On Thursday, July 25th, the following testimony by Health & Medicine’s Executive Director Margie Schaps was presented to the Cook County Board of Commissioners. Schaps spoke about the importance of the Independent Board’s management and supervision to the continued survival of the Cook County Health System.

Good morning and thank you for the opportunity to speak before the Board of Commissioners today.  My name is Margie Schaps and I am the Executive Director of Health & Medicine Policy Research Group, founded by Dr. Quentin Young, the long-time Chair of the Department of Medicine at Cook County Hospital. We are a 38-year-old health policy center studying public health and health systems reform. I am here today to speak on behalf of our organization about two critically important issues:  the role that the Cook County Health System plays in our community, and the importance of the Independent Board of the Health System.

The Health System, with its mission to serve all in need, serves as the major safety net provider in our community, serving over 45% of those without insurance, and even after the passage of the ACA and Illinois’ Medicaid expansion and the creation of CountyCare, there remain hundreds of thousands of people without insurance in Illinois.  CCH is positioned among its peer academic medical centers, but unlike others including University of Illinois, Rush, Northwestern, and University of Chicago, it plays a unique role as the leading safety net hospital along with several other, smaller safety net hospitals and community based clinics.

CCH is, without a doubt, the glue that holds a fragile countywide health safety net system together.  No other hospital comes close to serving the number of uninsured that CCH does.  If this system fails, we fail the people of our County and put in jeopardy the stability of the healthcare system and the health of our residents.  This system not only provides sophisticated hospital care, but also plays a critical role in looking at overall health needs, working with the Cook County Department of Public Health and a network of community health centers that secure the primary health care needs that help keep people out of the hospital and keep health care costs to a minimum.

In 2006, Health & Medicine led the effort to create an independent governing board for the Health System.  We did this because we as health experts believed that the complexity of health systems, and the pace of change in our country, demanded that governing boards of large systems like CCH must be made up of people who understand health systems, financing, healthcare delivery, and changing models of care.  We believed then, and we believe now, that the Independent Board is critical to the continued survival and mission of the system.  Is it perfect, no!  We believe the Board must openly grapple with the complex problems of the system, as well as must have full transparency from the leadership of the Health System, ensuring that they get the information they need to manage and supervise the CEO so there is trust and confidence in the system leadership. The recent IG report underscores the need for this transparency and that this recommendation should be followed.

The County Board should expect that the Independent Board keep them fully informed about the challenges, successes, financial stability, and growth opportunities for the Health System.  There are problems, we need to address them—it is your job to creatively think with the Independent Board and health policy experts like us about how to address system problems. The solution is NOT to eliminate this Board—in fact, with the rapidly changing healthcare landscape in this country, the Independent Board is our greatest hope of saving a system that could thrive and be a national leader in serving all in need. Finally, I want to thank the Independent Board for the thousands of hours of unpaid work they put into supporting and strengthening CCH—they too are a treasure!