The newbie leaders of local government, Cook County Board President Toni Preckwinkle and Chicago Mayor Rahm Emanuel, decided early on that they could save taxpayers a few bucks with a novel idea: working together to cut spending. Lo and behold, we saw the first results of that effort last week and there’s real money to be saved.
Emanuel and Preckwinkle released a joint report that outlined how consolidating some city and county operations could save up to $140 million a year.
The report goes after some low-hanging fruit, such as jointly buying road salt and using one custodial department instead of two to clean the vast downtown headquarters building they share. Why weren’t these things done before now? Because government tends to be about turf protection.
Preckwinkle and Emanuel are impressing people with their early commitment to provide strong and efficient services.
Here is one test of that commitment: The authors of the report say the savings could stretch well beyond $140 million by consolidating city and county health care services.
Health care gobbles up nearly a third of the budget for the county. Yet Preckwinkle’s struggle to revamp Oak Forest Hospital — opposed by unions and so far stymied by state regulators — shows the challenge of asking hard questions about how well people are being served and at what cost.
The city and county both operate primary health care clinics. In a few cases, they run separate clinics on the same block. That’s just wasteful.
The city and county will immediately pursue one of the report’s suggestions: a pilot program to merge services in at least one neighborhood where both run clinics. That is a good start. In the long term, the report argues, Chicago and Cook County must explore greater consolidation of health care. We can expect Emanuel and Preckwinkle (and the independent board that runs county health care) to embrace that.
They will likely run into some resistance, from department heads who don’t want to relinquish turf, from union bosses who don’t want to lose jobs, from some health care advocates who see efficiency as a dirty word.
Done right, though, these mergers can improve access for patients. The city has more capacity for mammography screenings than the county does. The county offers an automated prescription system that the city doesn’t have. An integrated system could better track the incidence of disease. Working together, the two systems would have a better shot at winning federal grants.
Cut costs and improve service? If Emanuel and Preckwinkle can accomplish that together, they can establish a model of cooperation for the rest of the state.
