Health Care

Statehouse Round-Up

Angela Caputo — Thu, 20 Nov 2008 16:35:07 -0800

Today saw no action in Springfield on the governor’s not-so-popular Emergency Budget Act. Two more days remain in the veto session, so we’ll have to wait and see what happens. Nonetheless, there were a few legislative developments worth noting:

Answering Prayers
Immigrant-rights advocates scored a long-fought victory today when the House and the Senate unanimously approved the Access to Religious Ministry Act, which grants undocumented detainees the right to religious counsel.

Lawrence Benito, associate director with the Illinois Coalition for Immigrant and Refugee Rights, was quick to praise the measure with a statement this afternoon: “[T]he passage of HB 4613 marks a huge victory against the politics of fear in our state, and a signal that our state stands for humane detention practices.”

Ailing Hospitals Get Relief
Some of the state’s most cash-strapped hospitals could be in for a little relief. Both chambers agreed to transfer $40 million from the Tobacco Settlement Recovery Fund to free up money for hospitals that are in “catastrophic” financial shape. The Illinois Department of Healthcare and Family Services will administer the one-time relief payments. The money should come just in the nick of time for hospitals who are struggling to cope due to the state’s $1 billion backlog on Medicaid reimbursements.

Plan For Taylorville Coal Gasification Plant Advances
For years, lawmakers have been trying to win support for a coal gasification plant in Taylorville. By signing off on SB197 today, the legislature agreed to back a pricey feasibility study on the power plant (estimated at $10-$18 million), which will eventually go before the General Assembly as they decide whether to move forward with the project. As we’ve noted before, many environmentalists are skeptical of these proposed “clean coal” plants because the carbon sequestration technology they rely on is largely unproven.

Share Your Views On Health Care In Illinois

Josh Kalven — Mon, 10 Nov 2008 15:24:47 -0800

As part of their "Video Storybanking Project," the Campaign For Better Health Care (CBHC) spent Election Day interviewing over 50 Illinois voters about "why health care reform was an important issue for them." The organization then compiled some of the answers into the following brief video:

Now, CBHC is seeking more stories from Illinoisans concerned about health care. They're asking invididuals to record their own thoughts on the issue, upload them to YouTube, and send the link to the following email address: sludwig (at) cbhconline (dot) org.

Cook County Health System Poised For A Comeback

Angela Caputo — Mon, 10 Nov 2008 12:59:55 -0800

The beleaguered Cook County hospital system appears poised to make a comeback.

After two-years worth of cuts to health clinics, women's and pediatric care, and dozens of other essential services, funding will be restored to these sectors at the start of 2009. By garnering the county commissioners' approval of their $930 million budget proposal, the new Health and Hospitals System Board of Directors proved that they can operate free of political influence.

No amendments were tagged onto the spending plan (despite an attempt by some suburban Republicans to expand a community health initiative). Had they done so, it would have presented a major setback for the hospital board members who've embraced the monumental task of fixing the failing system, said Patrick Keenan-Devlin, a health care lobbyist with Citizen Action. "It would have undermined their independence from the beginning," he said.

Under the proposal -- which includes a $77 million spending increase over the current year -- 400 new doctors and nurses will be hired. Current staffers are also set to receive cost-of-living raises.

With the ranks of the uninsured skyrocketing to now include 17 percent of the Cook County's population, immediate improvements in public health services are seen as critical to stabilizing the region's medical infrastructure.

Adding doctors and shortening lines at clinics and hospitals will attract people to the system and take some strain off local hospitals, Commissioner Larry Suffredin (D-13th) said. Improvements are also in store for the poorly-run prison health system, which we've highlighted before.

The new programs won't come without a cost though. Within months, the hospital board expects to announce roughly 900 jobs cuts, likely to include many custodians and grounds workers. Payroll reductions, coupled with a plan to chase millions in federal and insurance reimbursements, should do more than just get the faltering system back on track.

