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Today’s must-read: “The Human Toll”

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* Rep. Greg Harris sent out a “Springfield Update” yesterday which is an absolute must-read for everyone who visits my website…

Yesterday, I watched the faces and listened to the voices of my House colleagues from both sides of the aisle in a closed-door briefing as the implication of each of the Governor’s proposed cuts in Medicaid was explained. If 180,000 seniors lose prescription drug assistance, what were their options? If we eliminate combination therapy for 4,500 people with HIV/AIDS, what would the impact be?

If admissions to supportive living facilities or community care for seniors or people with disabilities was halted, wouldn’t that just drive costs up in nursing homes, hospitals or other more expensive treatment/living options? If the state stops paying for preventive care, aren’t we just shifting costs to ER visits, acute care and hospitals and increased costs for private insurance? And on down the list of pages and pages of charts and fine print.

Outside of that closed room, we were besieged by earnest board members from Catholic Charities, worried about budget cuts in the Homeless Prevention programs that would mean turning away nearly 16,000 families in distress.

Leaders of the Safer Foundation passed out fact sheets showing in the next 12 months how many of the adult population in Illinois prisons will be returning to the community. Their statistics show that the recidivism rate is around 50% for those that get no transition assistance, but only 31% for those that get substance abuse, job-placement and other reentry services at Adult Transition Centers. The proposed budget eliminates most of those.

Then came the hospice nurses with their fact sheets about the impact of the proposed cuts to the hospice program. They compared the costs of home hospice care to hospital stays for people at the end of life: $150-$650 per day to die at home versus $1,948 per day to die in the hospital.

When I got back to my office there were piles of reports. The Families USA report showed that the proposed Medicaid changes would cost Illinois 25,615 jobs. CeaseFire reduced shootings and killings 16% and 28%. The Illinois Chamber of Commerce had a Medicaid proposal and the Illinois Hospital Association had another. The Center for Tax and Budget Accountability research brief indicated that over the last several years the cuts to human service providers had eliminated over 18,000 jobs and $2.14 billion in private economic activity. The minutes of the COGFA hearings on state facilities closures told of job loss and economic harm in communities across Illinois where the facilities are major employers, and the fears of families of those in the facilities for what a closure might mean to a loved one.

The numbers say that we must pay our bills and live within our means. The numbers say that we have to pay debts; we have to cut over $1 billion from last year’s expenses, plus cut another $2.7 billion from Medicaid and further reform our pension systems. That’s what the numbers say. You can read the reports, and see the studies and say what must be done must be done. And at the end of the day we will pass a budget that may make some of these cuts, or may close some tax loopholes, or may “transform”, “modernize” or “right-size” government or “give everyone a haircut” or whatever the consultants and commentators cheerfully call it.

But for those of us who will cast a vote for it, and for those of you who have to deal with the consequences to your family, your town or your business, there are no good choices. We will pick winners and losers and there will be a human toll.

* Rep. Harris also included a list of recent studies…

· Governor’s Medicaid Proposal

· Governor’s Pension Reform Proposal

· Illinois Chamber of Commerce Medicaid Proposal

· Illinois Hospital Association Medicaid Proposal

· Families USA Medicaid Study

· Center for Tax and Budget Accountability Study on Human Service Cuts

· Illinois Policy Institute Medicaid Proposal

· Testimony and Studies on Facility Closures

posted by Rich Miller
Friday, Apr 27, 12 @ 10:48 am


  1. –If 180,000 seniors lose prescription drug assistance, what were their options?–

    I’m a little confused. If seniors are dual eligibles, shouldn’t they already be in Medicare Part D prescription drug assistance?

    Comment by wordslinger Friday, Apr 27, 12 @ 11:04 am

  2. Excellent!!

    Comment by Wensicia Friday, Apr 27, 12 @ 11:05 am

  3. Yes. Decisions have consequences, and they go beyond the numbers alone. But the budget decisions also reflect the setting of priorities. I have personally witnessed the continued waste of Illinois taxpayers’ dollars on useless politically-motivated contracts, the waste of incessant patronage, and other financial abuse of the public trust. Apparently, these abuses are given a higher priority than the true safety-net programs and the perhaps unnecessary largess established to pander for votes. In considering the human impacts of budget decisions, we should also keep these other factors in mind and insist that they be corrected.

