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The rest of the story

Friday, Jun 1, 2012 - Posted by Rich Miller

* Reporters often write only about what they see, or what they want to see. Here’s a standard article

The Illinois Hospital Association took no chances as state lawmakers debated in recent weeks whether nonprofit hospitals should pay property taxes. It unleashed a self-described media blitz.

“My baby is sick — anyone help, please!” screamed an actress portraying a mother in radio ads aired in Chicago and 41 other markets starting in early May. A baby wailed, an ambulance siren blared and a voiceover asked what the terrified parent would do if no hospital were around.

The blitz worked. The Illinois General Assembly this week handed hospitals a long-sought victory: a sweeping legislative antidote to a recent state Supreme Court decision that threatened to slap many hospitals with potentially millions of dollars in tax liabilities just as they say they’re struggling to survive.

The radio ads worked? That was what passed the bill? OK. Or maybe it was the ad the IHA bought here. That seems more likely, actually, because legislators and staff actually saw that one. But, whatever. Ads weren’t the only factor highlighted in the story…

The association, representing about 200 hospitals and health systems, urged Illinoisans to write to state officials. By this week, the IHA reported, more than 12,000 people had signed an online petition. The group created templates for member hospitals to customize anti-tax e-mails to legislators and letters to local newspaper editors. And it suggested members provide kiosks or special computers for workers to send notes condemning property taxes for hospitals and Quinn’s proposed $2.7 billion in reductions to projected Medicaid payments.

An online petition worked? Well, maybe. I’m not sure how many legislators actually saw it, though. And then, of course, there was this…

For 2011 and the first quarter of 2012, the association contributed about $397,000 to state office holders, candidates and the state Democratic Party, according to the Illinois Campaign for Political Reform, a watchdog group. That included $143,000 to legislative leaders of both parties and $198,000 to other lawmakers in the General Assembly.

The IHA gave even more than that in 2010: $725,089.56. It has a very active, very aggressive political organization.

* But there’s more to this story. Hospitals are in every legislative district. And hospital boards are usually made up of the region’s biggest bigshots, who are accustomed to hob-knobbing with local politicos. Hospitals are also large employers, and their workers usually earn pretty good salaries. They are almost always involved with local charitable causes, spend big money on public relations and they advertise heavily in local media. As a result, they’re the most trusted institutions in almost every region. Crossing them ain’t easy.

The IHA lost its top lobbyist and political guru when Howard Peters retired. It recently hired AJ Wilhelmi right out of the state Senate. Wilhelmi had never been a lobbyist before, but he worked like a dog. He returned one of my calls after midnight one evening, waking me up.

Add all that up and it’s no great feat to figure out why they did pretty well this year. They almost always do.

That’s not to say they’re right all the time. They used to constantly battle with nurses in Springfield. Those fights hurt them. And getting crossways with the attorney general has had many downsides. She was right to question their level of charity care. Some of what they classified as charity was just silly PR.

* And they’ve been one of the most aggressive bill collectors of any industry, prompting legislation to clamp down on entities that seek to put people in jail for not paying a bill. From a press release…

Attorney General Lisa Madigan today applauded state lawmakers for supporting the Debtors’ Rights Act of 2012, a measure that would protect poor people from being jailed over unpaid debts.

House Bill 5434 would prevent creditors from abusing the court system to put debtors in jail to collect on a debt they are clearly unable to pay. Over the last year, Madigan has learned that residents in roughly a third of Illinois’ counties commonly face incarceration when they fail to appear in court over a previously entered judgment to pay a debt. In many of these cases, notices of court hearings were mailed to addresses that were no longer valid, leaving many debtors unaware of the hearings. In spite of the failure to notify the debtors, courts have frequently issued warrants for their arrests.

“Long ago, our society recognized that it was immoral to send a poor person to debtor’s prison. Yet this practice has reappeared in Illinois through creditors’ abuse of the courts,” Madigan said. “This legislation will ensure that people who have the means will pay their debts, while also preventing poor older and unemployed persons from being illegally and unfairly incarcerated.”

Compounding the problem, Madigan said, is that many victims of these practices are living solely on income that is legally protected from being used to pay outstanding debt judgments, including Social Security, unemployment insurance or veterans’ benefits.

Madigan’s legislation would also ban abusive and burdensome “pay or appear” orders that are routinely entered against debtors in some Illinois counties. These orders – which usually remain in effect for three years – require debtors to make a monthly payment or appear in court each month to explain why they are unable to pay, even if their financial circumstances have not improved. Madigan said if a debtor misses just one payment and court hearing, they can end up in jail. Debtors who have been victim to this practice typically owe outstanding medical bills, credit card debts or payday loans.

