Chicago Tribune Article Showcases David Ansell's Book & Observations About Cook County Hospital

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Cook County crucible shows perils of one health care system for the poor, one for the rich

Dr. David Ansell's chronicle of his early years at shuttered Cook County Hospital sheds light on horrors of two-tiered health care system that continue today

By Judith Graham

9:00 PM CDT, June 3, 2011

Twenty-five years ago, Dr. David Ansell helped expose an appalling practice in Chicago: Private hospitals were routinely transferring uninsured patients — many of them unstable and dangerously ill — to Cook County Hospital, the city's medical refuge of last resort.

The practice was dubbed "patient dumping," and it exploded in the early 1980s when Illinois and the federal government tightened health care spending, according to a study in the New England Journal of Medicine by Ansell and several colleagues. In addition to Chicago, public hospitals in Atlanta, Dallas, Washington, and Los Angeles reported similar experiences.

Outraged, Congress passed the Emergency Medical Treatment and Active Labor Act, which requires medical centers across the country to evaluate and stabilize all patients who come to their emergency departments, regardless of their insurance status. That 1986 law remains the only guarantee of health care for the general population currently in effect in the U.S.

It was a significant accomplishment, but it hasn't fundamentally changed the harsh reality of health care in Chicago. In his new book, "County: Life, Death and Politics at Chicago's Public Hospital," Ansell describes an "apartheid" system, "separate and unequal," both in the 1980s and now. Read the full article