    Comment by JustaJoe Friday, Apr 27, 12 @ 11:12 am

  4. Some time around to 2005, I questioned former Rep. Fritchey on the 13% increase in school enrollment and the 153% increase in school funding. His reply?

    “Yeah, but that all went to pensions.”

    As all the “human tolls” are collected in the upcoming budget cuts, there is only one place to put almost all the blame.

    It falls on the legislators who voted for every mandate, every payroll expansion, and every pension benefit increase in the last 10-20 years.

    The facts speak for themselves. Unwilling to say no to the powerful spending, borrowing, and taxing interests, these folks (in both parties) voted future generations of Illinoisans into pension poverty and tax increase hell.

    You are all now left with a choice. Fund the pension payroll, perks monster you created, or fund government services.

    If the taxpayers are asked to do more, which is not an entirely unreasonable request under dire circumstances, the very least you can do is put a stiff, enforceable, and robust constitutional amendment on the ballot.

    That amendment should place hard spending caps on all governmental entities, with virtually NO exceptions, and such a cap should be raised only upon a referendum, preferably requiring a super-majority of some sort.

    Taxpayers should realize such a cap is worth the cost, and government employees and elected officials should realize taxpayers deserve nothing less after their decades long ride on the debt and pension gravy train.

    Comment by Bruno Behrend Friday, Apr 27, 12 @ 11:19 am

  5. What a really sad reality.

    Comment by kerfuffle Friday, Apr 27, 12 @ 11:23 am

  6. ===”We come to it at last, the great battle of our time,” Gandalf said in the movie. ===

    Someone tell Pippin that the quiet is going away.

    Comment by Been There Friday, Apr 27, 12 @ 11:30 am

  7. –There is not enough money for every program the bleeding hearts want funded. For example, those with AIDs hould have been more careful and accept the responsibility for their prior actions.–

    Clearly, money spent on your public education was a waste.

    Comment by wordslinger Friday, Apr 27, 12 @ 11:34 am

  8. Rich, please remove StarLighter’s ignorance..

    Comment by Apple Friday, Apr 27, 12 @ 11:35 am

  9. But the most important part is that Illinois won’t need a service tax. Therefore, members of the Civic Federation,Chamber of Commerce,and Tribune Editorial Board don’t have to pay tax on their yacht servicing, spa treatments, and wealth management services. Just think of what the human toll would be of that!

    Comment by Honestly Friday, Apr 27, 12 @ 11:37 am

  10. Rep. G. Harris belabors the obvious. And his lament about having no good choices to vote for cast legislators in the same light as their victims, thus ignoring chronic legislative irresponsibility and ineptness. This screed is only a “must read” if you enjoy such maudlin pap.

    Comment by Anonymous Friday, Apr 27, 12 @ 11:38 am

  11. Anon 11:38,

    Mega dittos!

    Comment by Bruno Behrend Friday, Apr 27, 12 @ 11:45 am

  12. ===I would be a start.===

    Self-deporting? You’ll be missed Dan, but thanks for taking personal responsibility.

    Comment by 47th Ward Friday, Apr 27, 12 @ 11:47 am

  13. The cuts in hospice care are absolutely counterproductive. And StarLighter — you should be deeply ashamed of yourself. That is a hateful, hateful thing to say.
    I can only assume that you would deny diabetes care to anyone who is overweight, and coronary care to anyone who is sedentary. Or do you limit your call for “personal responsibility” to specific groups of people?

    Comment by soccermom Friday, Apr 27, 12 @ 11:50 am

  14. Rep. Harris is a caring, empathetic and intelligent individual, which we need more of in the statehouse. This is definitely a must-read for anyone who thinks cutting here and cutting there is an easy thing. There are people behind these numbers.

    Comment by T Friday, Apr 27, 12 @ 11:55 am

  15. The human cost is very real but austerity leads to fiscal costs as well.

    The layoffs described in this piece will shrink the Illinois economy reducing future revenues and forcing future cuts.

    Ending hospice will increase Medicaid expenditures rather than reducing them.

    Increased repeat criminal offenders will grow the prison budget.

    Austerity does not beget prosperity no matter how loudly folks shout: “Hayek!”

    Comment by Bill White Friday, Apr 27, 12 @ 12:05 pm

  16. The choices are incredibly dire but I hope our leadership in Illinois remembers this is also an opportunity to hit the re-set button, remembering to never let a “good” crisis go to waste. I think perhaps Governor Quinn is embracing that mentality at this point. Maybe a service tax, a graduated income tax amendment on the revenue side, maybe pension reform and medicaid on the spending side. Maybe all of it. We can dream, can’t we?

