As the second in command of New York City’s public health and hospital system, Ramanathan "Ram" Raju helped initiate a plan to close a $1.2 billion budget deficit in four years. The New York experience should come in handy when Raju, 60, starts his next job, as CEO of the financially-troubled Cook County Health and Hospitals System, on Oct. 3. Public hospital systems throughout the country are struggling to keep pace with the rising demand for services from the uninsured and underinsured, and Cook County faces a stiffer challenge than most. According to the Civic Federation, a government research organization in Chicago, uninsured patients in the Cook County health system in 2008 incurred 54.6% of the system’s charges. This year, the Cook County health system faces a deficit of more than $90 million as a result of underestimating revenues.