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Budget horror stories

Monday, Nov 23, 2009

* Cook County Board President Todd Stroger has said he wants to stem the flow of out-of-county patients to Stroger Hospital. As of last year, they were still streaming in

In 2008, 26,000 patients came from the Collar Counties; 25,000 were from downstate counties; 1,800 came from Indiana; and 5,200 were from other areas.

The cost to the county is about $50 million a year. One story…

Aurora housewife Bushra Ayaz has colon cancer. She’s now being treated at Stroger Hospital, because, when she sought treatment at hospitals in DuPage and Kane counties, they declined because she has no health insurance.

“The doctors over there, they were saying, ‘Oh, you cannot afford the chemo. … It’s very expensive, and we will not give you here,’ Ayaz said.

Her sister, Nuzhat Fahim, explains the runaround they received at other hospitals.

“I just felt like a rolling stone,” she said. “When we were in a hospital, they sent (us) to another one. And they sent (us) to another one. They said, ‘No, you go to Cook County Hospital.’”

* The Sun-Times takes a look at Gov. Pat Quinn’s pledge to “fumigate” Illinois government of top Blagojevich hires. The paper’s first problem was getting Quinn’s office to comment

[Quinn’s] spokesman would not directly answer questions about how many Blagojevich administration workers have been let go as a result of Quinn’s fumigation pledge.

And the numbers appear disheartening…

Today, despite a failed effort by House Speaker Michael Madigan to force Quinn “to accelerate the pace” of the housecleaning, dozens of high-ranking, top-paid hires from the Blagojevich era are managing to hold onto their state jobs.

At least 70 have done so despite coming under scrutiny in a federal investigation of what U.S. Attorney Patrick Fitzgerald termed in 2006 were “very serious allegations of endemic hiring fraud” under Blagojevich, who is awaiting trial on federal charges that he used his job as governor to improperly benefit himself and those close to him.

* Paratransit riders are facing an RTA fare increase, and they want Gov. Quinn to step in

A dozen paratransit protesters pressured Gov. Quinn Friday to give them the same fare freeze he gave other CTA riders this month.

“Since Gov. Quinn was able to freeze fares for people who ride fixed routes, that same courtesy should have been afforded to the riders for paratransit,” said Debbie Pittman of Chicago, spokeswoman for the Concerned Citizens of Paratransit. “We understand there might be a budget that needs to be met,” she added, “but it shouldn’t be on the backs of the riders.” […]

[Pittman] said they got “a big runaround” with the governor’s representatives when they finally met with them at the Thompson Center in downtown Chicago Friday in a meeting barred to the media. “So, we are going to keep fighting,”
[Pittman] added.

* Chuck Goudie takes a look at the top users of the state’s turboprop fleet since Rod Blagojevich left office

Attorney General, 326
Senate Operations, 257
House Operations, 251
Transportation, 222
Public aid, 188
Public health, 177
Revenue, 166
Secretary of State, 147
Human services, 122
DCFS, 109

* And in other budget news, the Pantagraph once again publishes an editorial demanding that the Legislature “do something” about the budget without ever saying what it would like to see done…

We asked state Rep. Dan Brady, R-Bloomington, and state Sens. Bill Brady, R-Bloomington, and Dan Rutherford, R-Chenoa, what they personally are doing to resolve the state’s budget problems.

Rep. Brady, who is running for re-election, said he has been meeting with various groups and individuals, such as current and retired ISU employees, and conveying information to the governor’s staff.

Sen. Brady, who is among seven Republican candidates for governor, said there needs to be a 10 percent cut in spending. He said one of the problems in formulating a solution is the difficulty getting information from state agencies.

Sen. Rutherford, who is running unopposed for the Republican nomination for treasurer, said he is repeating his call for reforming the state’s pension system and Medicaid system before considering an income tax hike. He also said he speaks about state issues every other day with Senate Minority Leader Christine Radogno.

It’s good to hear our lawmakers are “involved,” but the General Assembly never should have gone home in September (not to mention July) without directly addressing the state’s budget problems.

That’s “involved”? Hookay.