    My thoughts and prayers - seriously - to our leadership and all those of you elected people who I believe will rise to the occasion. I dont know why really, I just think you’ve got it in you as a collective to do it this time. I dont know that you have a choice this time…

    Comment by Peter Snarker Friday, Apr 27, 12 @ 12:06 pm

  17. We will need to chart a tough, tough course because our self serving representatives have taken the easy way out for so long.

    Those that suffer most will be those most in need and least able to lobby for themselves.

    JustaJo, Bruno, Anon 11:38 are spot on.

    Comment by Sunshine Friday, Apr 27, 12 @ 12:16 pm

  18. Rich, you deleted my response to 47th because?? I know the drill it’s you website, but really?

    Comment by Dan Shields, Springfield, IL Friday, Apr 27, 12 @ 12:20 pm

  19. –How big of a dent would be put in the budget mess if welfare fraud and illegal’s were eliminated from the waste?–

    You tell us. You seem to have drawn conclusions without any information.

    Plus, get over yourself that you’re in the “minority that pays taxes.” Every individual pays taxes one way or another.

    Comment by wordslinger Friday, Apr 27, 12 @ 12:20 pm

  20. If we “those with AIDs hould have been more careful and accept the responsibility for their prior actions”, let’s be fair about it. If you ever smoked a cigarette, drank a beer, ate a hamburger or drove over 55 mph, no health care for you, right?

    Comment by ChicagoR Friday, Apr 27, 12 @ 12:21 pm

  21. This is the cost of a legislature that fails to govern. A legislature that adds to government programs and kicks the can down the road on how to pay for them.

    When you skip over tough decision after tough decision, they get increasingly tougher.

    If you don’t like the position we find ourselves in, then don’t do it again. Harris has been part of the voting body that us here. He did it to himself - and the people who may suffer.

    Comment by Old Milwaukee Friday, Apr 27, 12 @ 12:23 pm

  22. Hey, StarLighter, congratulations. I haven’t banned anyone for life in a very long time. Goodbye.

    Comment by Rich Miller Friday, Apr 27, 12 @ 12:23 pm

  23. Wow a bit more ‘it sucks to be you’ than I expected on this.

    Yep, these cuts are going to have real impacts,impacts that people are not going to like one bit.

    Just like cutting how much the state pays school distrcits to cover transportation is going to have impacts, by having more families pay for bus transportation, by having kids take longer walks to school.

    You raised my income taxes, fine, in the bigger scheme of things I understood the need to do this. You want to raise taxes on cigarettes I don’t smoke so knock yourselves out.

    But it is also time for the state to start saying no and that is going to be hard.

    But you know what is kind of easy, pointing out how these or any cuts to speak of are going to hard.

    For too long, it has been far easier to kick the can down the road than it should have been and the state has been too eager to do so, we are reaching the end of the street and as much as we may not like it, we need to deal with that can.

    Comment by OneMan Friday, Apr 27, 12 @ 12:31 pm

  24. I am conservative and I am Republican, and so any of the respondants know that up front. Before you dump, know that most Republicans I know are truly sensitive to the needs of most of these folks effected by the discussion here. However, because we feel the need for a controlled and cost effective use of our/your tax dollars, we are branded as insensitive. Makes us easy targets. The truth be told, even hospitals perform triage.
    I beleive in the need for us to be our brother’s (sister)keeper. But in order to help some, we may not be able to help all. Yes, the pension system is a mess. It is not the fault of the pension receivers. It was problems on both sides of the aisle. too many pols taking the easy way out and going along to get along. But now it is what it is. I worry for so many friends who trusted the system and the pols. The best way to regain trust is to do the right thing in the best way possible. Taxing more doesn’t work. We just spend more. If this gets me banned, I guess it was nice knowing you and reading all of your notes. You are an extraordinary bunch. However, we all need to face the facts that somethings are going to be cut by choice or bounced check.

    Comment by LisleMike Friday, Apr 27, 12 @ 12:55 pm

  25. Really, services only reduces the recidivism rate by 19%? That is much lower than I would have expected. It would be interested to calculate the rate of return on moneys spent in total vs. those who aren’t in prison because of the money spent.