"By the end of next year I think we're going to be talking about surpluses," said Suffredin, a Democrat who represents the Far North Side of Chicago and some northern suburbs. "We'll be able to reinvest that money in additional health services."

It was Suffredin who helped broker the deal that wrestled the declining health care system away from the county's increasingly dysfunctional control last spring. In exchange for voting along with Board President Todd Stroger's controversial sales tax hike, Suffredin won support for an ordinance that transferred oversight of the health care system to an independent authority. In three years, the ordinance will sunset.

"We lost our way," Suffredin said. "The infrastructure for treating people was destroyed ... Now we have to rebuild it."

Rising Health Insurance Costs Weigh Illinois Down

Angela Caputo — Thu, 23 Oct 2008 14:54:39 -0700

New evidence out today confirms that Illinois consumers have been paying a heck of a lot more for health insurance while getting less in return.

Coverage and real wages have declined steadily since 2000, while health care premiums for Illinois families have risen by 73.1 percent, according to a report released by the Campaign for Better Health Care (CBHC). If the pattern continues -- and consumers and employers continue to take on a greater share of the insurance burden -- Jim Duffett, CBHC's executive director, says the state's already struggling economy will be crippled.

"The tipping point is here. Businesses say they can't compete anymore," he said. "We can't afford not to [rein in costs]. Healthcare is the key to our economic security."

Just how much more consumers and employers are paying? The "Premiums vs. Paychecks" report sums it up:

- For family health coverage in Illinois, the employer's portion of annual premiums in the 2000-2007 period rose from $5,581 to $9,587 --an increase of $4,006, or 71.8 percent. Worker's portion rose from $1,639 to $2,912 --an increase of $1,273, or 77.7 percent.

- For individual health coverage, the employer's portion of annual premiums rose from $2,432 to $3,630 an increase of $1,198, or 49.3 percent. Worker's portion rose from $548 to $874 --an increase of $325, or 59.4 percent.

To get a handle on the rising costs, CBHC is recommending that state lawmakers form a regulatory body under the Illinois Department of Insurance that would require insurance companies to make the case for raising premiums and co-pay rates. Otherwise, those decisions will continue to be driven by profit goals over coverage costs. Requiring insurance companies to take on patients with pre-existing conditions would also take some stress off of both workers and taxpayers who end up picking up the tab for emergency services.

The cost of not acting is too great, Duffett says. "If we don't fix this, more people are going to be eligible for Medicaid because they can't find jobs. That's going to expand the state's budget."

Comptroller Dan Hynes signaled just last month that the rising Medicaid costs have already put a tremendous strain on Illinois' finances. Just three months into the current fiscal year, the state was already dealing with a $1.8 billion backlog of unpaid bills.

If the program's costs aren't either funded adequately or curtailed, Hynes says the mounting bills will simply overwhelm the state.

Meanwhile, Illinois' uninsured population only continues to climb. Even after the addition of the AllKids program -- a safety net covering children and pregnant woment -- 1.7 million people in Illinois remain uninsured.

In Duffett's eyes, a single-payer health care system would be the optimal solution. In the short term, "It's going to take lawmakers in Springfield to step forward and shed their do-nothing approach."

To Refill Or Not To Refill?

Adam Doster — Wed, 22 Oct 2008 11:44:26 -0700

As the recession deepens, many Americans are facing impossible decisions over which everyday necessities are the least devastating to pass up. As belts tighten, many are choosing not to refill their medical prescriptions, the New York Times reported yesterday:

“People are having to choose between gas, meals and medication,” said Dr. James King, the chairman of the American Academy of Family Physicians, a national professional group. He also runs his own family practice in rural Selmer, Tenn.

At the end of the piece, the Times highlights one such case from Champaign. Lori Stewart, a 45-year-old self-described "insomniac textbook compositor, artist, and mother of [a] U.S. soldier" is deciding whether or not to discontinue her mother's Alzheimer’s medications, which she says only provide a marginal benefit. The reporter learned about Stewart's story from this heart-wrenching blog post she wrote earlier this month:

We discussed medication. There's nothing out there, really, that will help this. I asked him, then, about the medication she's on, Razadyne. It costs $182 a month for this one prescription. 1 pill a day, $6 a pill.

