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Enough with the games already

Friday, Apr 4, 2008 - Posted by Kevin Fanning

* There has been a lot of drama the past few days over the Senate democrats’ plan to sweep $530 million from special state funds. Part of this plan includes an expansion of health care programs.

In the Senate Executive Committee on Wednesday, where these amendments were introduced, I witnessed President Jones and Minority Leader Watson square off on a Crain’s article regarding the closing of St. Francis Hospital.

Watson contended that the main problem with St. Francis was the large number of Medicaid patients it had to accept, and that bringing the threshold of eligibility in the state up to $80,000 for a family of four would further exacerbate the problem.

Jones, whose district includes the hospital, countered that the main problem was really the losses the hospital sustains from having to treat patients with no health insurance at all.

Personally, I think the problem stems from a combination of the two. The democrats argued yesterday on the Senate floor that the state needs to step up to the plate and do something about health care since there is no leadership from the federal government.

True, but then there is this caveat to think about:

The company said a quarter of patients admitted to St. Francis either don’t have health insurance or are covered by Medicaid, and that it gets about 10 cents in Medicaid reimbursement from Illinois for each dollar it spends supplying medical care. Dixie Platt, a senior vice president with SSM, said Illinois’ reimbursement rates are the lowest of the four states that SSM operates in, and that the state’s reimbursement level hasn’t gone up since 1993.

Platt also said that the company hadn’t received a “significant” Medicaid payment from the state since October.

So if absurdly late Medicaid payments from the state to hospitals is further adding to the burden, then what difference would expanding Medicaid benefits really have if hospitals that accept them continue to close?

Additionally, this state is flat-out broke. Can we afford an expansion?

* The sad reality tough is that the entire debate doesn’t even matter. The whole trilogy of sweeps amendments passed by the Senate aren’t going anywhere. They’re D.O.A to the House as Rich has already lamented.

I wonder how much longer the constituents of this state are going to put up with the smoke and mirrors. What we currently have in our government is a three-ring-circus that is unresponsive to the dire and urgent needs of this state.

Whether it’s health care, a capital plan, education, or a myriad of other issues the theory holds that nothing is getting accomplished, and won’t.

It’s absolutely irresponsible to continue this charade. This bill is being passed to aggravate Speaker Madigan, and the recall bill in the House is being passed to scare Governor Blagojevich, knowing full well that it is in turn D.O.A. in the Senate. Enough.

Here is an idea? Stop passing legislation that won’t ever effect public policy, and start talking to each other. It would be refreshing for the citizens of Illinois, and might even get us all out of here before November.

       

56 Comments
  1. - GoBearsss - Friday, Apr 4, 08 @ 9:36 am:

    “Stop passing legislation that won’t ever effect public policy”

    Then what would legislators do all day?


  2. - GoBearsss - Friday, Apr 4, 08 @ 9:40 am:

    Here’s the thing you skip out on in your logic - the fund transfers are primarily designed to help get rid of that deficit everyone is talking about.

    I don’t have much confidence that Speaker Mad-again will suddenly grow a heart and embrace the health care plans. But he should at least pass a fund transfer bill.

    Everyone knows this deficit is real, and ALL payments will eventually halt if there is no money in the checking account.


  3. - GoBearsss - Friday, Apr 4, 08 @ 9:41 am:

    “Stop passing legislation that won’t ever effect public policy”

    Then what would legislators do all day?


  4. - GoBearsss - Friday, Apr 4, 08 @ 9:42 am:

    Here’s the thing you skip out on in your logic - the fund transfers are primarily designed to help get rid of that deficit everyone is talking about.

    I don’t have much confidence that Speaker Mad-again will suddenly grow a heart and embrace the health care plans. But he should at least pass a fund transfer bill.

    Everyone knows this deficit is real, and ALL payments will eventually halt if there is no money in the checking account.


  5. - can't imagine - Friday, Apr 4, 08 @ 9:48 am:

    here is a better idea…why doesn’t the whole group of them go home, ocntinue to do nothing and let us reelect people who care about Illinois and not themselves!! For this group term limits should be until 4-4-08 or sooner!!!


