civic Federation chief Laurence Msall argued in a Feb. 14 Crain's guest op-ed, the county health system was plagued with poor management and inadequate county board oversight before the formation of the independent panel. Decision-making, including hiring, was dominated by political considerations, breeding patronage and incompetence, Msall wrote with co-authors Don Villar of the Chicago Federation of Labor and Margie Schaps of the Health & Medicine Policy Research Group.

    79彩票注册网址Due to poor record-keeping, the health system back then often failed to collect payments from insured patients or those who could afford to pay. In 2007, during the Todd Stroger era, $130 million in unpaid bills were found stuffed into storage boxes. At the time, U.S. Sen. Dick Durbin said the health system would have to make reforms, or else the Illinois delegation would no longer advocate for federal funding.

    Reforms took shape under the leadership of the newly formed independent board, leading to modernization and professionalization of the system and improvements in billing. But now, with the cost of uncompensated care ballooning in an increasingly complex system, the size and scope of the health system's financial problems are just beginning to be fully understood.

    79彩票注册网址Preckwinkle's proposal calls for the health system CEO to, among other things, collaborate with Preckwinkle's administration on operational and policy issues. Preckwinkle team members will also "assist the system board in developing the strategic and financial plan."

    These changes will make the health system's board less independent and any CEO it hires more answerable to Preckwinkle and county commissioners. If that's truly what the Preckwinkle administration wants, then it's incumbent on her and her team to articulate a strategy, to prove to us that they have an idea of what they're going to do to solve the financial problems plaguing the health system. What are the president's ideas for dealing with the growth of uncompensated care? If she and the commissioners are going to demand control over the health system, they owe their constituents answers to these difficult questions.

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