* Related…

* Inside one questionable clout hire

* Election Remains Big Obstacle to Budget Fix

* Quinn creates Human Services Commission

* Quinn signs bill to get more federal money for health care

* New law nets more federal money

* Controversy leads to reforms at Statehouse

* Campaign finance tops reform scorecard

* Campaign Finance Wait Continues

* Quinn Promises Action On Campaign Finance Bill

- Posted by Rich Miller        

40 Comments
  1. - wordslinger - Monday, Nov 23, 09 @ 10:10 am:

    Aurora housewife Bushra Ayaz has colon cancer. –She’s now being treated at Stroger Hospital, because, when she sought treatment at hospitals in DuPage and Kane counties, they declined because she has no health insurance.

    “The doctors over there, they were saying, ‘Oh, you cannot afford the chemo. … It’s very expensive, and we will not give you here,’ Ayaz said. ==

    Is that an example of rationed care? Because I know some people are really against that.


  2. - Amalia - Monday, Nov 23, 09 @ 10:17 am:

    Hospitals in Cook County, especially the Resurrection Healthcare system, are getting hit for not taking in enough cases where the
    patient needs financial assistance.

    Dear Hospital Administrators in Illinois outside of Cook County….you are next for an analysis.

    The figures quoted in the article make me, a Cook County taxpayer, with really high property taxes, VERY angry.


  3. - Carl Nyberg - Monday, Nov 23, 09 @ 10:19 am:

    Not that many people consider Todd Stroger credible, but….

    It seems hard to reconcile his claims that he is motivated by compassion for the downtrodden when he raises taxes and then wants to keep non-residents from using the Cook County health care system.

    If he was looking for reimbursement for out-of-county users that would seem consistent with compassion for the downtrodden. But excluding people who need health care?


  4. - VanillaMan - Monday, Nov 23, 09 @ 10:19 am:

    No.
    Rationed care is when the Feds decide you can’t go to any hospital.


  5. - Will County Woman - Monday, Nov 23, 09 @ 10:27 am:

    Re: Campaign Finance Reform

    “Quinn has previously praised the bill and said he looked forward to signing it. But on Friday he wouldn’t say if he would sign the bill in full.” —CBS2

    Unlike the previous effort, Governor Pagt “You Ain’t Seen Nothing Yet” Quinn indicated in August that he would play a lead role in the new and “improved” campaign finance reform legislation. Then we learned in October, from Cindi Canary, when the reform legislation was done that Quinn wasn’t really engaged in the legislation making process. If memory serves, she described him as sitting in the corner and doing nothing. But of course he didn’t mention that when he hailed the second coming of the reform legislation, thus making it seems as if he had been a hands-on player this time round. He should sign the bill that he hailed again as a success, because the onus would be completely on him to explain what is wrong with this bill this time and why he didn’t get involved to make it better this time.

    he hailed the bill as a success the first time and then turned around and complained about it saying that it didn’t do enough. I hope he isn’t going to try to make the same or similar argument the second time around.


  6. - Rich Miller - Monday, Nov 23, 09 @ 10:30 am:

    ===a Cook County taxpayer, with really high property taxes===

    I’ll put my Sangamon County property taxes up against yours any day.


  7. - cassandra - Monday, Nov 23, 09 @ 10:31 am:

    I thought the feds were directing extra monies to hospitals who serve a lot of poor patients, which, presumably, would include Stroger.

    One problem with Stroger, if I recall, was that they weren’t bothering to bill and collect what patients could pay. Most people can pay something towards their care but Stroger’s underqualified and underperforming patronage employees didn’t want to bother doing the work—easier to register everybody for free and avoid the paperwork. Even if they have health insurance.

    Somehow I doubt that has changed much. Cook County property and other taxes have changed though. They’ve gone up. We’re not only paying for those out of county patients, whether they have insurance ir assets ir bit, We’re paying more than we were a couple of years ago. And our Pat wants us to pay even more via his middle class tax increase.


  8. - cassandra - Monday, Nov 23, 09 @ 10:33 am:

    Sorry, I mean whether they have insurance or not.