  6. - BIG R.PH. - Friday, Apr 4, 08 @ 9:52 am:

    Amen Brother Kevin!

    It’s nice that someone with a big platform is able to speak for the entire citizenry of Illinois.


  7. - steve schnorf - Friday, Apr 4, 08 @ 9:52 am:

    To say that Medicaid reimbursements haven’t gone up since 1993 is at best disingenuous. And, if they are only getting 10 cents on the dollar in Medicaid costs, their costs are way out of line.


  8. - My Opinion N - Friday, Apr 4, 08 @ 9:58 am:

    Geez Kevin, you just got here and now you want to leave by November? Wow what is Rich doing to you? (Kidding of course) Great commentary!


  9. - Kevin Fanning - Friday, Apr 4, 08 @ 10:01 am:

    Go Bearssss-

    Give me a break. The whole sweeps thing is a PR to make Madigan look like what you just called him “Mad -Again.” Cmon.


  10. - Sir Reel - Friday, Apr 4, 08 @ 10:07 am:

    Kevin, it’s smoke AND mirrors, but otherwise a good summary. If the Gov and leaders were grown-ups, they would find a realistic way to at least partly achieve all their goals and also address the low Medicaid reimbursement rates and late payments. Not necessarily solve everything at once, but move forward. Alas, they place a higher priority on getting shots in at each other.


  11. - GoBearsss - Friday, Apr 4, 08 @ 10:10 am:

    Kevin - there’s a 750 million deficit.

    You either find new revenue to cover that (which nobody is willing to do). Or you take the “surplus” money from these funds. Or you cut the budget.

    There really is no alternative.

    I don’t know what you don’t understand.


  12. - Sir Reel - Friday, Apr 4, 08 @ 10:10 am:

    Go Bearsss, I have a problem with fund sweeps in same same breath as new fees, as proposed for DNR. Looks like the plan is to raise fees, then sweep special funds generated by those fees. In my book that’s worse than raising taxes. It’s stealing from those who pay the fees and pay taxes too.


  13. - Princeville - Friday, Apr 4, 08 @ 10:11 am:

    GoBearsss, get real. Speaker Madigan is not anti healthcare programs and pointing a finger at him as the evil one that is heartless is totally misleading, as I’m sure you already really know. What is wrong here is the manner Blago is trying to go about getting his expansion. And while we’re all told how broke this state is we see a governor trying to give persons who make between 63,612 and 84,804 a year $0 cost for ER visits. Typical family of four on premium level 3 can certainly afford more than ROd’s plans call for.

    Gee, I guess than according to Blago state worker healthcare and co-pays during the contract negoiations, will be offering the workers a huge savings in their current fees up front. Good, looking forward to it. Next time I trip by the ER I’ll leave my now expected co-pay at home. I’m not against healthcare assistance, but Blago’s expansion and guidelines are unrealistic.


  14. - GoBearsss - Friday, Apr 4, 08 @ 10:14 am:

    I understand what you are saying, Sir Reel.


  15. - GoBearsss - Friday, Apr 4, 08 @ 10:18 am:

    Number one lesson all elected officials need to learn -

    If you aren’t for the revenue, you can’t claim you are for the spending.

    It is not often that you can just magically pretend that more revenue will be coming in (like the House Dems did last fall when they created this budget).


  16. - Reddbyrd - Friday, Apr 4, 08 @ 10:26 am:

    Young Kevin —– chill. Way too much fury for so “early” in the session.
    IL folks love smoke and mirrors and Santa Claus.

    Remember they elected Gov Delusionvich (with a little help from the Ryans and AccordinanGal)

    Quick Fact Check shows Madigan has supported nearly every health care expansion suggested especially when the proposals had a common sense foundation.

    Since the state is not paying for the health care the law currently requires it defies common sense to think the programs should be expanded.


  17. - OneMan - Friday, Apr 4, 08 @ 10:26 am:

    The problem I have with the fund sweep is these funds were set up for a reason, be it fire prevention, pet friendly or metabolic screening and fees are charged to interested parties to cover these programs.

