Good start toward better health care

It was extremely encouraging last week to hear one of the members named to a board overseeing Cook County public health care telling commissioners directly that, in essence, what may be good enough for them is not good enough for her.

The comments came as a county board committee was confirming Sister Sheila Lyne and three other proposed new members to what is being called an independent panel established to reinvigorate the debt- and patronage-ridden Cook County Bureau of Health.

As commissioners noted with pride that Medicaid rejections had been reduced to 14 percent from more than 80 percent, Lyne, the CEO of Mercy Hospital and Medical Center on Chicago's South Side, was quick to point out that 14 percent wasn't an acceptable end goal. The better target, she asserted, should be 3 percent.

It will be interesting to see whether the new independent board can actually make that kind of difference. It has only a three-year life span built in, after all. But it was nice to hear someone talking about specific high standards that ought to be set for measuring the health board's success. For an agency that hasn't been known for high standards -- indeed quite the opposite --this is the kind of tone that must be established and maintained.

But this project is about much more than tone. That the independent oversight is set to expire just before the next county board elections is not a comforting realization, and, as some critics have pointed out previously, important structural changes need to be made in the makeup, selection and accountability of health board leadership or, at best, any improvements the independent oversight manages to produce will be threatened by a return to the present bureaucratic, politics-driven unacceptable conditions.

As the new overseers were getting the committee's confirmation, Commissioner John Daley allowed that some of his colleagues don't want them to succeed. Some, he said, want the entire system eliminated.

We dearly hope he is wrong on that point. The county public health system is set up to assist some of the most vulnerable and economically disadvantaged citizens in the county. They need this resource.

Which is precisely why the independent oversight board must get whatever support it needs to succeed and why its success begins with establishing not just minimal but rigorous standards. The addition of members to the board -- which officially can begin its work assuming approval by the full board this week -- is an important start to the process.

But it is just a start. There is much work to be done to repair the financial, cultural and political shambles into which the county's health system has been permitted to decay. Comments like Lyne's suggest that it could be a good start, and we look forward to watching as commissioners of all political allegiances focus attention on making it a good finish as well.