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Press release of the week and some budget news

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Illinois

* State Rep. Jack Franks (D-Marengo) wins our award…

I offer a simple alternative, in return for my support of more borrowing. I call on Governor Quinn to make $2 in cuts for every $1 borrowed.

I’ll let you know when Franks comes up with $10 billion in cuts. Simple. Right.

* The governor has been using his “cuts” to education spending as a way to win support for a tax hike. This has often backfired, with people blaming him for the cuts and trashing him for the tax hike. Senate President John Cullerton has now proposed a partial solution to Quinn’s school cuts through a cigarette tax hike. He also got in some digs at the governor’s school funding cuts. From a press release…

“On March 10, 2010, Governor Pat Quinn proposed a series of cuts to education that includes spending reductions of $613 million in General State Aid payments and $400 million in mandated categorical spending for critical programs such as special education and school transportation.

After serious assessment and discussion with members of the Senate Democratic caucus, it is evident that there remains little if any support for these cuts to schools. So, to be clear, Senate Democrats support a budget plan that holds General State Aid payments to schools at current levels.

To avoid a reduction in mandated categorical spending, a bi-partisan coalition of members of the Illinois House of Representatives must pass the cigarette tax (SB 44). Through this measure, Illinois will realize approximately $200 million that will be matched with $120 million in federal funds, relieving pressure from Medicaid costs in the budget.

Our caucus continues to maintain a serious commitment to developing a short-term and long-term approach to stabilizing the state budget. We support significant spending cuts and recognize that Illinois’ outdated revenue system is in serious need for reform. However, draconian cuts to education would drop Illinois to worst-in-the-nation status when it comes to state support for schools and will kick an estimated 20,000 teaching professionals into the unemployment line.”

They’re going to try a piecemeal approach to closing this school budget hole. The cig tax is just one of the tools. Quinn is sticking to his tax hike guns, however.

…Adding… Oy…

A Carterville mom says she was denied medical care for her children because the state isn’t paying its bills. […]

“On one point, I want to be mad at the doctors because I feel like they have a moral obligation to hang in there and not bail on us when times get rough,” says [Ashley Wright of Carterville].

During a recent check-up, Ashley’s four month old son Noah was denied immunizations by his pediatrician.

The doctor said Ashley’s insurance provider wasn’t paying its bills. Ashley doesn’t know how to fight back.

“We can’t go after the doctors, they’re not being paid. We can’t go after the insurance company, they’re not being paid. But how do we fight the state?” she asks.

* Related…

* Gov. Quinn talks tax amnesty, adjournment (Part 1)

* Gov. Quinn talks tax amnesty, adjournment (Part 2)

* Live Blog: Evanston goes to Springfield

* Lawmakers Mull Budget with No Tax Hike

* Quinn angling for more education money as Obama visits Illinois

* Lawmakers Fear Deja Vu with Budget

* Herald & Review: Crisis has no bearing on senators’ decisions

* Pantagraph: Moving deadline for paying bills ignores problem

posted by Rich Miller
Thursday, Apr 29, 10 @ 12:14 pm

Comments

From the Chicago Public Radio link cited above:
(Sen. Bill) “Haine says pushing off state payments even longer could be part of the final solution.”

My impression is that Quinn and many of the legislators do view their budget proposals as “solutions”. Even “final solutions”.
We are in big trouble.

Comment by Vole Thursday, Apr 29, 10 @ 12:35 pm
What, exactly, is the governor or any legislator doing to make sure Ashley Wright and the tens of thousands more mothers, fathers, seniors and children are getting adequate, timely medical care NOW, no delays, no excuses?

Nothing, that’s what.

Comment by Reality Check Thursday, Apr 29, 10 @ 12:35 pm
I remember a few years ago there was a series of TV ads that had people proclaiming their doctors as “heroes.” I guess a hero is only heroic when s/he is paid. I found the ad nauseating then and medical profession has done nothing to make me feel better about it since. Health care is health care, insurance is not health care. If you do not want to provide health care, be something else; but don’t call yourself a health care provider, or a doctor.

Comment by Captain Flume Thursday, Apr 29, 10 @ 12:37 pm
A Reason Foundation study of cigarette tax increases throughout the US found that 68% of them DO NOT meet revenue expectations. Sen. Cullerton is dreaming if he plans on it bringing in $200 million. That is even more delusional than the notion that only cuts will get us out of this mess. How about we call Cullerton on his inflated and damaging revenue estimates.

