In other areas, public hospitals have boards of advisers or directors who devote enormous time and effort to planning for the institutions' future.
Not in Cook County.
Here, public hospitals are run by the government, and that means they are bound by county regulations, hobbled by outmoded business practices and captive to county politics. Practically, it also has meant the County Board president runs the county health system with little effective oversight
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Many observers say the setup has left the $830 million county health system adrift, without a clear plan for dealing with existing or future challenges, as financial pressures mount and growing numbers of needy county residents seek expensive medical services.
The only other major city that runs its health system in a similar way is Los Angeles, and that system is teetering on the brink of collapse.