Gapers Block has ceased publication.

Gapers Block published from April 22, 2003 to Jan. 1, 2016. The site will remain up in archive form. Please visit Third Coast Review, a new site by several GB alumni.
 Thank you for your readership and contributions. 

TODAY

Thursday, March 28

Gapers Block
Search

Gapers Block on Facebook Gapers Block on Flickr Gapers Block on Twitter The Gapers Block Tumblr


The Mechanics
« Bank of America Ignores Citizen Tax Enforcers Guzzardi Calls for Vote Recount »

Op-Ed Fri Apr 06 2012

Can Chicago's Health Care Problems Be Healed?

According to an article posted Tuesday by Crain's, Chicago was ranked 215th out of 306 health care markets by a report from the Commonwealth Fund. According to the article, it was ranked so low due to "high costs, high rates of uninsured, very high rates of potentially preventable hospital admissions and low rates of preventative care such as screening for breast and colon cancer."

For context, Boston, Philadelphia, Manhattan, Atlanta, Detroit and the Bronx ranked higher at 41, 101, 127, 166, 189 and 206 respectively. Among the cities that ranked lower were Los Angeles, Miami, Dallas and Memphis.

A possible problem Chicago has is that in some areas it has too many hospitals and in others not enough. For example, in Uptown, where I live, there are two hospitals that I could easily walk to: Thorek Memorial Hospital and Weiss Memorial Hospital. Additionally, Advocate Illinois Masonic Medical Center and Swedish Covenant Hospital are not that far of a trip. The North Side also has two hospitals with Level One trauma centers, while the West Side has one and the South Side has none. The geography of Chicago's hospitals suggests that if you need a hospital, the closer to the Loop you are, the better. Unless you live on the North Side.

But hospitals cannot be the only way to treat people. Primary physicians and clinics are important as that can help with preventative medicine, which could in turn reduce the number of ER visits. Unfortunately, doctors throughout Chicago vary in quality and appointments for specialists have to be made months in advance.

Ultimately, Chicago's health care problem is rooted in its hyper-segregation. Primary physicians are not that easy to find outside of the downtown area of Chicago, unless you live on the North Side. Chicago is lacking in urgent care clinics, which serve as great alternatives to emergency rooms. Additionally, most urgent care clinics charge what a physician would charge rather than an emergency room, which saves a patient money as well as the health care provider.

Furthermore, Chicago has a problem with charity care. In order for a hospital to keep its non-profit status, it must provide a certain percentage of charity care to patients. This means that if someone is treated in the hospital and they will have a hard time paying or cannot pay, the hospital has to help them out. Last year, Northwestern's Prentice Women's Hospital lost its non-profit status as a result of not providing enough charity care.

As a result of this, someone might think that this requires hospitals to treat everyone who walks through the door. That would be the Emergency Medical Treatment and Labor Act that was passed in 1986, making "patient dumping" illegal. This doesn't mean that patient dumping doesn't happen. In fact patient dumping allegations were leveled at University of Chicago Medical Center in 2009 after a boy who had been mauled by a pit bull was allegedly sent to Stroger Hospital for treatment.

The program at University of Chicago responsible for that is called the Urban Health Initiative, which is supposed to send people to a primary physician if they come into the ER with a minor problem.

This is a well-intentioned program since some things like a cold or the flu can be checked out by a doctor. However, there are questions that are raised by this program. Are patients followed up with to see if they are actually seeing a physician? And how many of these patients actually have minor ailments that should be seen by a physician?

The most depressing thing about Chicago's health care is that the best solution anyone can come up with might be the cause of patient dumping.

There is no easy way to fix Chicago's health care problem because it would require for solutions like more quality community clinics with low or no cost or urgent care clinics to be invested in. But Chicago may not be a city to attract people to invest in more health care since at least four hospitals in Chicago closed in the past decade.

Chicago's health care situation is not new and the city has been struggling with improving preventative measures for the poor and uninsured. In the book County: Life, Death and Politics at Chicago's Public Hospital, Dr. David Ansell tells about the creation of the Breast Cancer Screening Program at Cook County Hospital while he was there and says this at the end of a chapter:

In 2006, my colleagues and I discovered that, despite efforts like the Breast Cancer Screening Program, black breast cancer mortality had not budged in Chicago since the early 1980s and the Chicago racial gap in breast cancer mortality was the largest in the U.S. Why? We postulated that the health-care system in Chicago was designed in such a perverse way that black women were still unable to receive the best outcomes despite all advances in breast cancer care. As a result, hundreds of black women died from breast cancer each year in Chicago because they did not have the same outcomes as white women.

Can Chicago really improve its health care? Considering that in some ways the system has worsened by losing clinics and hospitals, it seems like that might take a lot of hard work.