    If we want to treat everything as general revenue, fine. But then lets do that and stop calling these funds in the first place.

    Lets stop giving people the impression that when they get the pet friendly plate the money is going to go to spay and neuter programs when it can end up becoming part of general revenue.

    If you want to expand health care fine, then be adults and talk about real ways to pay for it instead of stupid accounting tricks and tri-annual fund sweeps. If the people of Illinois want this and their leaders want to provide it they should then ask people to pay for it via taxes.

    If we keep fund sweeping and retirement accounting tweaking things we are truly toast.


  18. - Princeville - Friday, Apr 4, 08 @ 10:29 am:

    GoBearsss, I seem to remember the Senate and the governor signing off on this budget, come to think of it, Blago even adjusted it, so where’s it the House’s fault with all the shortage.


  19. - wordslinger - Friday, Apr 4, 08 @ 10:32 am:

    It’s absurd to talk about expanding anything right now. As Charlie Wheeler’s column, pointed out, the state has been enjoying pretty good “natural” revenue growth, and we’re still late on bills, putting off maintenance, cutting higher ed, etc. There’s a structural problem that needs to be fixed before anything new can come online.


  20. - Budget Watcher - Friday, Apr 4, 08 @ 10:32 am:

    GoBearss,

    Yes, the budget was knowingly crafted with overstated revenue assumptions, but to blame only the House Dems, when an OT budget required a 3/5 majority vote of both chambers, is a rather biased assessment of blame.

    It appears that the Speaker and others, including Seante and House Republicans knew the 08 budget would create a fiscal dilemma for the Governor…how to expand programs when he couldn’t afford the ones he already has. There’s no way Madigan is going to help him out of this year’s budget hole. The Governor is going to have to cut, and cut big, before he gets any cooperation from the House


  21. - Todd - Friday, Apr 4, 08 @ 10:32 am:

    GB –

    you just don’t get it. this isn’t the state’s money. lots of groups have gone tot he captiol to propose ideas and a funding stream to go with it. Then the state says hey we can hold back this money, create an artificial surplus by short changing the program, and then sweep the money.

    this isn’t GRF money thats being talked about. and when fees are raised to cover regulatory costs that don’t exist its another tax on a group of people to pay for the gov’s pet projects.

    you want to raid the road fund and capitol construction accounts, then repeal all the gas taxes and lower the vehicle registration fees.

    We ain’t the piggy bank for the rest of the state.

    And it was only after I testified, even with emil’s cat calls from the back of the seating that they were forced to remove the road Fund fromt he sweeps in a floor amendment.

    Todd


  22. - GoBearsss - Friday, Apr 4, 08 @ 10:35 am:

    The House sat down with their revenue estimates, then drew up their spending plan.

    When their spending plan exceeded their revenue estimates, they took that good ol’ eraser to their revenue estimates and adjusted them upward.

    I think the Gov’s office has said that the $500 million they cut out of the budget for healthcare wasn’t spent because of the revenue shortage.

    Don’t you find it convenient to rail against any revenue proposal that comes your way and then just create make-believe revenue instead?


  23. - GoBearsss - Friday, Apr 4, 08 @ 10:39 am:

    Nobody wants to do the fund transfers.

    Don’t you think it is a matter of priorities?

    Either make a cut somewhere, or use this surplus money that has been sitting unused for years?

    So, if you want to rail against fund transfers here, please tell me what you would cut to make up the gap instead. Or tell me your new revenue idea that could generate $750 million in the next 3 months.


  24. - Kevin Fanning - Friday, Apr 4, 08 @ 10:42 am:

    It’s not even that the fund transfers are that bad of an idea. Maybe it’s one of the better options, but it’s the manner in which it came to fruition. No one tried to work it out with House leaders, that’s the real problem, and knowing full well that it’s going nowhere. It’s just a PR game.