Sen. Cullerton, if your cigarette tax hike does not meet your revenue projections in the first will you personally make up the difference that non-smokers will end up paying, or will you immediately resign for being an incompetent legislator and manager our money?

In 2004, IL tobacco tax revenue was $760 million, and by 2009 it had fallen to $582 million. It went down by $178 million per year, since Cook County started tax gouging at $2/pack. Cullerton thinks another $200 million is going to appear after $178 million worth of business has already left the state?

If Cullerton wants to bring in more revenue to the state, the cigarette tax they should be attacking is the one in Cook County. Force them to drop it to $0.50 and IL revenue will go back up and it will bring business and jobs back to the state. That is the healthy economic policy to take for long-term revenue stability and growth. Jacking up the cig tax by $1 overnight, after it took 61 years for the tax to go from $0.03 to $0.98, is irresponsible and damaging.

Comment by TaxMeMore Thursday, Apr 29, 10 @ 12:45 pm
Captain,

That comment is incredibly silly. From your argument, you believe each individual family physician should cover the expense of the immunization out of the their own pocket. After all, the actual immunization coctail costs money. So, are you saying the Doctor should pay for the healthcare of the patient? Also, these docs have nurses and staff to pay. So, should the doctor’s secretary also work for no money?

This idea that Docs should just work for the “good” rather than to make money is dumb. The best and brightest often become doctors. They go through the hell known as Med School and residency. When these doctors lose 8 years of their life to torture, they then expect to make a good living.

Essentially, if you don’t allow docs to make money, the best and the brightest will do something else for a living……like become a State Worker because at least then they will be guaranteed money and a pension too. Of coarse, using your logic, state worker should work only because they are concerned about “public” good; Thus, at this difficult time, all state workers should work for free because if you don’t want to provide for the commong good, you can go do something else.

Comment by cuban pilot Thursday, Apr 29, 10 @ 12:53 pm
This week I read a list of insulting comments over a newspaper article claiming that since Townships aren’t in debt, then they aren’t helping the poor. So if you are not in debt, you are the problem - and if you are in debt, you are the problem.

Well, it is better to be conservative and actually pay local health care bills for the poor, than be liberal and expect the local health care providers to work without pay.

So, not only are we at the point where local health care providers are filing bankruptcy, turning citizens away that depend upon state funded services, but we are at a point where we are making our local health care providers the fall guys both for their creditors, and within their communities.

Our current system rewards politicians who make promises but send their bills to everyone else.

We need a completely new General Assembly in January in order to restore the massive damage residing with current government leaders. It isn’t everyone’s fault - but we are paralyzed until voters feel enough of them are gone.

Comment by VanillaMan Thursday, Apr 29, 10 @ 12:58 pm
- So if you are not in debt, you are the problem - and if you are in debt, you are the problem. -

I wouldn’t doubt that there were insulting comments about townships, but your statement here isn’t exactly accurate. Many examples have been shown of townships sitting on very large reserve funds and also spending twice as much on salaries for those in charge of distributing aid to the poor than the actual funds distributed. No reasonable person thinks the townships should operate with debt to be efficient, but when you’re dealing with money you collected in taxes, you should at least not operate with a huge surplus other than what is truly needed for emergencies.

Comment by Small Town Liberal Thursday, Apr 29, 10 @ 1:11 pm
Well, Quinn got himself into this education funding boondoggle, now the Dems have to get him out of it. It was–raise taxes or cut the schools. A bluff. And a dishonest one at that. As we all know, state monies are fungible. Monies designated for one thing free up other monies for something else. Like–you know, patronage, no-bid contracts for the Dem faithful, suck up to the unions state employee raises, and so on. The ever-hungrier pension monster.

Apparently, the Dems, who could pass Quinn’s income tax increase on the middle class in a hot minute have decided they can’t take the risk. Would it be safer to do so if the Blago trial weren’t coming up fast. Probably. But nobody to blame but themselves.

So I guess the cigarette tax might be the replacement. It’s the next best tax “for education.”

Comment by cassandra Thursday, Apr 29, 10 @ 1:17 pm
I wonder if nero used the same process to manage the fire

Comment by Ghost Thursday, Apr 29, 10 @ 1:31 pm
Many examples have been shown of townships sitting on very large reserve funds and also spending twice as much on salaries for those in charge of distributing aid to the poor than the actual funds distributed.

