Toni Preckwinkle and the Chicago Austerity Machine

First in a series.

By Daniel Lichtenstein-Boris, Research Director of Service Employees International Union Local 73 from 2012-2017

For many Chicagoans, Toni Preckwinkle is considered the progressive, or even leftwing choice for Mayor.  Labor unions such as the Service Employees International Union and the Chicago Teachers Union have endorsed her, as has the Democratic Socialist Alderman Carlos Rosa.   But as organizers, activists, and everyday voters decide whom to campaign for and support to be the next Mayor of Chicago, it would be wise to look closely at her record.

As head of the Cook County Board of Supervisors, Toni Preckwinkle has been no real friend of labor or of the left.  Instead, she has dutifully implemented the policy prescriptions of the Civic Federation and Commercial Club of Chicago; the same corporate entities who backed the Mayor’s school closure agenda.

She ran for office on a ‘good government’ platform, to make the County more ‘efficient’ and to roll back the County sales tax, increased by incumbent Todd Stroger with union support after massive community and worker demonstrations protesting public health cuts, which included Stroger’s closure of half of the County’s public health clinics in 2007.

Once in office, she did what she campaigned to do.  Her first budget included repealing the sales tax increase, the revenue loss offset by over a thousand layoffs, and the closure of Oak Forest Hospital, which provided care to predominantly poor black and Latino patients in the County’s south suburbs.  Visiting Oak Forest Hospital as the county turned it into an outpatient health center in the summer of 2013, transportation workers testified that many of the hospital’s long-term care patients died after transfer.  Those with Medicaid were transferred to NuCare and other long-term care facilities that did not have the same level of specialized intensive services.  Undocumented severely disabled patients were deported.  The Oak Forest Outpatient Regional Health Center never provided the level of care  that the former hospital did, and starved of resources, budget cuts continued until the facility was finally closed in 2018.  

Toni Preckwinkle also brought in the Commercial Club of Chicago’s Civic Consulting Alliance (CCA) to implement “good government” reforms.  Already working with the Emanuel administration, these consultants worked to streamline joint city-county purchasing, and in 2012, attempted to privatize custodial services in the County courthouses, an effort that was halted after protests from unionized custodians and their union, SEIU Local 73.  That same year, through the same pro-bono consulting agency, Republican presidential candidate Mitt Romney’s former conglomerate, Bain and Company worked with the Chicago Public Schools on labor negotiations that eventually resulted in the 2012 Chicago Teachers Union strike.  

Though stymied in the County’s facilities management department, and busy working with the Emanuel administration to implement mass school closings, the Commercial Club’s pro-bono consultants worked with Cook County, along with others, including former and current Health Management Associates personnel, to direct federal Obamacare funds to non-union non-profit clinics and hospitals rather than a public system still reeling from years of annual cuts.  

While Toni Preckwinkle takes credit for the expansion of health access under the Affordable Care Act, the County dramatically reduced general fund subsidies of the health system for much of her tenure, boasting in an August 2018 budget proposal that the County had decreased funding by more than 75% since 2009.  Rather than reopen clinics closed by her predecessor Todd Stroger, Cook County directed the influx of federal Affordable Care Act funds to a network of non-union private non-profit health clinics; many of the same ones that took over City of Chicago public health clinics that Rahm closed in 2012.

While the County used federal funds to launch a health plan and support a broad network of private providers, Chicago’s mental health safety net was being shredded.  With Medicaid managed care reforms, a state government that increasingly delayed reimbursements to service providers in a budget balancing gimmick, and local government focused on directing Obamacare funds to private sector friends instead uncompensated care, mental health clinics closed like falling dominos.  The County was slow to step in to help, even as it expanded Medicaid enrollment and funded physical health and primary care services. 

In 2012, the same year that the northside Counseling Center of Lakeview, southside nonprofit Community Health Council Inc, and six City of Chicago public mental health clinics closed their doors, the County health system planned the early launch of Medicaid expansion, carving out mental health separately in what seemed as an afterthought.  The County first contracted with a third-party administrator, Psych Health, which developed its own secretive and inaccessible Medicaid behavioral health network, according to patient advocates.  Finally, in 2015, after therapists protested the eminent closure of the north side’s Community Counseling Centers of Chicago, the County saved that mental health clinic network.  But again, rather than incorporating staff as part of the public healthcare system and paying them a union wage with a pension and public sector benefits, they created a network of privately-run clinics, funded and controlled by the County’s health plan.