    I think we are going to have to break things down to items that hurt but cause inconvenience (like ending school transportation) and items that hurt but cause death like ending AIDS care or prescription drug benefits. Even with the latter, we need to make sure there is no federal care that could substitute (yes, I know robbing Peter to pay Paul, but Paul can’t just print more money).

    Comment by cermak_rd Friday, Apr 27, 12 @ 1:10 pm

  26. Interesting that this article doesn’t place blame with anyone for these sudden and certainly devastating cuts. Probably because if anyone is to blame, it’s the legislature for having the system become so unsustainable under their watch.

    Comment by Blame Friday, Apr 27, 12 @ 1:14 pm

  27. ===Really, services only reduces the recidivism rate by 19%?===

    No, it’s 19 percentage points. That represents a 38 percent decrease.

    Comment by Rich Miller Friday, Apr 27, 12 @ 1:16 pm

  28. Legalize marijuana farming as industrial/agricultural concern. Down-state ag property values sky-rocket (school pension dunding!), our red-state neighbors cant follow our lead (immoral!), tax all facets of production and eliminate crime.

    Comment by Peter Snarker Friday, Apr 27, 12 @ 1:29 pm

  29. We have to remember that the state budget is an hydraulic system — apply downward pressure in one spot, and you get an unexpected surge somewhere else. This doesn’t mean that you can’t make cuts — it just means that the cuts never have the full impact you expect.

    Comment by soccermom Friday, Apr 27, 12 @ 1:37 pm

  30. Peter, farmland is assessed based on its productivity, not its fair market value.

    Comment by Sir Reel Friday, Apr 27, 12 @ 1:42 pm

  31. Cuts to any social program will hurt. I believe times are coming where these types of cuts/unfairness are dwarfed by a new normal where services will not be widely available. Sounds gloomy but look at our federal deficit as well as the state. What would happen if you ran your house like that?

    Comment by Dawn G. Friday, Apr 27, 12 @ 1:45 pm

  32. We have a half century(+) of GA financial misbehavior. And we are trying to “fix” the system at a time when we are worse than broke. It will be difficult and hard choices have to be made - by the GA members who’ve kicked the can down the road for generations.

    Comment by titan Friday, Apr 27, 12 @ 1:57 pm

  33. Sir Reel - ah. Darn. I just knew there was some reason it couldnt happen. Haha

    Comment by Peter Snarker Friday, Apr 27, 12 @ 2:01 pm

  34. Rep. Harris has been doing a wonderful job of explaining the impacts of the cuts. I don’t see this as “maudlin pap” - he explains it in human terms and then backs it up with quite a bit of research, in a transparent way for all to see.

    Comment by Robert Friday, Apr 27, 12 @ 2:10 pm

  35. Rep. Harris recognizes the human toll from the unprecedented slashing of Medicaid. People will die.

    I’m not sure most of his colleagues recognize it, esp. not the ones who insist even more be cut so as not to raise the cigarette tax.

    If the choice is cutting poor people off from medical coverage, or reducing tax breaks for millionaires, I know what side the GOP is on. Every tax deduction is sacrosanct, even for those who don’t need it — such as those enjoying six-figure pensions tax-free — while Medicaid for the least of this is dispensable.

    Comment by reformer Friday, Apr 27, 12 @ 2:16 pm

  36. Rich,
    OK, 38% is much more reasonable. It still seems low though. I mean, some guys are going to come out (ironically murderers have a low recidivism rate) and not re-offend regardless of whether they receive services or not. Others are addicted to various substances, but I would think getting treatment for such would reduce their changes of offending.

    Comment by cermak_rd Friday, Apr 27, 12 @ 2:37 pm

  37. Lets build a water pipeline from Lake Michigan to the dry west, sell water, land develops out there, jobs on the oipeline, and new lakefront oroperty here with kower lake levels! Outside the box people… Growth, not cuts or taxes!

    Comment by Peter Snarker Friday, Apr 27, 12 @ 2:48 pm

  38. This screed is only a “must read” if you enjoy such maudlin pap.

    First I’m going to get a thesaurus to figure out what that sentence means and then I’m going to smack this guy upside the head with it. Harris isn’t the problem here. He is, in fact, the only one telling the whole truth of the matter. Sorry you would rather mock his good faith effort to frame the situation in human terms. The system is cracking. Real people are going to be hurt. Go be above the “maudlin” somewhere else, troll.