  25. - Been There - Friday, Apr 4, 08 @ 10:42 am:

    Kevin, It’s only April 4th. They don’t need to talk this early, nor do we want them lying to each other this early. Wait until mid May. Then they can meet and if the stars align themselves, we can get out of here by the end of May. But more than likely sometime in June. No matter what has happened in the past, Madigan & Jones have their eyes on the November elections and they don’t want to be here too late.


  26. - GoBearsss - Friday, Apr 4, 08 @ 10:45 am:

    Sorry Kevin, maybe Emil should send the Speaker some flowers as an apology for hurting his feelings.


  27. - Kevin Fanning - Friday, Apr 4, 08 @ 10:46 am:

    lol, that may be a nice gesture.


  28. - Princeville - Friday, Apr 4, 08 @ 10:49 am:

    No, bad idea on the flowers. Madigan will just have to send them back and then we’ll have another story about somebody being offended.


  29. - montrose - Friday, Apr 4, 08 @ 10:57 am:

    “He sent me daisies. He knows I hate daisies.”


  30. - Todd - Friday, Apr 4, 08 @ 11:00 am:

    GB–

    first quit spending money and creating new programs we can not afford.

    No new spending and take the budget back tot he levels it was when Blago took office.

    that more than makes up for the shortfall.

    you can not create new programs, when the money is not there. You can not increase spending when the money is not there.

    since gas has gonve over $2.50 a gallon, we saw a 176Million windfall in the state sales tax on gas. what did they do? spent it. this year with gas going over $3 you can expect about 18cents a gallon just in sales tax. a natural growth in revenue and what will they do? Increase spending to match.

    many more could support a tax increase if it was used responsibly. First a capitol plan. next paydown the pension debt. 3. no new programs for 5 years. no new expansions for 5 years.

    4. pay our bills on time, eliminate medicaid backlog. 5 increase ednucation funding. 30% of $$ to increas foundation levels, 30% for lowest/worst districts. 20% higher ed. and 20% for a educational reserve for other issues thayt pop up.

    then you just might convince some people the need for a tax increase. but when you increase spending just becuse you want new programs at a time when the economy tanks, it ain’t gonna happen. not to mention no one believes the state will live within it’s means.

    Todd


  31. - Louis G. Atsaves - Friday, Apr 4, 08 @ 11:04 am:

    So the state is now $750 million behind in last year’s budget as projected income has not materialized. This after spending nearly a half year of overtime sessions by the legislature. Left out of the picture was the announced $1.7 billion in bills the state has not paid, including to hospitals. They announced that figure several months ago so now it is probably over $2 billion.

    Now they want to increase spending and sweep funds to try to close the financial gap? By sweeping funds they interrupt state services those funds were designed to pay for.

    How about living within your means and paying your bills?

    Democrats have completely controlled state government for the past 6 years and they are still blaming everyone else but themselves for the state’s financial problems.

    Its time they grew up and acted like adults.


  32. - Learning the Ropes - Friday, Apr 4, 08 @ 11:18 am:

    In all MY “infinite wisdom” and 3 months “experience” of watching this comedy/tragedy of a performance that is our state government, here’s my idea:

    Madigan should turn around and amend/rewrite a Senate Bill to reflect a better, more controlled fund sweep with the sole purpose of plugging the hole. Then he might be able to kill the Trifecta that BlagoJones is trying to jam down his throat, issuing a press release that the Dems choose to give up their personal projects for the sake of this budgetary crisis and that everyone has to make sacrifices until that and the capitol bill is taken care of, House Dems and Governors included.

    I’m sure some more finesse can be worked in there, but I’m new at this and its just an idea.


  33. - Truthful James - Friday, Apr 4, 08 @ 11:26 am:

    Smewhere, someone has got to have the list of allegedly ’surplus funds’ they are going to sweep into this program.

    How did they get to be surplus? Is this on a cash basis or were some of the funds informally reserved for expenditures later in the fiscal year? Given lower revnue expectations across the board, will replacement revenues in these funds come to pass?

    This appears to have been a feel good “I’m for health care” thing as well as getting the Governor off the bad front pages and on the good ones.