After Dr. Ram Raju left as CEO of Cook County Health and Hospital System to run the public hospital system in New York, Toni Preckwinkle supported the hiring of Dr. John Jay Shannon, a former County doctor who had been the Chief Medical Officer of the Parkland public hospital system in Dallas, a non-union facility in a right to work state, where nurses attempting to organize complained of being fired and blacklisted from future employment in the region.  Under Shannon, as CountyCare directed federal funds to private entities that rather than the struggling public hospital, Cook County Health and Hospitals System decided to weaken labor unions also by hiring temp workers rather than public employees.  Side by side union workers, temps worked in food services, custodial operations, radiology, laboratory, and outpatient clinics.  Almost the entire oncology department was outsourced.  In addition, dozens of correctional mental health specialists, many who worked at the jail for decades, were forced to enroll in graduate programs to keep their jobs. As healthcare changed, the County refused to support dedicated employees in gaining the necessary job training to remain employed.  A proposed labor management partnership supported by AFSCME and SEIU fell through. Preckwinkle insulated herself from these and other anti-union moves by blaming a revolving door of labor relations personnel, who rotated through the county at a rapid clip, conveniently taking the fall time and time again.

Toni Preckwinkle’s conservative fiscal policies and budgetary practices have reduced the size of County government, something that the Mayoral candidate has boasted repeatedly in her tenure.  In 2009, there were 24,454 full time budgeted positions, which reached its lowest point of 22,579 in 2013, and has now stabilized at 23,233 according to the County’s 2018 Comprehensive Annual Financial Report.  Most of the initial cuts were in the heath system, which reduced staff from over 7,500 in 2009 to just over 6,600 in 2011.  As a common practice, many of these budgeted items were never filled.  In the third quarter of 2017, there were 1,633 unfilled positions, 368 of which were in the County health system.  In the middle of the decade, as Rahm Emanuel was running for his second term, there were over 1,000 vacancies in the health system.

Along with these layoffs and refusal to fill vacancies from retirements and turnover, Preckwinkle’s fiscal policies has reflected her conservative ethos.  After repealing the sales tax increase, she passed a tobacco tax, a bullet tax, which ultimately was pulled in the face of opposition, a hotel occupancy tax, reinstated the sales tax increase to stabilize the County’s pension system, and passed her widely known ill-fated sugary beverage tax, which was later repealed.  What the county did not do was increase property taxes by the rate of inflation, or pass a tax on businesses something that would have had less of a disparate impact on the urban poor than one-time fee increases and consumer taxes.

Outrage over the County’s regressive property tax structure led to the defeat of Democratic Party leader and County Assessor Joe Barrios in the March 2018 Democratic primary, whom Toni Preckwinkle supported up to the end.  The collateral impact of the outrage over the regressive tax system and often cozy relations between elected officials and wealthy property owners is being felt to this day.  Indicted Alderman Ed Burke, as well as Illinois Democratic Party leader Michael Madigan, have been widely known for their property tax assessment appeal side businesses.  Burke notoriously helped Donald Trump avoid taxes on his giant loop skyscraper with its big giant gold signage that bears his name facing the Chicago river.

Some give Preckwinkle the benefit of the doubt.  But folks should know who they are dealing with.  True, she is no Rahm or Daley.  She criticized Rahm’s 2013 mass school closings, embraced Obamacare, reduced the jail population, and developed a justice advisory council to give micro-grants to community groups to engage in recidivism reduction and restorative justice.  She once said Ronald Reagan deserved “a special place in hell” for his role in the war on drugs.

In the crowded 2019 Mayor’s race, besides Preckwinkle, the main frontrunners include Mayor Rahm Emanuel’s former City Clerk Susana Mendoza, and Bill Daley, who if elected would be the first Mayor whose brother and father were both Mayors as well.  Other candidates include other former Emanuel or Daley allies, or have flirted with Donald Trump, including businessman Willie Wilson, and former police chief Gerry McCarthy.

Then there is thirty five year old Mayoral candidate Amara Eniya.  Despite endorsements by hip-hop stars Kanye West and Chance the Rapper, Eniya trails other Mayoral contenders, placing 7th in recent polls.  Over the last decade she has joined protests against Rahm’s school and clinic closures, the police murder and cover-up of foster teen Laquan McDonald, and briefly ran for Mayor in 2015. Many say she has no chance, and only Preckwinkle has a viable chance of beating the old Chicago machine. But in today’s political climate, anything is possible.  Alexandria Ocasio-Cortez, at age 28, rose in the last year from waitress, to Congresswoman, and an internet sensation with two million twitter followers and fierce dance moves.

The Mayor’s race is just heating up, and a lot can happen in fifty-two days.  As Chicago native Fred Hampton used to say, “Dare to struggle, dare to win.”


  1. Finally using your head Dan! You’ve escaped the cult of SEIU. Good for you! Great article!

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