Cook County commissioners on Thursday expressed frustration at the rising amount of free medical care the county-run health system doles out. And now they’re considering ways to urge other hospitals to step up.
The Cook County Health system, a medical safety net for the poor and uninsured, provides nearly half of all the free care in the county. That’s even though there are nearly 70 hospitals in the region.
The amount of charity care plus debt the health system has taken on from unpaid bills has climbed around 60 percent in five years, records show. It’s a troubling trend, and the opposite of what’s happening at hospitals nationwide.
The issue of how much charity care the county gives came up during a hearing on the county’s proposed 2019 budget. Dr. Jay Shannon, CEO of Cook County Health, said the county alone can’t shoulder the growing demand for health care from people who can’t pay for it.
“Simply put, we have reached kind of our plateau,” Shannon said. “If there’s $600 million of need of charity care across Cook County, we cannot provide that. There are not the dollars to do it.”
Chicago Democrat John Daley, the powerful County Board finance committee chairman, suggested his fellow commissioners approach hospital leaders in their districts and ask them treat more patients for free.
“That’s what I intend to do,” said Commissioner Tim Schneider, a Republican from Bartlett. “They need to step up a bit.”
Commissioner Larry Suffredin, an Evanston Democrat, questioned whether the County Board should tax other hospitals who don’t provide enough free health care. He added that would be “draconian.”
Daley said the board could also call for a summit between county and other hospital officials, or even ask state lawmakers to step in.
“I think it’s important because you see the breaks they’re getting,” Daley said.
He’s referring to property tax breaks for nonprofit hospitals in Illinois. The majority of hospitals in Cook County and in Illinois are nonprofit, state records show. In 2012, they won a huge debate over how much free care they need to provide to get what can be lucrative tax breaks.
In order to qualify for those tax breaks, hospitals must provide some services to their communities that at least equals what their property tax bill would be. It doesn’t have to include free care. Research and training doctors counts. So does providing trauma care to patients who are shot.
A spokesman for the influential lobbying group that represents Illinois hospitals told WBEZ Thursday they’re already doing their part to support Cook County’s health system by providing more than $2 billion in such community benefits.
“We’re always happy to meet with county officials to talk about ways we can partner together in strengthening the health care system in Cook County,” said Danny Chun, spokesman for the Illinois Health and Hospital Association.
The ripple effect of the 2012 law is partly what’s fueling the rise in free care at the county health system, WBEZ revealed in August.The county health system has taken on a greater share of free care in the county, while other public and private hospitals have provided less.
In 2016, the county health system’s two hospitals — John H. Stroger Jr. Hospital on the Near West Side and Provident Hospital on the South Side — provided nearly half of all the free care in Cook County, totaling about $266 million, according to a WBEZ analysis of the latest state records. Stroger shouldered the bulk of it, with $246.9 million.
No other hospital came close. Northwestern Memorial Hospital, one of the richest hospitals in Chicago, was a distant second to Stroger with just $38.1 million worth of free care provided.
Five years earlier, other hospitals were picking up more of the slack. Back then, the county’s two hospitals provided just about 40 percent of all the free care.
To be fair, hospitals generally don’t have as many uninsured patients, so there’s less demand for free care. That’s because more people qualified for government-subsidized coverage under the 2010 Affordable Care Act, while others were were required to buy it.
Shannon, the county health system CEO, told WBEZ he believed other hospitals were sending more uninsured patients his way. They’re notably people who are expensive and need more than a quick office visit, like those who need surgery or have cancer.
He can’t say which hospitals are to blame because his staff doesn’t track it. But he points to state data WBEZ analyzed that shows the disparity.
Kristen Schorsch covers Cook County politics for WBEZ. Follow her @kschorsch.