  9. - Ghost - Monday, Nov 23, 09 @ 10:44 am:

    == I’ll put my Sangamon County property taxes up against yours any day. ===

    second that! Everytime I see the insanely low property tax bills for cook county I wonder what all the whining is about.


  10. - DuPage Resident - Monday, Nov 23, 09 @ 10:55 am:

    The CBS2 Article is inaccurate and misleading. First, Medicaid revenues, on which Stroger depends for a high percentage of its budget, come from Federal sources. Secondly, DuPage County has an outstanding program, Access DuPage, that serves over 10,000 low income persons who are not eligible for any other program. Under this program, the hospitals and doctors of DuPage County donated services worth over $42 million last year. Further, DuPage County has indicated to Cook County that they should refer DuPage residents to our health department, where they will be assessed to see what program might meet their needs. Nearly all of the DuPage residents seen so far turned out to be eligible for Medicaid, Medicare or another existing program. Last, my son was treated at Stroger hospital last summer for a life threatening injury. Although he actually has insurance, I have not been able to get Cook County officials to properly bill his insurance so they can get paid. Before Cook complains about the collar counties, they should get their own house in order.


  11. - Sweet Jane - Monday, Nov 23, 09 @ 11:05 am:

    What is it called when the private market won’t let you get treatment at any hospital, then?


  12. - Leroy - Monday, Nov 23, 09 @ 11:09 am:

    I’m interested in watching if Quinn caves to a dozen protesters.


  13. - train111 - Monday, Nov 23, 09 @ 11:14 am:

    rationed care = whatever the spinmeisters, marketeers, and 30 second soundbite creators on your chosen side of the aisle decide to define it as.

    train111


  14. - Capitol View - Monday, Nov 23, 09 @ 11:17 am:

    The state planes story is bogus.

    A higher ranking state employee can call and ask what routes the state plane is taking that day or the next. That employee becomes merely another passenger that makes the entire flight cost more cost effective by filling more seats and not requiring auto or train reimbursement.

    The Herald should have asked which state officials initiate flights the most. Once the flight is scheduled, everyone else on it is cost effective for IDOT and often for their own agency.

    More sloppy journalism and cheap shots at state officials…


  15. - Leave a Light on George - Monday, Nov 23, 09 @ 11:17 am:

    I sure hope the Sun-Times article on Quinn’s failure to fumigate lights a fire among the media, public, or anybody. The continued employment by the state of these illegal/unethical, unqualified hires is disgusting.

    There was an article in the SJR yesterday about a current state employee (of CMS of all places) starting an orgainization decrying the hiring practices of Blago and Quinn’s holdover of these folks.


  16. - 47th Ward - Monday, Nov 23, 09 @ 11:25 am:

    VM,

    Playing the Euro Death panel game again, huh? Thanks for elevating the debate. I’ll hang up now and listen for you to call me names…


  17. - Amalia - Monday, Nov 23, 09 @ 12:30 pm:

    bring it on the taxes, Rich. i’m looking at over $6600 per
    year.


  18. - Rich Miller - Monday, Nov 23, 09 @ 12:31 pm:

    ===i’m looking at over $6600 per year.===

    And your house is worth how much?


  19. - Rich Miller - Monday, Nov 23, 09 @ 12:32 pm:

    Just so you know, my tax bill is about double that.


  20. - Amalia - Monday, Nov 23, 09 @ 12:38 pm:

    based on a recent assessment, only worth $350,000.

    but if you are paying so much, it means your county
    can pay for those who cannot pay for health care down there.
    why is it up to my county to do that?


  21. - Rich Miller - Monday, Nov 23, 09 @ 12:39 pm:

    ===based on a recent assessment, only worth $350,000.===

    Mine isn’t much higher than that.

    Don’t change the subject. And stop whining.


  22. - Rich Miller - Monday, Nov 23, 09 @ 12:43 pm:

    And now you know first hand why “Bring it on” was such an unfortunate remark from the past administration.


  23. - Scooby - Monday, Nov 23, 09 @ 12:44 pm:

    I think it’s an admirable quality that Chuck Goudie is just as unlikable in print as he is on tv.


