The paint on the trim outside Jackson Park Hospital, located at the corner of Stony Island and 75th Street, is peeling, and its brick exterior badly needs tuck-pointing. The front lobby is a little dingy, certainly in need of renovation. But the shabby building is the least of the problems this 75-year-old south-side hospital has.

The neighborhoods closest to Jackson Park Hospital–Chatham, South Shore–are flourishing middle- and working-class communities. But there are pockets of poverty nearby, and many patients come from the poorer communities to the south and west. Like so many other inner-city hospitals, Jackson Park can’t find money to pay for indigent patients.

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“For many of our patients the first visit to the hospital is when they deliver the baby,” says JoAnn Matory, the doctor who directs Jackson Park’s newborn nursery. “We ask them why they didn’t show up earlier, and they say, ‘I did it this way last time, and everything went all right. So why go now?’ I tell them, ‘Well, you were lucky this time. But in the future, you wouldn’t want something bad to happen that could be prevented.’ Reaching pregnant teenagers is one of our biggest concerns.”

The larger problem is that the hospital can’t afford to get services to people that need them. “We’d like to reach more drug cases, particularly the young mothers,” says Friedell. “It’s difficult. One nature of a chemical dependency is denial of the problem. Unless you have a program to detect every single mother, you don’t know.”

“Paying taxes, on the one hand, I can see all the problems. On the other hand, our health problems don’t go away. They only show up later when the kids go to school. Drug-dependent children, for instance, have neurological problems. These are the kids who will have learning disabilities. Isn’t it better that we reach them as soon as we can? I don’t know what else there is to say. The demand for health care far outstrips reimbursement. There are no easy solutions.”