    The key about the St. Francis Hospital closing is that they couldn’t give it away — even with $75 Million in new improvements on hand. Granted, SSM is a not for profit corporation running other hospitals, but this is a huge hit.

    And what does this say about the State’s Medicaid reimbursement, whioh has been choked down afor years, not unlike pension fund contributions.

    The State used to count on inflation induced revenue increases. It isn’t happening.

    Frankly, not unlike St. Francis, I don’t think they could give the State of Illinois away. It has been looted.


  34. - Ghost - Friday, Apr 4, 08 @ 11:29 am:

    “Here is an idea? Stop passing legislation that won’t ever effect public policy, and start talking to each other.”

    They did talk to each other during the last budget deal. Jone promised madigan they would override any veto in exchnage for support on certain spending items. The Gov then vetoed out money for members of the house and Madigans supporters, leaving in money for Jones and the Senate, cut every Consitutional officer who spoke out against him. When it came to the Senate Jones refused to honour his word or the deal he had made with madigan.

    What is the point of talking with each other? this is a child like niativette to the current political situation :) Talk to jones, but he wont do what he says. Talk to the Gov, but he wont talk, do what the Gov say or be subject to his wrathe (which came out during the Rezko case for those who refused his shakedowns).

    Talk is no longer a viable solution with Jones or the Gov. So what else would work?


  35. - Reddbyrd - Friday, Apr 4, 08 @ 11:33 am:

    The biggest reason the fund sweeps are dopier now than before is that many groups who pay the fees that go into the funds are ready to follow the bankers’ lead and sue….IL pays lawyers millions (good for Slick Willie Quinlan’s pals) ….IL loses and deficit does not resolved.
    How about we tell Gov Delusionvich & Team Delusionvich to stay in Wrigleyville and charter the planes.
    Keep the flowers, it would violate the gift ban :)


  36. - Kevin Fanning - Friday, Apr 4, 08 @ 11:34 am:

    ===What is the point of talking with each other?===

    I don’t know, maybe solving problems that plague the state?


  37. - anon - Friday, Apr 4, 08 @ 11:58 am:

    GB

    “Either make a cut somewhere, or use this surplus money that has been sitting unused for years?”

    This is just more of the govs spin. A lot of the funds are flow thru funds. Money comes in throughout a quarter and is disbursed the next month. THERE IS NOT SURPLUS MONEY THAT HAS BEEN SITTING UNUSED FOR YEARS IN ALOT OF THE SWEPT FUNDS.

    Our agency was ready to allocate out of one of the funds(info had already been sent to the comptrollers office to issue checks), we had stop the comptroller from issuing the checks the day they should have been mailed because the gov and Legis wiped out the fund balance.

    The checks were over two months late going out!!!


  38. - Levois - Friday, Apr 4, 08 @ 12:17 pm:

    Since when does anyone expect common sense to prevail at the state house. lol


  39. - Kevin Fanning - Friday, Apr 4, 08 @ 12:18 pm:

    lol


  40. - ivoted4judy - Friday, Apr 4, 08 @ 12:23 pm:

    The problem is: there are 117 mushrooms in the House, and 58 in the Senate. They should all walk out of the building on 5-31 and not come back.


  41. - Bill - Friday, Apr 4, 08 @ 12:48 pm:

    If Mad-again obstructs this band-aid to the House Dem budget which was passed and Av’d last year the draconian cuts that will be necessary to balance it this fiscal year will decimate our state. Since three-fourths of FY 08 revenue has already been spent any % cuts will be magnified by a factor of four. If the governor had not cut over four hundred million or if Emil had allowed an override vote to be called and passed the problem would be even worse. Good foresight on their part. This crisis is mostly Mad-again’s fault. It is now up to him to fix it.


  42. - Princeville - Friday, Apr 4, 08 @ 12:49 pm:

    oh, judy,judy,judy, that would not work. Gov would just declare special sessions and blame ‘the evil one’ for them all not showing up whether Senate or House, he might even file more lawsuits.