  24. - Ashley - Monday, Nov 23, 09 @ 12:49 pm:

    Stroger should do less to worry about out-of-county patients and more to worry about what is going on in his own backyard. He is currently supporting something called the HAPI tax for private hospitals in Cook County who do not provide the arbitrary amount of Charity Care that HAPI wants to mandate.

    Firstly, the 4.5% Charity Care amount that would be enforced does NOT take into account the numerous other community benefits and services that these hospitals provide. Secondly, think of the effect that this will have on these hospitals, many of which are already flailing. You think people are having a problem getting quality care now? What will happen when these hospitals, who provide a myriad free benefits and services, are taxed for not meeting an irrelevant quota?

    Finally, the problem of the uninsured is a national problem and one that national leadership is currently fighting to remedy. Why should it be brought to a local level, penalizing private Cook County hospitals and putting those health resources in dire straits?

    You can read more about the topic here: http://bit.ly/8VJsJg


  25. - Amalia - Monday, Nov 23, 09 @ 12:51 pm:

    the question is, what do people pay in their county, what
    services do they get, what can be done to bring down costs,
    and in the case of Cook County, why should Cook County
    pay for residents of other counties for the hospital.
    if I’ve chosen words that harken to some administration,
    whatever……


  26. - cassandra - Monday, Nov 23, 09 @ 1:00 pm:

    I am wondering if the lady described in the access to cancer care article was getting her information from private physicians re: going to Cook County hospital. Private physicans are just that, private, and I doubt that many of them spend a lot of time collecting info on free or low cost health resources. Part of the problem with Downstaters’ use of Cook County may be a lack of information.

    Maybe some of those highly paid and underworked
    state bureaucrats could put up a resource information line for the uninsured and publish it. Most folks would rather get their care close home if feasible. And if DuPage Resident is correct, many of them are likely eligible for Medicaid, Medicard and so on. The latter, if true makes it particularly annoying, as we Cook County residents are being, in a sense, doubly taxed for their care.


  27. - cermak_rd - Monday, Nov 23, 09 @ 1:02 pm:

    I am a Cook county tax payer. I chose to live in Cook county so I could have access to (then) Cook County Hospital if necessary. If people need to access our hospital, why don’t they move here first? Why couldn’t Ms Ayaz have rented an apartment in Cook County? That would have been all she needed to do to legally and ethically access Cook County’s health services.

    DuPage Resident:

    It could be word hasn’t gotten to all the doctors yet. Many of them are in the long time habit of directing patients to Cook County.

    Carl Nyberg,

    I see no contradiction in Stroger’s actions. His responsibility is to the citizens of Cook County and to the citizens of Cook County only. President Obama may feel compassion toward the poor in Somalia, but he hasn’t opened the immigration system wider to them as a result of his compassion.


  28. - Irish1 - Monday, Nov 23, 09 @ 1:35 pm:

    I can tell you that the hospital I work at admits patients with no insurance, and it doesn’t have to be a life threatening emergency, but only if a doctor will admit them. The problem is that unlike Stroger Hospital, we do not have employed specialists such as Oncologists who will treat the patient. Hospitals cannot order chemotherapy for a patient, only doctors can do that. So when a private physician says “go to Stroger Hospital”, what he/she really means is go to Stroger and they will assign an employed physician who will order these treatments. Most private physicians, which most specialists still are, cannot afford to treat uninsured, chronically ill patients.


  29. - Redbright - Monday, Nov 23, 09 @ 1:45 pm:

    An acquaintance who works at Jewel says all of the women she works with go to Stroger (particularly to have babies). It is the only place they know to go. It’s where their family and friends go. They all have good insurance, of course. She said they don’t want to pay the co-pay and no one at Stroger cares.

    BTW: I have a friend who works in Chicago for a large labor union. Her job is to make the decisions about the medical treatments the union members can have. The members, of course, don’t know that a one-time nurse is telling their doctors what they can or cannot do.

    But isn’t that the way it works with all ‘health insurance’.


  30. - VanillaMan - Monday, Nov 23, 09 @ 2:25 pm:

    But isn’t that the way it works with all ‘health insurance’.

    What is it called when the private market won’t let you get treatment at any hospital, then?