That point was made, and it is nonsense. You don’t use that kind of argument when discussing other government services. Or we would be complaining that we have too many firemen because there haven’t been enough fires. Or complaining that the cost of fighting fires last year was less than the amount paid in salaries to firemen.

The idea that overhead costs should never exceed operating costs is ridiculous. It is exactly for those economic reasons why governments exists.

Comment by VanillaMan Thursday, Apr 29, 10 @ 1:33 pm
*Well, it is better to be conservative and actually pay local health care bills for the poor, than be liberal and expect the local health care providers to work without pay.*

Cute way to twist the situation. It ignores that the primary way conservatives make sure they can pay local health care bills is by limiting for whom and what type of health care is available to the poor. There is no worry about whether a bill will be paid if the service is not covered in the first place.

More to the point, those that honestly believe the poor should have access to decent health care support raising revenue to address the state’s structural deficit so bills will be paid on time. That is contributing to the common good, which the conservatives (and far too many others) are not too keen on doing right now.

Comment by Montrose Thursday, Apr 29, 10 @ 1:35 pm
The story about Ashley is this:

She has health insurance…members of her family work at SIU and are on the state plan. The state is very slow in making it’s payments, including health insurance claims. The doc wants Ashley to pay up front so he doesn’t have to wait for the state payment. Ashley could pay up front and then she would do the waiting for the state payment. So the doc isn’t refusing the service….he’s asking for payment for services.
She and/or the reporter who wrote the story may not understand it, but Ashely’s beef isn’t really with the doc, it’s with the state health insurance provided to her family by the employer, the state of Illinois.

Comment by Deep South Thursday, Apr 29, 10 @ 1:35 pm
As a follow up, Ashley should find another health care provider who is willing to be patient with the state. Here in Southern Illinois, some docs are willing to be patient, some are not.

Comment by Deep South Thursday, Apr 29, 10 @ 1:37 pm
===Ashely’s beef isn’t really with the doc===

It is in part. A doc refusing to give a child an immunization shot because he won’t wait a few months for payment? I don’t think I’d ever go back to that doc again, and I’d tell all my friends.

Comment by Rich Miller Thursday, Apr 29, 10 @ 1:38 pm
Also, please review the “surpus” being discussed. They would be easily spent paying the costs of one child undergoing chemotherapy. A million dollars? Since when does that go far enough within one year covering health care costs for the poor?

How can anyone predict what kind of health care bills within a year’s time will arrive? Or how many people will need assistance? Are we, or are we not seeing more need, not less? How helpful would these townships be regarding this kind of work, if they had no money at all?

What I believe we are seeing here are township government operating differently than state and federal levels. Not better or worse, just different. If, at the end of the year, these townships still have a surplus during these economic times, and have proof that they have served every citizen completely and fairly, then I believe they know what they are doing.

Comment by VanillaMan Thursday, Apr 29, 10 @ 1:40 pm
Most local health departments provide low-cost or free immunizations. Actually, if he can’t wait for payment, the doc should have made a referral.

Comment by cassandra Thursday, Apr 29, 10 @ 1:40 pm
It ignores that the primary way conservatives make sure they can pay local health care bills is by limiting for whom and what type of health care is available to the poor.

That isn’t a conservative approach at all. Obamacare will do it. Your insurance company does it. Every European country does this. Why? Because that is the situation in the real world. No one is offering a smorgasbord without limits.

Comment by VanillaMan Thursday, Apr 29, 10 @ 1:43 pm
*That isn’t a conservative approach at all. Obamacare will do it. Your insurance company does it. Every European country does this. Why? Because that is the situation in the real world. No one is offering a smorgasbord without limits.*

It is an issue of degree. Federal health care reform does a whole lot of expansion in who and what is covered. There are limits that a reasonable and there are limits that are punitive. There is a huge difference.

Comment by Montrose Thursday, Apr 29, 10 @ 1:49 pm
Yeah, the huge difference is that people like myself are paying for it. When we managed our affairs conservatively, just to have it taken for others against our will.

Comment by wizard Thursday, Apr 29, 10 @ 2:08 pm
OK, Ashley may have a beef with the doc, and she should tell all her friends what happened. But, there are alternatives…the story fails to point that out. Its not like Ashley can’t get her kids the immunizations. It’s not time to panic…yet.

Comment by Deep South Thursday, Apr 29, 10 @ 2:13 pm
Their is a clear medical interest in providing your patients with immunizations even if you will have a delay in medical payments. It is a little different then say choosing not to treat a cold or a rash or any other item which impacts the patient. Denial of immunizations actually puts more people at risk than just the patient. It is sad that her doctor doesn’t see that.