Have I mentioned that my Mom lives on Social Security? She has health insurance. She has Medicaid. And still this 1 prescription alone takes up roughly 1/5 of her annual income. (Oh, and she has 5 other prescriptions, but let's don't get me started.)

Razyadyne, then, Doc: Is it doing any good?

Probably not, he told me. The effects are most likely minimal, and not changing the quality of her life in any way. She scored 8 out of 30 on the test he gave her that day. He said she may score a 7, without the Razadyne. In essence, she may or may not be able to name the season, or the day of the week.

"It's up to you," he told me, about continuing onthe Razadyne. Each family feels differently. Personally, he said, "Skip the Razadyne and put the money towards good food or something she enjoys. Cable TV, books, movies."

This has been a torturous decision for me. Man, when you only have 8 points left in that little head of yours, it kind of seems like every one is kind of precious. If I take her off the meds, it may not affect her, but what would it be like, at this point, to have even slightly more deterioration?

Also important to note is that while Stewart's mother is in the latter stages of a degenerative disease, the majority of people who choose not to pay for their drugs likely suffer from preventive or controllable illnesses. If a critical mass of patients go off their meds and their conditions worsen, it could wreak havoc on the nation's health care system. "If enough people try to save money by forgoing drugs," the Times writes, "controllable conditions could escalate into major medical problems. That could eventually raise the nation’s total health care bill and lower the nation’s standard of living."

Cheney, Ozinga, And Health Care

Adam Doster — Thu, 16 Oct 2008 10:39:56 -0700

Using a notorious quote we grabbed from a cable access interview back in July, SouthtownStar columnist Kristen McQueary gets in a good dig at Marty Ozinga the day after Dick Cheney had to cancel a fundraiser with the Republican congressional candidate for health reasons:

Had Cheney's heart problems developed during the course of his Will County visit, rest assured he would have been in good hands. Ozinga could have recommended any number of area emergency rooms. After all, as Ozinga said, health care accessibility isn't a serious problem in this country: "You just go to the hospital, and you get taken care of."

Of course, Cheney is covered by the federal government, a point the California Nurses Association raised in a stinging ad campaign late last year:

The patient’s history and prognosis were grim: four heart attacks, quadruple bypass surgery, angioplasty, an implanted defibrillator and now an emergency procedure to treat an irregular heartbeat,” the ad states, referencing Cheney’s lengthy medical chart. “For millions of Americans, this might be a death sentence. For the vice president, it was just another medical treatment. And it cost him very little.”

CNA exectuive director Rose Ann DeMoro sums it all up: "Take that chart to Blue Cross, UnitedHealth, or Aetna and try to get coverage or even continued care."

Cook County Uninsured Population Reaches 17 Percent

Angela Caputo — Fri, 10 Oct 2008 15:28:06 -0700

For the countless Cook County residents who've spent long days in crowded health clinics and emergency rooms waiting to see a doctor, a new government study highlighting the magnitude of the local uninsured population probably doesn't come as much of a stunner.

A new U.S. Census Bureau study reports that 785,000 Cook County residents do not have health insurance. That's 17 percent of the overall population. Cook County Commissioner Larry Suffredin (D) actually suspects the figure, based off a 2005 census report, is low.

The latest number comes as the county's newly-formed Health and Hospitals System Board grapples over drafting a budget that can provide enough services to meet the demands of nearly one million patient visits expected next year. Within weeks they're anticipated to release an annual spending plan that's likely to top $800 million.

Slumping revenues coupled with rising demand wil no doubt make it nearly impossible to run the kind of programs that fully meet patients' needs, says Patrick Keenan-Devlin, a health care lobbyist with Citizen Action. "You don't have to be a budget expert to do the math."

