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Having it both ways

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* House GOP Leader Jim Durkin during floor debate over the Democrats’ budget proposals…

“Why in the world are we sending for the second year in a row an unbalanced budget to the governor?” Durkin said. “We’ve all seen this Greek tragedy before.”

Durkin even raised the old saying about repeating the same action and expecting a different outcome being the definition of insanity.

“If we pass these budgets and send $36 billion of budgets to the governor, this is insanity,” Durkin said. “You’re insane, and history will look upon you unkindly.”

All Republicans voted against all the approp bills. Most, but not all, Democrats voted for them.

* But Leader Durkin and several other House Republicans voted for this bill yesterday, which was sponsored by a GOP lawmaker…

Provides that on and after the effective date of this amendatory Act of the 99th General Assembly, every insurer that amends, delivers, issues, or renews a group or individual major medical policy of accident and health insurance in this State providing coverage for hospital or medical treatment shall provide coverage for hepatitis C screening and confirmatory testing consistent with reasonable medical standards. Makes conforming changes in the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code.

* From the fiscal impact notes…

Balanced Budget Note (Office of Management and Budget)

This bill will likely have a significant fiscal impact to the State’s Medicaid and Group Health Insurance programs due to increased screening and treatment of Hepatitis C. The anticipated costs are not available at this time. Passage of this bill without an accompanying source of revenue will result in an unbalanced budget.

Fiscal Note (Dept. of Healthcare & Family Services)

For purposes of this analysis, it is assumed that primary care providers are offering and/or recommending testing to at-risk populations based on sound medical reasoning. However, there may be an indirect impact to the Department from the publicity of hepatitis C legislation and the new hepatitis C drugs. Increased awareness of those in an at-risk population coupled with a mandate is likely to increase testing utilization. In FY14 and FY15, the Department did and is estimated to spend about $1.5 million for testing. A 10% increase in FY16 testing utilization would increase liability by $150,000 thousand. Additional testing would potentially double the population receiving treatment. This would result in an added pharmaceutical cost of $8.5 million annualized.

Emphasis added.

Look, this is a very worthy bill. Hep C has to be stopped. And $8.5 million is a teensy, tiny drop in the budgetary bucket.

But, if you’re gonna argue that nothing should be appropriated without a bipartisan budget deal (and that’s a reasonable argument to make, especially considering the Illinois Constitution: “Appropriations for a fiscal year shall not exceed funds estimated by the General Assembly to be available during that year”), you shouldn’t then vote for bills like these.

posted by Rich Miller
Wednesday, May 27, 15 @ 9:52 am

Comments

Jus bring the 3% tax back and raise sales tax on new purchases! we would be out of sent in 10 years,

Comment by Mitch1959 Wednesday, May 27, 15 @ 9:55 am
debt

Comment by Mitch1959 Wednesday, May 27, 15 @ 9:56 am
Name calling-must be a new way of finessing compromise at the last minute?

Comment by Slippin' Jimmy Wednesday, May 27, 15 @ 9:57 am
“…Greek tragedy…”

“You’re insane and history will look on you unkindly….”

The lead tenor in this season’s Springfield Bad Opera.

Comment by Wordslinger Wednesday, May 27, 15 @ 10:12 am
There you go again, Rich..being all logical and stuff.

Comment by Skeptic Wednesday, May 27, 15 @ 10:12 am
I think that there are much better examples of fiscal insanity.

What’s missing here is the cost of treating Hep C once it gets to an advanced stage, which can require liver transplants and other astronomically expensive treatment regimens. The $8.5 million cost to HFS for Hep C drugs is miniscule compared to what it costs taxpayers if Hep C goes full blown on a patient. And I’d like to know why OMB doesn’t have even a ballpark estimate. It would seem logical that actuaries have calculated the prevalance of Hep C in a given population, and surely there are per-patient average treatment costs.

Regardless, it’s still the same old adage: You can pay me now or pay me later, and if you pay me later, the bill is going to be a lot higher.

Comment by Common Sense Wednesday, May 27, 15 @ 10:12 am
“You can pay me now or pay me later, and if you pay me later, the bill is going to be a lot higher.” Yup, like Pension payments, or Medicaid, or education or drug rehabilitation or . . .

The point was that R’s simultaneously railed against out-of-balance while pushing for something that was out-of-balance.

Comment by Skeptic Wednesday, May 27, 15 @ 10:20 am
As usual, both sides of the aisle, talking out of both sides of their mouth

Comment by challengerrt Wednesday, May 27, 15 @ 10:32 am
Picky, picky, picky, Rich.

You still gotta sweep up the floor, while the elephants dance in the ring.

Comment by walker Wednesday, May 27, 15 @ 10:33 am
To say that the impact would be $8.5 million is on the low end. You have to remember that the new Hep C drug is $100,000 per year for treatment. That is only 85 new cases per year and if you are talking about screening everyone (12.5 million population) with a +/- of 1% incidence you are a talking about a big enchilada.

Once again, unintended consequences of legislation. Don’t these folks ask any questions??

