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Letter to the Editor: An Efficient Cook County Public Health System


The Emergency Network to Save Cook County Health Services was among the earliest proponents of an independent county health system board, and we too welcome its efforts to create an efficient public health care system ("Don't back down," Editorial, Nov. 4).

To do so appropriately, however, is a challenging task given the complexities of health care needs and services in this large and diverse county. The board's fundamental responsibility, as laid out in its establishing ordinance, is to provide universal access to quality health care, regardless of a patient's ability to pay. Consequently, any long-term plan for transformation adopted by the health system board must be framed, first and foremost, by its effectiveness in meeting the health needs of all county residents.

As clearly documented by the board's outside consultants, the demand for health services in the county exceeds current resources, increasing the importance of efficient operations. However, efficiency in meeting that demand means doing more with existing resources, not using fewer resources to do less.

It is not efficient to propose the layoffs of some 150 nurses while spending tens of millions of dollars every year to contract with outside nurse registries to meet chronic staffing needs.

It is not efficient to pay physicians to fill out paperwork because you have reduced clerical and support workers for those doctors.

It is not efficient to shut down inpatient services at Oak Forest Hospital when the surrounding communities constitute the most medically underserved area of the county.

It is not efficient to reduce the number of county-operated community clinics and thereby reduce access to preventive and primary care.

While we applaud efforts to eliminate patronage and root out of expenditures that do not add value to the system, that does not translate into cutting frontline staff and the services they provide. These are the devilish "details" that CEO William Foley and Chairman Warren Batts rightly need to consider.

Rather than simply rubber-stamping a first draft, it makes sense for the board to develop a sound strategic plan that gives top priority the mission of universal access to the full-range of care needed by Cook County residents, even if it takes a while longer.

Quentin Young, MD
Health and Medicine Policy Research Group

William McNary
Citizen Action/Illinois