Whether the board will be able to reverse the the 17 percent across-the-board cuts instituted during the '07 and '08 fiscal years -- which led to the closure of more than a dozen clinics -- remains to be seen.

According to Suffredin, the county has no choice but to bring back as many services as possible -- and quickly. "If Cook County fails, it will have a devastating effect on hospitals around us," he said. "They'll go bankrupt."

The county's struggle is hardly unique. We've noted before that the number of uninsured in Illinois continues to climb. DeKalb, Crass and Jackson counties all have uninsured rates that top 20 percent, according to the latest census report.

With the health care system "in crisis" and the cost of services constantly on the rise, Keenan-Devlin says, "I can't imagine that the new health board, with a magic wand, is going to be able to fix [the system]."

Image used under a Creative Commons license by Flickr user Comtesse DeSpair.

What A Deregulated Health Care Market Would Look Like

Adam Doster — Thu, 09 Oct 2008 08:21:35 -0700

Conservative health care reformers love to bash state regulations. In their estimation, differing regulations keep premiums artificially high in some states by restricting consumer choice. John McCain has railed against these regulations on the stump and in Tuesday's debate. Right-leaning economists claim that as many as 12 million people who are currently uninsured could end up purchasing medical coverage if interstate competition were allowed. The Illinois Policy Institute, a Springfield-based right-wing think tank, argues Illinois families could save a bundle:

With the ability to purchase insurance in Iowa, a downstate family of four could expect to save $200 per year while a Chicagoland family would save over $3,000 per year.

But as Sandy Praeger, the president of the National Association of Insurance Commissioners, told the Tribune's Judith Graham, lifting restrictions on the sale of insurance across state lines opens up an entirely new can of worms.

If the change was implemented, here’s what she predicts will happen: Insurers will set up shop in states with few regulations and market low-cost policies to people across the country. These policies will offer minimal coverage and appeal primarily to younger consumers.

“It will be a race to the bottom,” Praeger said, and there will be “very few consumer protections. … You’ll have plans that don’t cover the benefits that people need. … And healthy people are going to buy those less costly plans, because they don’t think they need [the protection].”

Want a good model? Look no further than credit card companies. In 1978, the U.S. Supreme Court ruled that banks could charge the maximum interest rate determined by state legislatures in the banks’ home states, not the interest rate of the states in which they do business. Credit card businesses quickly set up shop in Delaware and South Dakota -- two states with virtually no interest caps. The result? State usury laws were rendered worthless and consumers were left to fend off an array of confusing and punitive measures aimed at raking money from customers. Another good example is our current banking system. And we all know what happened there.

In a deregulated health insurance market, Praeger says its those who need insurance most that will be the most adversely effected:

That may be a good deal for young people who don’t have health problems, but it would probably become a bad deal for everyone else, Praeger said. The policies that sell comprehensive coverage would draw a sicker, older customer base, becoming more and more expensive.

The end result will be a segmenting of the insurance market into the “haves and have nots,” Praeger said. One segment of the market will become more affordable, but the other segment will become less so, disadvantaging those who need coverage most.

HCAN To Attack Ozinga On Health Care (UPDATED)

Adam Doster — Wed, 08 Oct 2008 14:49:51 -0700

Marty Ozinga really should have watched his words back in July. Opponents of the 11th District GOP congressional candidate have jumped all over a cable access interview we originally flagged in which the concrete magnate opined that "very few people nowadays that have no health service at all," because anyone can "go to the hospital and you get taken care of."

First, the DCCC issued an ad calling Ozinga "oblivious." Democratic rival Debbie Halvorson joined the chorus, dropping an ad painting her opponent as "out of touch." According to The Hill, the health care reform coalition Health Care for America Now (HCAN) is also getting in on the action.

Healthcare for America Now, a union-backed liberal health reform advocacy group, is making a $4.3 million ad buy in support of Barack Obama and other Democratic candidates.

Over the next two weeks, the organization will run ads on TV and radio attacking Republican presidential nominee Sen. John McCain (R-Ariz.) and seven GOP congressional candidates for their views on healthcare.

