Some are calling it political gamesmanship. Others say it would be a disaster in the making.
If two Cook County hospitals close because of a budget chokehold, the effects could be far-reaching and even catastrophic, experts say.
The proposal, floated last week by County Board President Todd Stroger, would close Oak Forest and Provident hospitals, as well as 16 clinics, if a 1 percent sales tax hike is repealed. Stroger must decide today whether or not to use his veto powers to block the tax rollback, which was approved 12-3 last week.
"It would absolutely be a catastrophic thing," says Susan Reed, an associate professor in the School of New Learning at DePaul University.
Oak Forest serves mostly as a long-term care facility. Provident's emergency room is the city's third busiest, seeing about 50,000 people a year; the hospital has some clinics.
Stroger warned last week that repealing the tax hike, instituted in March 2008, would result in a cash shortfall of $300 million. It was then that he threw out the idea of closing hospitals.
The issue is speculative at this point, and members of the Cook County Health and Hospitals System board have not discussed it together. But they are in the midst of creating a strategic plan.
"We haven't put our heads together to talk about those comments...to close those facilities and streamline our operations, per se," says Warren Batts, chairman of the health system's board. But, he says, previous discussions by the health board have included the possibility of closing some facilities to save money.
Commissioner Jerry Butler, who sits on the health board, says he hopes public outcry would eliminate the idea of closing the hospitals.
"I would pray that they would get angry enough to get down here and stop this conversation before it gets out of hand," he says.
Dave Lundy, acting executive director of the Better Government Association, says the Stroger's idea is nothing more than grandstanding to intimidate commissioners.
"It is the most vile fear tactic," he says. "They're trying to spread fear among poor people that they're going to have their services cut, and put pressure on the elected officials. I think it's a phony tactic, and it's a fear tactic, and it's not real."
Stroger spokesman Eugene Mullins acknowledges that closing hospitals would have a damaging effect. However, Mullins says commissioners are engaging in their own game of political theater, distancing themselves from Stroger as he is forced to make a tough decision.
But if hospitals do close, the consequences could linger for years and touch many different parts of the county.
"I think it would have an immediate and a drastic effect on the people getting health care," says Bill Sullivan, president of the Illinois College of Emergency Physicians. "The patients aren't going to stop getting sick, and I think it would overwhelm the other hospitals in the area."
"A decrease in accessibility in primary health care for families, particularly underserved families, would be a disaster for the county," says Rachel Abramson, executive director of HealthConnectOne, an agency that trains community health workers.
She says closing the facilities would cost the county because many illnesses and conditions may not be diagnosed in time to avoid costly treatments.
"I absolutely think that any policy that would close clinics and close hospitals - particularly Oak Forest and Provident (that) serve people in the county that have less providers right now - that would be a mistake," she says.
Batts says closing the hospitals would flood other hospitals.
"(Hospital administrators) would not be thrilled by this whole idea. They would be swamped with patients who don't pay, and they see us as a safety net," Batts says.
But the idea is just a concept for now, he says.
"I think they just floated an idea. We'll just have to wait and see how the commissioners react. I would think that they would ask us first to come back with a plan before anything happened," Batts says.
"To me, it sounds like it's just saber-rattling," Sullivan says. "The flip side is if it did go through, you'd probably see an increase in deaths and adverse outcomes. It just shows how fragile the health care system is, and how important it is to fund it."
Daily News Staff Writer Alex Parker covers public health. He can be reached at 773.362.5002, ext. 17, or alex [at] chitowndailynews [dot] org.