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Cook County Weighs Co-Pay for Jails, Clinics

Officials said, Cook County's cash-strapped health system is considering charging co-payments for patients treated at its community clinics, emergency departments and the jail, much as it does for prescriptions at its pharmacy.

The pharmacy co-pays have generated in excess of $100,000 since they were introduced, about two months ago, county health officials said during their budget presentation to the County Board's Finance Committee. Thomas Glaser, chief operating officer of the Bureau of Health Services said, "We have done a survey of other public hospitals throughout the United States and found that we were the only ones that really had no co-payments. The first was the pharmacy because we thought that was the easiest to implement."

Dr. Robert Simon, the health bureau's interim chief, said the health system needs to expand co-pays to further areas but officials have no timeline.

He said officials are concerned about a potential public relations reaction.

Simon said, "It's a tough one. If you guys stand in our shoes and in the board's shoes, the moment we do, say, $20 for a clinic visit, what will end up happening is you're going to get patients that will say, 'I can't afford it,' and then it will become a newspaper article."

"We'd never, not take care of a patient, but it's to be very careful how you start that," Simon said. "So, we have to start one, yes. But how we start it and when we start it, it'll be a very delicate program."

In August, the health system began charging $3 co-pays for every prescription filled, up to a highest of $10 for each visit.

After making dramatic cuts to the hospital and clinic system earlier this year, Cook County Board President Todd Stroger wants to put in hundreds of health bureau jobs as division of his proposed $3.2 billion county budget that would boost sales and other taxes.

The health system has long failed to accumulate payment for services, and Simon's team is scrambling to make the system more self-sufficient.

Glaser said past finance officials from the health bureau misled the County Board in 2006 regarding their ability to bring in tens of millions of dollars in patient fees.

Glaser, who previously served as the county's chief financial officer, said health officials in the past tightly controlled the information that released.

He said it can take up to three years to fix all the problems.



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