In 1990, the City, County and state elected executives convened the Chicago/Cook County Health Summit which prepared a prospective road map to address the problems of that day. The ensuing 15 years have seen demographic shifts, health funding shifts at the national, state and local level, and changes in patterns of health service utilization suggest that the time is right for another examination of the safety net and the development of a road map for the coming decades, but this time these changes demand that the planning be done from a northern Illinois regional perspective.

The public health systems in Philadelphia, New Orleans and other cities have disappeared in recent times. Many others have been turned over to a variety of private management structures. The elements in the current Cook County crisis have the same admix that undermine these once vigorous enterprises:
Political mismanagement including patronage

• Leadership and management deficits

• Structural deficit in the financing structure for the County of Cook

• Failure to achieve a high level of public awareness and appreciation played by public sector services

In a very urgent sense, remediation of these deep seated problems based on public consensus is the challenge of this project.