In addition, the group is airing ads against three candidates seeking to fill House seats being vacated by members not seeking reelection: Blaine Luetkemeyer, who is running to replace Rep. Kenny Hulshof (R-Mo.), Marty Ozinga, who is running to replace Rep. Jerry Weller (R-Ill.), and Erik Paulsen, who is running to replace Rep. Jim Ramstad (R-Minn.).

HCAN, who netted the endorsement of both Sens. Barack Obama and Joe Biden earlier this week, will spend $500,000 on direct mail and telephone campaigning as well, although it's unclear how much will be directed at the 11th District.

UPDATE (10:45 PM): Here's the ad. It turns out not to be centered around the July comment. Rather, it asserts that Ozinga "would let insurance companies make the rules -- they could even deny coverage for preexisting conditions like cancer":

McCain's Health Care Plan In Illinois

Adam Doster — Tue, 07 Oct 2008 14:46:16 -0700

Barack Obama describes John McCain's health care proposal as "radical." Tribune health care reporter Judith Graham and New York Times columnist Paul Krugman concur. McCain himself obviously disagrees. But according to a new study (PDF) by the Economic Policy Institute, the Arizona senator doesn't have much ground to stand on. EPI asserts that his plan will make it radically more difficult for Illinoisans to receive affordable medical care:

At the state level we find that the state of Illinois would see 848,281 people lose employer-sponsored health insurance under the McCain plan, and virtually all of these people would be forced to buy health insurance in the expensive and chaotic private insurance market. This means that 11.1% of people in Illinois who currently have employer-sponsored health insurance.

How does McCain's plan work? Currently, most Americans receive their insurance through their employer, largely because the tax code is written so that an employer’s contribution to insurance premiums is not taxed. McCain wants to change that by taxing those health insurance benefits. Non-partisan analysts estimate that up to 20 million Americans will be dropped from their current plans if employers have no tax incentive to provide medical benefits. According to EPI's state-by-state analysis, almost one million of those workers will come from Illinois.

McCain does provide a safety net for those dropped in the form of a refundable tax credit -- $2,500 for an individual, $5,000 for a family -- that can be used on the open market. He also argues that the cost of care is driven up by varying state regulations, a problem he hopes to ameliorate by creating a relaxed national regulatory structure.

There are a few problems here. One is that private insurance companies refuse to cover anyone with a pre-existing medical conditions -- you know, the ones who need insurance the most. The second problem is that the average employer benefit package costs $12,500 dollars, a considerable amount more than McCain's tax credit provides. Some conservatives argue that the additional $7,000 will be paid out in wage increases, an idea that's entirely possible but not something to depend on, especially considering companies could just pocket their newfound savings. Finally, while gutting state regulations could lower costs, it comes with a host of other concerns. "The McCain plan would do for health care what deregulation has done for banking," writes Krugman. "And I’m terrified"

Thankfully, we do have an alternative. Outside analysts contend that Barack Obama's plan is decidedly better at providing affordable care to more Americans. Yesterday, joining fellow Illinois lawmaker Jan Schakowsky and 70 others, the Illinois senator also signed the Health Care for America Now (HCAN) statement declaring "that he is on the side of quality, affordable health care for all and opposed to leaving Americans on their own with unregulated health insurance." From an HCAN press release:

"We applaud Senator Barack Obama for his courage and leadership in focusing on this issue," said William McNary, co-director of Citizen Action IL and USAction president. "Quality, affordable health care for all is a key human rights issue - transcending race, class, gender, and geography. At a time when people are losing their jobs and losing their homes, it's our moral obligation to provide health care security for these families. HCAN is fighting to provide security for our families and stability for businesses and workers and to ensure a new prosperity for all Americans."

For some opposing viewpoints on the HCAN campaign, check out the responses from Chicago-based single payer advocates Quentin Young and Nicholas Skala, who also penned a Progress Illinois column on how single payer health care could be instituted in Illinois.