What Federal Health Insurance Reform Could Mean for Cook County

No matter what your opinion is on the recent historic federal legislation reforming the health insurance industry, it is now law and it will have ramifications for most Americans. It also will have a significant impact on a major piece of what Cook County government does: provide health care for the insured, underinsured, and uninsured alike.

Over a third of the Cook County budget each year goes to the Cook County Health Care network that includes Stroger Hospital and other clinics and services. Many of those who use the public health system that our county provides ("safety-net health care," as it is often called) will have more health insurance now under the new law.

What impact will this have on Cook County taxpayers?

At first glance, one might hope that this would simply mean less of a burden for Stroger Hospital because fewer uninsured patients will be coming through. And by extension, hopefully less of a burden for the Cook County taxpayer. But it's more complicated than that, of course.

What this law will likely do is create more competition for Cook County's public hospital and clinic system, thereby forcing a better product, more focused on customer service. And potentially, that can be a good thing.

We will need to be able to attract patients who will now have more options and more insurance coverage, by offering better services to those customers.

Cook County health care systems will need to do an even better job of customer service in order to continue to attract patients who actually have insurance with which to pay their bills.

The financial danger comes if more patients with more choices and more and better insurance don't continue to come to Stroger Hospital and other Cook County facilities, thereby taking away vitally needed funding, and opt instead to go elsewhere to private hospitals. This would leave one major population of the still uninsured coming to Cook County for care: undocumented residents.

The federal health insurance reform bill now signed into law does not cover illegal and undocumented workers, of which there are many thousands in Cook County. They will still come to our public hospital for care. Legally, Cook County public health facilities cannot turn anyone away, and there will be no federal monies to cover their expenses. This is why many feel that next item on the national reform agenda for our Congress has to be immigration reform.

Immigration reform is a real issue for my future constituents, even up here in the northern suburbs, and here is one example: thousands of seasonal undocumented workers live in cinder block buildings at the end of the Arlington Park race track located in the 14th, working to clean up after the horses several months of the year. When health care emergencies arise, there is only one place they can go - Cook County.

What Cook County will need to do to best manage the effects of the new health insurance reform legislation in the months ahead will become clearer as we go. But one thing I am already talking to experts about is how to turn the 16 Cook County Clinics into "FQHCs" -- Federally Qualified Health Centers. By earning this new licensing that the clinics currently do not have, they could compete and draw in the insured as well as uninsured. They and the hospitals will have to become better at what they do, more customer focused, in order to earn their share of the expanded market of insured patients.

And Cook County can offer unique specialization and skilled expertise in trauma care and other areas because of the many good doctors and years of experience that our large public hospital system has. We can be among the best, with the right focus, moving in the right direction by delivering the best possible customer service.

In other words, this recently enacted change in health insurance regulations could make us or break us.

One thing is clear -- the County Board will need the best people possible to lead us into the future in all these areas -- leaders with new energy and commitment to implement best practices long neglected in the status quo. We will need leaders who are policy experts, who have raised institutional standards in prescient ways, anticipating trends. I have long done these things as an educator and school administrator. More of the same, lacking in leadership, will not get the job done. It is my intent to get this job done -- it is my campaign promise to you.

And there are other areas of recent federal reforms informing this discussion about the impact of recent federal reforms and their impact on Cook County: the stimulus package monies.

I am forced to ask the obvious: how is it that the current incumbent Commissioner from the 14th district took credit in his e-newsletter this week for bringing federal stimulus money to Cook County? Especially because he did not bring it home -- the administration in Washington sent it in the wake of the recession crisis. In fact, the incumbent Commissioner Goslin has repeatedly publicly associated himself with political extremists who vehemently oppose more federal aid in this crisis, while also attempting to take undeserved credit for these federal dollars.

Just asking.