January 22, 2014
Dr. Ram Raju arrived in 2011 from New York as the new chief executive of the Cook County health system with two great qualities: He had excellent experience in health care management and no experience in Chicago politics. Both served him and county citizens well. He improved patient care, streamlined the health care delivery system and reduced the financial demands on taxpayers.
He’s leaving, unfortunately. New York City Mayor Bill de Blasio has lured him back to run New York’s public health care system. We wish Raju well.
He did a good job. Doctors and the county’s health facilities have billed patients and insurers more regularly for services. The county has moved aggressively to snag more Medicaid dollars through Obamacare. Services have been delivered more efficiently.
That has provided some relief to taxpayers. The county health system requires a smaller subsidy today than it did when Raju arrived.
Two caveats to that. Expenses still run ahead of revenue, so taxpayers still have to pony up. And the county has been expanding its services as Obamacare has arrived.
So the demand for sound crisis management may have lessened a bit, but the demand for a top-notch professional to run the system has not lessened at all.
So who’s next?
“Raju has turned this into one of the top public hospital jobs in the nation,” Cook County Board member Larry Suffredin said. “We’re going to have some really talented people interested, better candidates than we’ve ever had before. We need to make sure that we don’t miss any of those people.”
That’s a challenge for the independent county health board that runs the system. Find the best candidate in the nation, someone who knows how to run a large, complex system and who will not be tempted to dabble in politically driven featherbedding.
The county health system once was a notorious, cushy home for patronage hacks, a stunningly wasteful operation. Power over the system finally was shifted from the county politicians to the independent board.
Those board members now have a huge decision. They need to find a candidate with high credentials, a candidate free of controversy.
The next leader should find ways to eliminate taxpayer subsidies. The next leader should make a critical assessment of whether the expansion of the county’s network of doctors and medical facilities, done in a bid to compete for Medicaid patients, makes sense in the era of Obamacare.
The next leader needs to understand the sorry history of how politics infiltrated the county health system, and be determined not to let it happen again.