Comment by Gish Thursday, Apr 29, 10 @ 2:22 pm
I’m a pediatrician, and the story about Ashley Wright of Carterville does not make any sense to me. If her child is covered by state insurance - Illinois Medicaid or All Kids - then the vaccines for her child should be available through the Vaccines for Children program. VFC vaccines are provided to the practitioner FOR FREE and then administered to the patient FOR FREE except for an administration fee. These fees usually run from $8-$10 per vaccine at local health departments up to $15-$25 per vaccine in other clinics & private practices.

I suppose the “between-the-lines” point of that blurb is still valid: late payment by the state does force physicians to consider changing their payer mix to see fewer patients with public health insurance.

Comment by Matthew Thursday, Apr 29, 10 @ 2:31 pm
@Matthew, this is not a Medicaid or All Kids recipient, this is a participant in the state’s group insurance program. Her insurer may be Blue Cross, Cigna or what have you.

It is shocking to me that people’s response to this story is to blame the doc or the mother — rather than asking, “When will the governor and legislators do the right thing to PAY the BILLS?!”

Comment by A Naughty Moose Thursday, Apr 29, 10 @ 2:45 pm
ANM, of course the state should pay its bills. But those who benefit from the state might also show a bit more empathy for their patients’ children.

Comment by Rich Miller Thursday, Apr 29, 10 @ 2:47 pm
@Naughty Moose, I wasn’t BLAMING anyone. I was stating that the story didn’t make sense to me if the child was covered by public health insurance. It makes more sense if you have a private insurance provider not being paid by the state and then subsequently delaying payment to the practitioner. Thank you for the clarification.

Comment by Matthew Thursday, Apr 29, 10 @ 2:56 pm
Mr. Moose has it right, and I think Matthew is on to something…that the story doesn’t make total sense. Everyone, it seems, has an agenda. Or perhaps they simply don’t understand the fine points of the situation. Perhaps Ashley didn’t know she had options…and claimed she was refused care. And I might imagine that’s what got the reporter interested in the story. Of course, the story is about the little guy vs. the big bad system. But instead of blaming the big bad system, the reporter seemed focused on the doc. I don’t think the reporter understood the nuances of the situation…at least refused to adequatly explain the reality.

Comment by Deep South Thursday, Apr 29, 10 @ 2:59 pm
DS, click through and read the story before slamming the reporter, please.

Comment by Rich Miller Thursday, Apr 29, 10 @ 3:01 pm
Rich, I’ve read the story. Believe me. Perhaps I’m too close to the story. I’ll stop now.

Comment by Deep South Thursday, Apr 29, 10 @ 3:19 pm
If I understand VFC guidelines it is for persons who don’t have insurance or insurance that does not cover the baby shots.

Neither is Ashley’s case. She has insurance, her insurance covers shots, only this dr is not getting paid in a timely manner so he is not giving baby shots to Ashley’s baby unless she pays up front.

If Ashley goes to health dept she either pays private pay or has to meet guidelines for VFC.

State is only current back to 8th of Oct 2009 in paying claims through QC, they are talking of even delaying payments for claims on QC longer than the current payment delay.

No matter what we,you, I think of the dr. in this ’story’ fact is rural area drs with small businesses do not always have the finances to float cost. Take the story of the Kewannee Birth Center for example. When these drs in the boonies are getting very delayed payments and a high percentage of medicaid clients and/or some cross of the mix they are going to start having problems providing services and stocking supply cabinets, paying staff blah blah.

The dr did do a well baby check-up, which I guess he could have refused until paid up front, so baby was not totally denied services on the drs part, he did see baby knowing he’d not be paid his time for quit some delay. Based soley on the article I can’t judge the dr without knowing more facts. Ashley may have to look for another which might mean driving farther on her part. QC, if what she has for coverage let’s client chose drs, unlike HMO with a set primary care provider.

Comment by Cindy Lou Thursday, Apr 29, 10 @ 4:02 pm
Our politicians don’t either understand or care. What about the state senator who is going to grill the evil University of Illinois over why tuition is going up? He apparently doesn’t think that the $450 million that the State owes the Unviersity has anything to do with that. And now the legislature is considering freezing tuition for those who take more than 4 years to graduate because the State education system failed them, and we shouldn’t penalize those students.

Comment by Champaign Dweller Thursday, Apr 29, 10 @ 5:34 pm