  43. - Budget Watcher - Friday, Apr 4, 08 @ 12:52 pm:

    My guess is that the administration needs these fund sweeps in the near term to finance the hospital assessment program totaling $1.2 billion. In essense, the state has to trigger the spending using its own money and then gets compensated by federal matching funds and hospital tax payments. Past practice has been to short term borrow, but a bond issue of this size could prompt the bond rating agencies to downgrade the state’s borrowing status. So short term financing is probably an unattractive option right now. Fund sweeps would be preferable for the Governor’s Office.


  44. - Captain America - Friday, Apr 4, 08 @ 1:06 pm:

    Medicaid payments are pathetically low and unconscionably slow. Any hospital with a high percentage of Medicaid patients and uninsured patients - these two situations correlate closely- inevitably finds itself in a financial vice that jeopardizes its financial viability and threatens its long-term survival. Typically these hospitals are in the inner city or in an inner ring suburb where there is a lot of poverty or a large number of low income residents.

    Since the State of Illinois is chronically short of money, and there is little political will among the populace to pay increased taxes, I’m not sure there is a practical solution to Low Medicaid payments to hospitals and other health providers.

    Schnorf would know for sure, but I think Medicaid expenditures might typically be the biggest line item in most State budgets. If not the highest line item,Meidcaid would be among the top three line items in most state budgets.


  45. - It's 5 O'clock somewhere - Friday, Apr 4, 08 @ 1:16 pm:

    Kevin, if they did not act kids on a playground, what would you have to write about?


  46. - steve schnorf - Friday, Apr 4, 08 @ 1:40 pm:

    Captain, it might frequently be the largest, and would certainly be among the top three.


  47. - Truthful James - Friday, Apr 4, 08 @ 2:01 pm:

    Regarding Illinois NFP hospitals, today the WSJ has an article on them in general, indicating the NFPs are more profitable than the For Profit hospitals. It mentions Northwestern in particular

    “…At some nonprofits, the good times are reflected in new facilities and rich executive pay. Flush with cash, Northwestern Memorial Hospital in Chicago has rebuilt its entire campus since 1999 at a cost of more than $1 billion. In October, it opened a new women’s hospital that features marble in the lobby, birthing rooms with flat-screen televisions, 1,000 works of art and a roof topped with 10,000 square feet of gardens. In 2006, Northwestern Memorial’s former chief executive officer, Gary Mecklenburg, received a $16.4 million payout.

    WSJ’s John Carreyrou provides a tour of Chicago’s non-profit Northwestern Memorial Hospital, which underwent a renovation costing more than $1 billion.
    But Northwestern Memorial has been frugal in its spending on charity care, the free treatment for poor patients that nonprofit hospitals are expected to provide in return for the federal and state tax breaks they receive. In 2006, Northwestern Memorial spent $20.8 million on charity care — less than 2% of its revenues and a fraction of what it received in tax breaks. By comparison, the hospitals run by Cook County, where Northwestern Memorial is located, spent 14% of revenues on charity care.

    Northwestern Memorial says that in addition to charity care, it provides other benefits to its community, such as pioneering research in obstetrics and other areas that improve standards of care nationally…”

    The tax exemption according to the WSJ saves Northwestern a total of $50 Million ($37.5M in property taxes and $12.5M in Sales taxes.

    The measurement of community benefit is done by the IRS with a very flexible ruler. Yet St. Francis could not hack it.


  48. - MOON - Friday, Apr 4, 08 @ 2:03 pm:

    BILL

    Given the dire straights the State is in, why didn’t Blago veto all the legislatures perks…….senate and house…..not just a selective group?


  49. - This does speak for me......... - Friday, Apr 4, 08 @ 2:05 pm:

    Thank you for speaking the truth and saying it like it is - I too am sick of the games, and disgusted with Illinois politics. Now, I am out of here to get working on electing leaders - I know there must be a few somewhere. When are you running for office Kevin? (I am not kidding here.)