    Comment by no doubt Friday, Apr 27, 12 @ 2:54 pm

  39. Not to play to an advertiser, but it seems to me a bit silly that we are leaving casino revenues that are going to Indiana on the table (no pun intended) at this point.

    Comment by OneMan Friday, Apr 27, 12 @ 2:54 pm

  40. “maudlin pap”

    And conservatives wonder why people laugh in their face when they try to add the word “compassionate” before “conservative”.

    I don’t see newspapers rushing to say they’re willing to give up their paper subsidies nor businesses rushing to say they’re willing to give up their transportation, commerce, export and other subsidies and support.

    Cutting all that to the bone, nay, the marrow, would have a human toll too.

    But it wouldn’t be a direct impact on those who can least afford it.

    Seems to me like Someone around 2000 years said something about caring for the least among us…

    Yet those who claim to follow His teachings these days call it “maudlin pap”.

    Comment by G. Willickers Friday, Apr 27, 12 @ 2:57 pm

  41. - cermak_rd - Friday, Apr 27, 12 @ 1:10 pm:
    “items that hurt but cause inconvenience (like ending school transportation) and items that hurt but cause death”

    Ya know, I never have understood why we cut funding to elderly/handicapped/social services/healthcare etc. when public schools (k-colligate) seem to be the one “industry” in which the state has the chance of substantially addressing the budget issues. It would seem less people in public schools is a good thing as long as they’re educated somewhere else. But how do you encourage people that can to afford alternatives to leave the public system and move into private schools/colleges without every sports booster in the state throwing a tizzy fit?

    Comment by Bobby Hill Friday, Apr 27, 12 @ 3:09 pm

  42. Blaming legislators is sort of like a drug addict blaming his/her seller; markets give us what we consume, including political ones.

    A few months ago, I attended a candidate forum for State Senate. Responses to the question about repealing the state income tax increase ranged from a simple yes to something much stronger. But the question about cuts came back with drivel like eliminating the legislative scholarship program. Why? Because voters dislike tax increases and painful cuts by about the same margin (see Paul Simon poll from 2008).

    Politicians pander (with delusional rhetoric) and avoid tough choices because it works in getting them elected/reelected. I’m hoping that this will change in the face of the current crisis but I’m not holding my breath.

    Comment by Think Big Friday, Apr 27, 12 @ 3:17 pm

  43. ==Not to play to an advertiser, but it seems to me a bit silly that we are leaving casino revenues that are going to Indiana on the table (no pun intended) at this point.==
    Agree. In light of Rep. Harris’ explanations of human services cuts, it’d be nice if there could be a casino/cigarette compromise from Gov. Quinn to the legislature - “I won’t veto casino expansion if you can pass the cigarette tax hike”

    Comment by Robert Friday, Apr 27, 12 @ 3:17 pm

  44. We need to be adults and be willing to pay higher taxes if we want to maintain or add services. Otherwise, we cannot complain about cuts. Simply eliminating “fraud and waste” will not reach the numbers needed.

    Comment by Anonymous Friday, Apr 27, 12 @ 4:03 pm

  45. “Outside of that closed room, we were besieged by earnest board members from Catholic Charities, worried about budget cuts in the Homeless Prevention programs that would mean turning away nearly 16,000 families in distress.”

    Of course, the Catholic Church hierarchy puts its priority on killing Obamacare to keep its employees from getting contraceptives. Its good to know the laity have their hearts in the right place.

    Comment by wishbone Friday, Apr 27, 12 @ 4:11 pm

  46. The cigarette tax is not inherently problematic to me. But it will have two impacts that will lead to less revenue than projected (some people will quit or reduce cigarette consumption and some people will buy their cigarettes in Indiana, Wisconsin, Iowa, Missouri and Kentucky.

    Comment by titan Friday, Apr 27, 12 @ 4:11 pm

  47. “CeaseFire reduced shootings and killings 16% and 28%.” I don’t know about other statistics stated, but that one cannot be a pure fact.

    Comment by amalia Friday, Apr 27, 12 @ 4:36 pm

  48. Titan,

    The folks with the green eyeshades usually take such drop-off rates into account when calculating projected revenues from new “sin taxes” like cig or liquor taxes.

    I don’t know for certain that they did that in this particular case, but they usually do.

    Comment by G. Willickers Friday, Apr 27, 12 @ 4:39 pm

  49. What is to Be Done?

    Comment by Lenin Friday, Apr 27, 12 @ 4:41 pm

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