The legislation would amend the Code of Civil Procedure to codify and clarify practices followed by attorneys, creditors and courts across Illinois to ensure that courts make a finding of a consumer’s ability to pay before entering a payment order. The legislation also would prohibit payment orders that rely on legally protected income and prevent arrest warrants from being issued unless the debtor was personally served with a hearing notice.

The combination of mandated free care (pushed by AG Madigan) and the attorney general’s debtor protection bill were not hospital “wins.” But like all smart organizations, they recognized that getting what they wanted required giving up something else. So, they agreed to a scaled back (but still significant) Medicaid rate cut and they accepted the attorney general’s demands. That’s an optimal conclusion for pretty much everybody.

       

7 Comments
  1. - I'm Just Saying - Friday, Jun 1, 12 @ 1:03 pm:

    Thanks Rich, You’re like a Regular Old Paul Harvey, And Now, The Resssssssssst of The Story :)


  2. - PublicServant - Friday, Jun 1, 12 @ 1:42 pm:

    Actually Rich, as is plainly obvious by my often heated and some would say partisan (Schnorf) point of view, I’m not a lobbyist. I’m a partisan, because pension changes affect my family. So, this thread hit home for me in that I hope my personal, and admittedly partisan, remarks didn’t cause the pension steamroller to be worse than it otherwise would have been. I tend to think that even when you said in one thread a couple of weeks ago that now is the time to offer alternatives because you’re about to get steamrolled, that it was already to late, but I understand now really how things work. Hospitals are big. They have money. They know powerful people, that hob-nob with powerful legislators. Even then they can’t have everything they want, but they, in the end, get pretty close to everything. No so with the non-big and non-monied.


  3. - Team Sleep - Friday, Jun 1, 12 @ 1:45 pm:

    Another side of the rubicon is that the IHA is right to question legislators and advocates who push for better access to care and want hospitals to expand charity care and then want to slash payments to the same hospitals that are supposed to keep up with the wishes of said advocates.


  4. - zatoichi - Friday, Jun 1, 12 @ 2:14 pm:

    So what happens to the property tax issues of the other non-profits in every local community? Hospitals have the bucks and the constitution specifically exempts schools and churches from property taxes. Do the B/G clubs, mental health, day programs, drug/alcohol, youth camp, Salvation Army, food banks, child care, residential providers, and many other 501c3s get the same consideration when their property tax exemption is questioned by local taxing authorities looking to make up financial shortages? These groups do not have the same dollars, may not be the biggest employer, and usually serve a select portion of the community that the local ‘biggest bigshots’ may not be directly involved with. Doesn’t happen? Talk with the local mental health center in Johnson County who lost their property tax exemption.


  5. - amalia - Friday, Jun 1, 12 @ 2:31 pm:

    the hospital with which I am all too familiar does a fantastic job of community outreach and a range of free services. I’m glad to see a resolution because I was not happy to see any threat to the services provided when the particular hospitals were name in the discussion. and I’m especially happy because hospitals which engage in developing new protocols for difficult health problems, which support scientists who literally develop new ways to save lives, are invaluable to the State of Illinois.


  6. - Bemused - Friday, Jun 1, 12 @ 3:20 pm:

    Useing Hospital ERs and Charity care as a pressure relief valve will only work so long. There is a cost for everything and in this case the cost is passed along to those with healthcare insurance via higher costs for services and higher insurance premiums. So far that has worked for those involved.

    The problem is this causes a downward spiral of the percent of the population with health insurance.

    It tends to go like this. Company A is a long time local employer. They try to do the right thing for their employees but still have to compete in the marketplace. They have provided health insurance to their workforce for a long time. Now they compete with Company B which does not supply health ins. With a cost in the range of say 5-7 bucks per Hour per worker that puts A at a serious disadvantage. So Company A feels the need to either drop said coverage or pass it on to the worker who may feel they can’t afford it either.

    With fewer workers paying premiums and more Charity Care needing to be paid for, premiums go up and more Companys drop healthcare and so on and so forth. The present system does keep the masses from rising up with pitchforks but won’t work forever.

    Say what you will about “Obamacare” the cost will need to be spread across a larger pool. Those in the Medical field expect and deserve a paycheck at the end of the week. The money comes out of one pocket or another but it will come out.


  7. - chefjeff - Friday, Jun 1, 12 @ 3:57 pm:

    What happens to the property tax paid by Provena
    (Supreme Court test case) since 2002 when the dispute started. I believe it amounts to around a million dollars a year. Will the local schools, park district have to pay them back?


Sorry, comments for this post are now closed.


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