Critics of a new $570 million replacement for Chicago's public hospital contend that area providers who support the plan are trying to foist the cost of caring for the poor on taxpayers.
Critics told MODERN HEALTHCARE last week that a proposal for a Cook County
(Ill.) Hospital is premature in an unstable healthcare environment waiting for the future impact of healthcare reform. The Cook County Board of Commissioners voted to replace the hospital earlier this year (May 23, p. 28).
"Nobody in the provider community in Chicago is against this because they want to dump everything on the taxpayers," said County Commissioner Maria Pappas, one of three county board members who voted against the proposal. She was referring to reports that many hospitals don't want to deal with the indigent patients Cook County serves.
Healthcare providers have rallied to support the new hospital, which would replace the 82-year-old, decrepit 932-bed facility and its 13 buildings with a smaller hospital that's less than half the size at 464 beds. The replacement structure earned unanimous support from Illinois Hospital Association, the Metropolitan Chicago Healthcare Council and the Chicago Medical Society.
A key to Cook County's replacement is increasing the number of ambulatory-care clinics from eight to between 20 and 25.
Chicago-area hospitals and healthcare providers couldn't handle the volume of Cook County's outpatient load, which numbers more than 650,000 visits a year, said Ruth Rothstein, the hospital's director and chief of the Cook County Bureau of Health Services.
"I don't think the capacity is there to absorb the volume," Ms. Rothstein said in an interview with MODERN HEALTHCARE. "We haven't heard yet how one judges capacity. We also have 180,000 emergency room visits and 5,000 trauma patients."
Cook County Hospital executives will file their certificate-of-need application this week. The financing of the hospital won't be arranged until next year, and design and construction of the new replacement facility wouldn't be complete for another six to seven years.
Critics also say a new hospital doesn't make sense when another Cook County-owned facility, 243-bed Provident Hospital, reported earlier this year that just 20% of its acute-care beds are full on average.
But Ms. Rothstein said the number of acute-care beds isn't the issue.
"That's a fallacious argument," she said. "This is not a hotel where you sell a bedroom."
Both Ms. Rothstein and Chicago-area providers expect the replacement facility and ambulatory-care clinics to produce public-private healthcare partnerships.
"It needs to be run in a business-like manner and not be a political gem for whatever party is in power at a certain time," said Richard Risk, president and chief executive officer of EHS Health Care, based in the Chicago suburb of Oak Brook, Ill.
An inner-city public hospital has been replaced in Atlanta, and replacements are under way in Los Angeles and in New York City. In New York, a proposal similar to Cook County's would replace 1,234-bed Kings County Hospital Center with a smaller facility with 983 beds and more ambulatory-care sites (May 16, p. 43).
Cook County already has spent $80 million in the past three years just to maintain the existing facility.
At six public hearings, some 300 people testified in favor of a replacement facility, and just three people opposed it, on the grounds that it was a waste of taxpayer money.
Critics said healthcare reform could change the role of the public hospital.
"It seems premature to make these expensive decisions without all the facts," Ms. Pappas said. "It will not do harm to our citizens to wait a few more months. In the long run it will serve the users better to know what we're doing."