What's going on in Springfield? JohnR at Wonkish alerts us to some strange business involving Speaker Madigan signing on as a chief co-sponsor of House Bill 311, which was introduced by Rep. Mary Flowers (D-Chicago) and would establish a single-payer health care system covering all Illinois residents:

Has he gone Mad? Has the “revolution begun”, as some single-payer fanatics are saying?

No. It seems to be typical Madigan - playing another game. We just aren’t sure which game he is playing this time. Is it:

1) Build the majority? Allow his members to vote for healthcare to help them in the fall elections.

2) Appease Rep. Mary Flowers? Is she going to jump to the Green party after endorsing their presidential candidate? Madiganneed [sic] to hold on to as many members as possible.

3) Provide cover for his members on healthcare? The House has worked for almost a year now to destroy Governor Blagojevich’s healthcare for all plans. Is this the Madigan’s way of allowing his members pretend they are for healthcare to avoid more heat?

4) Stick it to the Governor? Seems the most likely - after the Governor’s healthcare expansions ran into resistance in court yesterday.

The Tribune's David Mendell seems to agree about the fourth scenario, describing Madigan's co-sponsorship as an "apparent jab at Blagojevich." The timing would seem to support this theory. As JohnR points out, a Cook County judge yesterday issued a temporary injunction that could hold up the governor's plan to expand, without legislative approval, the state's FamilyCare program to 147,000 parents and caretakers.

Flowers' bill passed committee 8-4 yesterday and could see a full debate soon. Whatever the reason for Madigan's co-sponsorship, it's encouraging to see renewed discussion of a single-payer system. After all, health care in Illinois is in dire need of reform, as the group Physicians for a National Health Program suggests:

Our state's health system is in crisis. More than 1.8 million Illinoisans lack health insurance coverage, and the ranks of uninsured swell with each year. Skyrocketing costs have resulted in additional millions of under-insured: those with policies so skimpy that they afford neither access to care when needed nor protection from financial ruin in the event of illness. Indeed, of the 40,000 Illinoisans bankrupted by medical bills each year, three-quarters had insurance when they got sick.

As always, large-scale reform is intimately tied to revenue. Some progressive health care advocates have argued that states are fundamentally unequipped to manage their own universal health care systems because they can't deficit spend. Advocates of HB 311 suggest that the cash they can save in streamlining administrative costs (some estimates put the current figure at $13 billion) could cover all of Illinois' uninsured, requiring no increase in total health spending. Regardless of one's position on those specifics, progressives can all agree that it's important for the state to create new revenue streams that are fair and sustainable and pay for the population's fundamental needs.

Reforming the state's regressive flat income tax would be a good place to start.