    The “private market” or “health insurance” is being incorrectly described here. This isn’t a question between “either/or”. When discussing the opposite of government ran universal health care, there isn’t a “yang” to that “ying” - instead there are thousands of insurance companies offering thousands of insurance options to millions of individuals with individual medical needs and cures.

    So the arguments are incorrect at the most basic level. So, those who support a simple plan, see those who disagree with them as having a similarly simple plan - and that would be wrong.

    This is not an ‘government care vs. health insurance care’ issue because of the thousand of ways health insurance functions in a free market. So using any one blanket to describe one side is only true for the universal health care side of this argument - not the other.


  31. - Ghost - Monday, Nov 23, 09 @ 2:50 pm:

    === Downstaters’ use of Cook County ====
    Um I dont belevie everything outside of cook county is downstate.

    This appears to be a urban/suburban local issue to the chicago “area”.


  32. - Arthur Andersen - Monday, Nov 23, 09 @ 3:29 pm:

    Capitol View wrote-

    “A higher ranking state employee can call and ask what routes the state plane is taking that day or the next. That employee becomes merely another passenger that makes the entire flight cost more cost effective by filling more seats and not requiring auto or train reimbursement.

    The Herald should have asked which state officials initiate flights the most. Once the flight is scheduled, everyone else on it is cost effective for IDOT and often for their own agency.”

    Both of your statements are flat wrong as well as misleading to folks who don’t understand how IDOT does the cost accounting for the executive aircraft.

    First of all, if an agency or official (more likely the latter) has chartered one of the planes for a trip besides the SPI-MDW shuttle, it’s both unusual and unlikely that IDOT DoA schedulers would ask say, “Gov. Quinn, do you mind if Comptroller Hynes shares the flight to Carbondale next Tuesday?” (Look at the logs posted online with Goudie’s story and see if you can find one instance of “pooling up” like this.)

    Secondly and more important, to say that filling up a scheduled flight with more flying state workers and officials is “cost effective” is a real stretch. Adding another passenger who is charged $60 for an SPI/MDW flight that has a true cost of several thousand dollars is something other than cost effective imho.

    Having blathered on about all that, AA is not opposed to State aircraft. I just think there should be straight up, full disclosure about the cost of the fleet.


  33. - Anonymous - Monday, Nov 23, 09 @ 5:45 pm:

    Some basic information -

    Medicaid doesn’t cover all poor people - just poor people who are in category - children, pregnant moms, the parents of some kids & the disabled. And only citizens. The state has some state-funded programs that cover non-citizen kids, but that’s basically it.

    Stroger Hospital is no longer governed by the Cook County Board, it has an independent board. That board has adopted policies to require that everyone be billed on a sliding fee scale and instituted measures to start collecting co-pays, etc. It has hired firms to revamp the entire billing process and retrain the staff. It has also made all jobs “merit” based - there are no “exempt” positions any more.

    Irish1 hit the nail on the head - hospitals absorb a certain amount “charity care”, mostly through their emergency room, but otherwise doctors make all admitting decisions to hospitals and if the doctor doesn’t want a Medicaid or uninsured patient, that patient is out of luck, unless it’s an emergency and the hospital has to admit the patient. Cancer treatment isn’t an emergency. The only thing I would take exception to is the notion that private doctors can’t “afford” to take on uninsured patients. It all depends on what your expectation of income is. If you expect to make $400,000 and spending some of your time on uninsured patients would pull you down to $350,000, then not doing so is a choice.

    Dupage Resident — Stroger Hospital may get a lot of Medicaid, which is half Federally funded, but it still gets about $300 million per year from Cook County taxpayers. And
    Access DuPage is a great program, but there are a lot more than 10,000 uninsured persons in DuPage County.