  50. - Sir Reel - Friday, Apr 4, 08 @ 2:18 pm:

    There are balances in special funds because (a) not all the revenue generated was appropriated, (b) not all the funds appropriated were released, (c) expenditure of released funds was delayed or denied, etc. So, the Administration can create a “surplus” of special funds, which then are a convenient target to raid. Here’s a novel idea, let agencies spend special funds on the funds’ statutory purpose, with no strings, no delays, no endless approvals. If after a reasonable period of time, there’s a balance in a special fund, then (1) reduce the fee, or (2) transfer the surplus into GR. This surplus is a manufactured “problem.”


  51. - Truthful James - Friday, Apr 4, 08 @ 2:57 pm:

    The Cash Accounting attitude is inappropriate. The State, like other well run entities, needs to keep its books on an accrual basis which includes recognition of payables and receivables at all points in time.

    Some have called that discipline “accrual and unusual punishment” but it takes politics of the table.


  52. - Bill - Friday, Apr 4, 08 @ 3:48 pm:

    MOOn,
    I can’t say for sure but it could have been that the Senate Dems,House Repubs, and JCAR members all had much needed,legitimate,worthwhile initiatives and House Dems and Senate Repubs all had useless pork.


  53. - Rich Miller - Friday, Apr 4, 08 @ 3:51 pm:

    lol.


  54. - steve schnorf - Friday, Apr 4, 08 @ 4:33 pm:

    James, articles that cherry pick a few wealthy “mega-hospitals” such as Northwestern to examine the state of NFP hospitals are misleading. Northwestern is a world class hospital, which Chicago and Illinois should be glad to have, and its revenues and endowment and capital campaigns reflect its world class status.

    Most NFP hospitals in Illinois stay pretty close to the bubble, trying to stay in the black each year if they can and accumulate some cash surplus to handle needed capital improvements.

    The measure of “charity care” that Northwestern (and other NFP hospitals) provides does not include uncompensated care/bad debt, and the subsidies they provide out of their own revenues to Medicare, and especially Medicaid, patients care costs.


  55. - VanillaMan - Friday, Apr 4, 08 @ 4:56 pm:

    I know a lot of us have been observing state government for years, but we are only so old to have witnessed it. My point is - this is Illinois, and we’ve had a lovely run of great state government between 1818 and 1999.

    Over the past eight years, and some would say, twenty, we’ve witnessed Illinois history we’d rather not have witnessed. Our economy isn’t what it used to be. Our political leaders aren’t what they used to be. Especially our governors. We’ve had far more great governors than ghastly ones.

    In my opinion, Illinois has hit a really tough spot. We don’t have experience within this state in dealing with our slow economic decline in this global economy. If you look at Illinois during the Great Depression, you will find two fantastic gubernatorial administrators protecting us from the kind of governmental failures common in other states. The Illinois economy and economic standing has kept us safe even during world-wide downturns and world wars.

    Now we have a state government led by people who couldn’t measure up to our leaders from the past. And we have a state economy that isn’t measuring up either. This is a one-two punch that has been long in coming.

    We’ve been fat and happy for a long time. It shouldn’t be a surprise that the old way of politics and the old way of doing business no longer work. It is time to change - but for a success story like Illinois - change to what? I know that success can kill an organization by lulling it into complacency and allowing the next generations to be spoiled into uselessness.

    This, my friends, seems to be a big part of our current problem.

    We are a great state. We can get around the current problems. We need new people within our governments, and we will find them - eventually. We just can’t sit around much longer and finger point. We just can’t sit around and complain how the guy next to us got a bigger piece of that shrinking economic pie. We just can’t sit around anymore, can we?

    Pass the bills. Cut the budgets. Cinch the belt. Enforce the law. Fire the boobs. Then we will once again see Illinois bounce back because we are the crossroads of North America, and we haven’t moved from that spot.


  56. - Emily Booth - Friday, Apr 4, 08 @ 7:32 pm:

    Before they split IDPA, Medicaid was 75% of our budget. That was in the Edgar administration. I had a doctor tell me 20 yrs ago that when he had a Medicare/Medicaid patient, he didn’t bill IDPA because it wasn’t worth it. HFS expanded the AllKids program last fall; I have yet to see a family of 4 with $80K apply. Families at this level of income have resources.


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