Patronage killing health hope for poor
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Chicago Tribune Commentary
By Forrest Claypool
September 11, 2007
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.