  34. - Former Cook County Worker who now Lives in DuPage - Monday, Nov 23, 09 @ 5:45 pm:

    Reading these stories about Health Care and John H. Stroger, Jr. Hospital of Cook County to me is very funny. As a former Cook County Health Department Employee (retired in 1999), I know for a fact that Collar Counties (DuPage, Kane, Grundy, Lake, Will and Kendell Counties) all refer serious medical patients to the ONLY true free hospital within the region, John H. Stroger Jr. Hospital of Cook County (Formerly Cook County Hospital). While its true, as recent as 2006, millions of unpaid billing was within that hospital, people have to remember that this hospital has since February 29, 2008 its administration has been in Independent Hands (Thanks to a Commissioner from Evanston, who lobbied his vote for a 1% sales tax increase, in exchange for this board ONLY to vote against it). On the other hand, for years County residents in more affluent areas of Cook (North, NorthWest) complained about the high taxes and NOT receiving anything in return. Then Former President Dunne built the Suburban CourtHouses in Skokie and Rolling Meadows. However, Stroger Hospital today has become a Regional Hospital within the nearly 9 million residents of the Chicago Area. Within the last two weeks a repoort came out that Illinois’ Unemployment Rate is at 11% (many more underemployed) and for many of these people the lack of Health Insurance has followed the job lost. While many can go to nearby clinics within their areas, serious medical conditions and their affordability only rest within Stroger Hospital. All of this occurs when municipalities and others units of local government DO NOT financially share Cook for these costs. While Washington D.C. currently is debating this Health Care situation, it will not get any better if their “public option” isn’t apart of it. How can ALL people of this region afford health care without jobs? This is a human issue which affects ALL, as a result although this is a political blog, this shouldn’t ALWAYS be apart of the discusssion!


  35. - Some Guy - Monday, Nov 23, 09 @ 6:15 pm:

    I wish that fumigation bill would get revived; the Blago holdover in our office is just running our department into the ground with ill-advised spending and crazy priorities. My state-employed after-hours bar buddies all say they can match me story for story on that.


  36. - Chicago Cynic - Monday, Nov 23, 09 @ 6:19 pm:

    Redbright,

    You’re exactly right about the failure of Stroger Hospital to collect potential insurance payments under the old regime. It’s one of the things the independent board committed to fixing and it’s working. They are bringing in millions of dollars in previously unbilled and uncollected insurance payments. This has led to no decrease in care, just smart policy that Todd Stroger had previously REFUSED to implement. It’s why the board needs to be made permanent and Todd needs to be thrown out of office.


  37. - Emily Booth - Monday, Nov 23, 09 @ 7:43 pm:

    There is the federal Hill-Burton Act which requires hospitals to service a certain number of local indigent patients in exchange for expansion loans. It’s been on the books at least 20 years.

    All Kids have a 50% federal reimbursement rate but I believe the Share/Premium programs have a 65% reimbursement.

    Don’t forget our AABD program: Assistant to the Aged, Blind and Disabled. They get Medicaid, too, but Medicaid is a supplement to Medicare for most of these recipients.


  38. - Wumpus - Monday, Nov 23, 09 @ 9:36 pm:

    ===a Cook County taxpayer, with really high property taxes===

    I’ll put my Sangamon County property taxes up against yours any day

    One of the selling points of the Wumpus Estate Mansion Home Castle was that it had Crook County taxes vs DuPage


  39. - Anonymous - Tuesday, Nov 24, 09 @ 7:15 am:

    All Kids is actually a higher than 50% federal reimbursement for the kids who are eligible under the federal S-CHIP program, but NO federal reimbursement for kids above certain federal poverty limits and NO federal reimbursement for ineligible aliens.

    Is the federal government still make Hill-Burton expansion loans to hospitals?


  40. - Stallion - Tuesday, Nov 24, 09 @ 9:16 am:

    Hey Some Guy, I see a lot of resentment as well. There will be nothing positive that will come out of hanging on to these people. They are very angry. There loyalty is with the prior administration, and so there atitude is shameful..


Sorry, comments for this post are now closed.


* Sherri Garrett responds to Hickey report
* Hickey wants Madigan to be more available to employees
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* Fun with numbers
* "Bank On" initiative signed into law
* AG attempts to dismiss lawsuit against gun dealer regulations
* Pritzker, Lightfoot launch new campaign committees
* Planned Parenthood loses federal funding for contraception, cancer screening and STD tests
* *** UPDATED x1 *** Hickey report released
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