Cook County’s health and hospitals system has hired a new CEO: the second-in-command of New York’s health system. One of Ramanathan Raju’s big selling points was fiscal shrewdness, since he helped reduce a $1.2 billion budget gap in New York.

That experience could come in handy in Cook County, where the health system is nearly $100 million in the hole. Raju said it’s too early to discuss how to close that deficit, saying he needs to study the budget first.

He also indicated he’s withholding judgment on the system’s controversial strategic plan.

“The plan is the plan on the paper,” Raju said at a news conference announcing his appointment. “But the problem is, how does it affect the local culture, and what will be the local community’s needs, need all be taken into consideration before we do any of those things.”

Raju’s predecessor, Bill Foley, was criticized for not communicating the system’s strategic plan well enough to the public. The plan calls for reorganizing services, including the closure of Oak Forest Hospital. That contentious move is set to come up for a third vote before a state board on August 16th. Raju won’t start the job until October.

County health officials also responded at the news conference to insinuations that the health system is dragging down county finances, suggesting that the money problems come in part from county government itself.

Cook County Board President Toni Preckwinkle pointed out Thursday that health care costs account for $96 million of the county’s $116 million dollar hole.

A big part of the shortfall comes from long delays by the state in processing Medicaid applications. Finance chairman David Carvalho said the health and hospitals board never promised that money would come this year, but county commissioners chose to count on it.

Another big source of the deficit is the fact that the county hospitals were supposed to start billing for physician services, but that’s been pushed back into at least the next fiscal year.

Carvalho didn’t expressly blame county government, but he said one reason is the lack of capital funds. That money, earmarked for new projects like the billing system, was frozen by Preckwinkle.