Health-care check, please

By Dennis Byrne
Chicago Tribune

It's nice and compassionate that Cook County is giving away free health care to thousands of people from the collar counties.

But with Cook County looking at a deficit approaching a half billion dollars, it's irresponsible, and the mooching by the collar counties should stop now.

Certainly not in a way that would suddenly throw indigent families from the collar counties who travel to Stroger Hospital and other Cook County health facilities into the cold. But in a way that Lake, DuPage, McHenry, Kane and Will Counties would at least pony up their fair share. Or take care of their own indigent. But in the four weeks since the news broke of the sponging, no one has stepped forward to say they should or would pay.

What can account for such generosity when doctors, nurses and clinics are getting the boot in Cook County because of budget cuts? Why, when tens of thousands of Cook County residents are waiting interminably in long lines for health care and medications, are thousands more non-residents allowed in line?

Are the boards of the collar counties jumping up and saying, let's do an accounting of how many of our residents are using services that we are morally and legally obliged to provide, and at least reimburse Cook County? Are the collar counties so poor that they can't pitch in for their share?

Apparently, the mooching had been going on for a long time, until Dr. Robert Simon, the county's health chief, tried last month to stop it. Patients, he said, would have to prove they are Cook County residents; those who aren't either must be referred to the public health departments of their own counties or pay in full. Elective surgeries or procedures would have to be paid up front.

But just before the policy could be implemented, Cook County Board President Todd Stroger rescinded it. A Stroger spokesman, speaking in the usual language of bureaucratic equivocation, left room for rescinding the rescission, or not. At the risk of appearing hard-hearted, the County Board should take matters into its own hands while it is struggling to find ways to balance its budget and end the practice.

County officials did not respond to requests by the Chicago Tribune for information on how many non-residents are served and at what cost. Whatever it is, it probably wouldn't cut very much into the mountainous deficit, which Stroger initially addressed with a cynical demand that county officers make across-the-board 17 percent cuts in their budgets.

Cynical because Stroger dodges the difficult job of finding and pushing for cuts that are more deserving than others. That would require sniffing out the worthless and undeserving who have infiltrated the ranks of county workers during his father's tenure. Stroger obviously doesn't want to be the one wielding the ax.

Cynical because it puts the onus on county commissioners to make the difficult choices. Cynical because he can veto the board's cuts, blaming the commissioners for supposedly (1) not cutting deep enough or (2) heartlessly cutting essential services--whichever serves his political purposes.

In demanding a sweeping cut of 17 percent, Stroger knew that he would raise a hornet's nest of protest, so, superficially, it appears to be a courageous act. Especially among the people who voted for him. Now, the same folks are calling it obscene and a betrayal.

If it weren't for the essential services being indiscriminately cut by Stroger, it would be hard to work up much sympathy for those voters and critics. They ignored the obvious dangers of voting for a political hack who is putting and keeping relatives and friends in well-paying positions. Some refused to vote against him because they couldn't bring themselves to vote for a Republican, any Republican. Others were so suffused with their pro-choice, anti-gun ideology that they couldn't bring themselves to vote for the reform that was so obviously needed. Many of them were self-styled progressives who, this time, couldn't stomach change or reform.

Time to let Stroger know that we don't like what he's doing, we're told. Call him up, give him a piece of your mind, attend a protest, send an e-mail. Too late. No use. He has almost four years left in his term, and when the next election arrives, he knows that the same people will vote for him again, for the same ridiculous reasons.