 
GB store

Emilie Junge / April 7, 2012 3:51 PM

Good, thoughtful look at health care in Chicago. The Fair Care Coalition, with more than 30 community organizations, is working to hold wealthy hospitals accountable for their failure to provide adequate charity care. Nevertheless, the Illinois Hospital Association perists in its refusal to agree to anything other than the status quo.
Also, the readers should be aware that the Cook County Health and Hospital System has several centers of excellence and continues to fulfill its mission to treat all, regardless of ability to pay, despite underfunding and constant struggles to make ends meet.

Pnappier / April 9, 2012 12:35 PM

Great article. You make good points about the need for low cost and free clinics to keep health costs down. Preventative care is cheaper and more efficient. Unfortunately, as I type this, the chicago is closing down 6 neighborhood mental health centers and moving on to privatize all 7 neighborhood primary care health centers. Health commissioner Bechara Choucair claims that this is an enhancement in care. Unfortunately patients will have to travel further to be seen by less qualified staff. The city will also lay off FEMA certified nurses who are trained as emergency coordinators for health disasters such as epidemics and weather emergencies.

benny / August 5, 2014 2:04 AM

Hi

jack smith / September 1, 2015 12:53 PM

State Farm is sad and filled with woe

Edward Rust is no longer CEO

He had knowledge, but wasn’t in the know

The Board said it was time for him to go

All American Girl starred Margaret Cho

The Miami Heat coach is nicknamed Spo

I hate to paddle & don’t like to row

Edward Rust is no longer CEO

The Board said it was time for him to go

The word souffler is French for blow

I love the rain but dislike the snow

Ten tosses for a nickel or a penny a throw

State Farm is sad and filled with woe

Edward Rust is no longer CEO

Bambi’s mom was a fawn who became a doe

You can’t line up if you don’t get in a row

My car isn’t running, “Give me a tow”

He had knowledge but wasn’t in the know

The Board said it was time for him to go

Plant a seed and water it to make it grow

Phases of the tide are ebb and flow

If you head isn’t hairy you don’t have a fro

You can buff your bald head to make it glow

State Farm is sad and filled with woe

Edward Rust is no longer CEO

I like Mike Tyson more than Riddick Bowe

A mug of coffee is a cup of joe

You can call me brother, but don't call me bro

When I sing scat I sound like Al Jarreau

State Farm is sad and filled with woe

The Board said it was time for him to go

Campaneris threw his bat at Lerrin LaGrow

Ursula Andress was a Bond girl in Dr. No

Brian Benben is married to Madeline Stowe

Betsy Ross couldn’t knit but she sure could sew

He had knowledge but wasn’t in the know

Edward Rust is no longer CEO

Grand Funk toured with David Allan Coe

I said to Shoeless Joe, “Say it ain’t so”

Brandon Lee died during the filming of The Crow

In 1992 I didn’t vote for Ross Perot

State Farm is sad and filled with woe

The Board said it was time for him to go

A hare is fast and a tortoise is slow

The overhead compartment is for luggage to stow

Beware from above but look out below

I’m gaining momentum, I’ve got big mo

He had knowledge but wasn’t in the know

Edward Rust is no longer CEO

I’ve travelled far but have miles to go

My insurance company thinks I’m their ho

I’m not their friend but I am their foe

Robin Hood had arrows, a quiver and a bow

State Farm has a lame duck CEO

He had knowledge, but wasn’t in the know

The Board said it was time for him to go

State Farm is sad and filled with woe

GB store

Feature

Parents Still Steaming, but About More Than Just Boilers

By Phil Huckelberry / 2 Comments

It's now been 11 days since the carbon monoxide leak which sent over 80 Prussing Elementary School students and staff to the hospital. While officials from Chicago Public Schools have partially answered some questions, and CPS CEO Forrest Claypool has informed that he will be visiting the school to field more questions on Nov. 16, many parents remain irate at the CPS response to date. More...

Civics

Substance, Not Style, the Source of Rahm's Woes

By Ramsin Canon / 2 Comments

It's not surprising that some of Mayor Emanuel's sympathizers and supporters are confusing people's substantive disputes with the mayor as the effect of poor marketing on his part. It's exactly this insular worldview that has gotten the mayor in hot... More...

Special Series

Classroom Mechanics Oral History Project
GB store



About Mechanics

Mechanics is the politics section of Gapers Block, reflecting the diversity of viewpoints and beliefs of Chicagoans and Illinoisans. More...
Please see our submission guidelines.

Editor: Mike Ewing, mike@gapersblock.com
Mechanics staff inbox: mechanics@gapersblock.com

Archives

 

 Subscribe in a reader.

GB store

GB Store

GB Buttons $1.50

GB T-Shirt $12

I ✶ Chi T-Shirts $15