Comment by BIG R. Ph. Wednesday, May 27, 15 @ 10:37 am
==I think that there are much better examples of fiscal insanity. What’s missing here is the cost of treating Hep C once it gets to an advanced stage. … Regardless, it’s still the same old adage: You can pay me now or pay me later, and if you pay me later, the bill is going to be a lot higher. ==

Well, duh, but is there any issue for which this isn’t true?

Infrastructure, education, preventative medicine, mental health and drug treatment, Medicaid dental, environmental regulation/cleanup, mild-to-moderate developmentally delayed children…oh, and fully-funding those pensions…?

Sorry to invoke a certain politically-connected organization making this point, but to quote Ben Franklin, “An ounce of prevention is worth a pound of cure.” It’s not just true for somebody’s pet Hep C cause.

And it’s not a new idea. It’s a wise idea. One most of us want our government to adopt.

But when you’ve made it crystal clear that your party intends to play the short game, slashing and burning worthy programs now while ignoring long-term fiscal sense?

And when you’ve hired a quarterly-earnings-driven flipper to run the state?

No, you don’t get to hide behind long-term benefit on one little pet project.

The entire problem is that these people aren’t in it for the long haul (except for when they are because it suits their purposes).

Comment by crazybleedingheart Wednesday, May 27, 15 @ 10:50 am
@big r:

You are in the ballpark about the cost of the Hepatitis C meds. The cost of that treatment is still less than not screening and treating full blown Hep C.

Please review the current guidelines for Hep C screening before making the irrational comment that everyone in
Illinois be screened.

Comment by Jack Stephens Wednesday, May 27, 15 @ 10:52 am
No pension holiday? snark

One could say we are making progress. semi snark

Comment by facts are stubborn things Wednesday, May 27, 15 @ 11:01 am
@crazy:

Ever drive under the CTA tracks on Hollywood? Guessing Bruce has done a cost/benefit analysis for Illinois Inc and probably cheaper to settle the lawsuits than fix it.

I’m agreeing with you.

Comment by Jack Stephens Wednesday, May 27, 15 @ 11:01 am
I’m rooting for Durkin and Radogno, but the choices, or the decisions, or the lack of awareness at times has me puzzled.

It does go back to the idea/ideal of automomy; rational thought sometimes runs counter to what is expected and what is actual.

Comment by Oswego Willy Wednesday, May 27, 15 @ 11:36 am
Well said, Rich.

Comment by Formerly Known As... Wednesday, May 27, 15 @ 11:42 am
@OW11:36 =I’m rooting for Durkin and Radogno=

I used to use that term as in “I’m rooting for the Bears against Green Bay”. A co-worker whose wife was from Australia told me that term has a very different meaning down there.

I now use the term “I’m cheering for the Bears against Green Bay.”

Comment by DuPage Wednesday, May 27, 15 @ 12:22 pm
- DuPage -,

I’m struggling with one form of the English language, now you have me worried about my global footprint? lol.

To all the Aussie commenters I made uncomfortable; I’m sorry.

Comment by Oswego Willy Wednesday, May 27, 15 @ 12:32 pm
Agreed that this might appear to go against political rhetoric, but it is, actually, a good thing when you take the long view. It is hard to argue that it doesn’t make sense for taxpayers, and so when something like this happens, I think that we should applaud and call it good news, of which there is entirely too little coming from the statehouse.

Sometimes, it seems, the pols can’t win for losing. They argue and bicker and quagmire themselves and get criticized for it. Then they agree on something like this, something progressive, something that makes fiscal sense in the long term and pass it with votes from both parties. And get criticized for it.

I prefer rational public policy over short-term political rhetoric, so I’m counting this as a win all around. They actually did something that might just matter. Who can criticize that?

Comment by Common Sense Wednesday, May 27, 15 @ 12:53 pm
I wish I could say that Rich’s example is an isolated example, but it’s not. It’s a variation of the old theme that when you do it, it’s bad, when I do it, it’s good public policy. I can’t help but laugh to myself whenever I hear a legislator lashing out at the irresponsible spending by the General Assembly when I know that same Solon voted for new programs/changes that raises spending.

Comment by Norseman Wednesday, May 27, 15 @ 12:53 pm
OR…you could agree on something and start somewhere. I always admire your attempt to play down the middle, but this one’s a real reach.

Comment by A guy Wednesday, May 27, 15 @ 1:17 pm
===OR…you could agree on something and start somewhere==

This wasn’t a “start” of anything at all.

Comment by Rich Miller Wednesday, May 27, 15 @ 1:18 pm
It’s not the start of anything at all–unless you have Hep C or loves someone who does. And there’s also the argument that $8.5 million spent now can save tens of millions down the road, but we’ve beaten that horse already.

Sorry. It sounds like a start to me, albeit not, perhaps, in the way some people analyze things.

Comment by Common Sense Wednesday, May 27, 15 @ 1:57 pm
===This wasn’t a “start” of anything at all.===

Or an ‘end’. Maybe just some vacuuming that needed to be done and no one decided to hold it hostage. A slim ray of hope for some.

Comment by A guy Wednesday, May 27, 15 @ 2:23 pm