1. - Cassandra - Thursday, Dec 20, 07 @ 10:40 am:

   No, patients won’t die if there are 10 percent cuts. The county medical services need to start sending out bills. It’s just that simple.

   Only under extreme pressure will Stroger Hospital and its associated hospitals and clinics start actually billing patients for their care. And I’m not talking about the ones without insurance including the ones with substantial assets who don’t bother to purchase insurance they could well afford.

   Stroger’s armies of patronage employees “working”
   in its health bureacracy need to actually bill patients with insurance. How hard can it be?
   And while they’re doing that, they can figure out
   a way to bill the wealthy counties surrounding Cook who send their indigent patients to Cook County for medical services. There is a reason these counties are wealthy, and one is that they cheap out big time on medical care for their indigent, uninsured population. But even if they were begging to be billed (and there are stories of individual, insured patients begging Stroger to bill them, please) it might just be too much for
   John and now Todd Stroger’s patronage armies.




2. - Six Degrees of Separation - Thursday, Dec 20, 07 @ 10:57 am:

   Pensions are constitutionally protected in IL, health benefits for pensioners are not.

   Therefore, there is little opportunity to reduce the costs of actual pensions in the coming years (with the possible exception of moving future employees to a defined contribution plan). However, as the # of state workers is going down, this will create other problems.

   Scenario 1. Under a defined contribution plan for new employees, these new employees will not contribute any money into the old system, cutting off an existing revenue source for the old pension system.

   2. If the system is kept as a defined benefit system, the reduced # of employees will again diminish a revenue source for the pension system, and the pension liability for old and new employees will continue to accrue. It is unlikely that the employee contributions can be jacked up high enough to make a big difference in the pension liability.

   Therefore, the greatest opportunity for reducing total pensioner liability is in reducing health care costs. Look for the state to move all employees and retirees to a managed care system, to put a greater % of payment responsibility to the employee or retiree, and other methods. Of course, if a national health care solution including state employees/retirees reduces state costs, it may come with less effort required on the state’s part.




3. - 7 degrees of Separation - Thursday, Dec 20, 07 @ 11:19 am:

   I do not usually comment and I am not a fan of the guv, but McQueary’s statement that the guv will give a sunny perspective of the systems is false. He hasn’t in the past so why now? Anyone remember this years State of State? McQueary obviously doesn’t. I am enjoying the guv bashing but lets be fair.

   Also I do not have time to explain to 6 degrees that DC plans won’t reduce state costs, but that is an old argument proven wrong by many pension groups and editorial boards. It is another example of a poorly thought out GOP argument. It certainly has more merit than their transit proposals, but not by much.




4. - Cassandra - Thursday, Dec 20, 07 @ 11:21 am:

   I did notice that the Pew report takes note of something I have been talking about for years…increasing resentment on the part of privately employed citizens who don’t have employment related health insurance and must pay not only for their own but for comparatively lavish coverage (with no strings, like premium increases if you actually get sick and no coverage for pre-existing conditions) for federal, state, and local employees.

   The solution is not to end public employee health insurance…although many of them should pay higher premiums based on those growing federal and state salaries with lifetime job security. The solution is to give all American citizens the same
   level of health insurance and the same menu of health insurance choices as we shower upon our local, state and federal employees. Happily, more citizens are actually beginning to see the huge inequity between publicly and privately employed citizens in this country with respect to access to health care.




5. - Princeville - Thursday, Dec 20, 07 @ 11:33 am:

   Six Degrees–the state would not be were it is in the pension funding had the state would have stopped robbing the funds. A large share of state workers are on HMO programs, it is the Quality Care type that cost the most in health care. On the other hand, HMOs are not all equal in timely payments, willingness to pay ect. Jacking up the cost of some of these will make them out of reach for many state workers. And you will notice that I make a direct point in usage of worker or employee as the worker is the bottom front line that does not get the wages that the ’sterotyped’ employee gets.

   There was a time as a state worker family, I could not afford state employee health insurance for my family. The actual worker had insurance, myself and children did not-I ended with paying $20,000 in health bills out of pocket and was at that time lucky enough to make weekly payments. Between what I pay now for our HMO plus the copayments for services and prescriptions is about all I can manage now. And as my husband has been with the state for 30 yrs, he makes more than most younger workers. A year ago during a ‘bad’ month I put out $1000 in copayments plus my premium and copays have to be made at the time of service. Jacking my premiums by much will put me right back to having no insurance.




6. - Louis G. Atsaves - Thursday, Dec 20, 07 @ 11:40 am:

   In my primary field of law (Workers’ Comp) we are constantly asking Stroger Hospital for bills so that they may be presented to the Workers’ Compensation insurance carrier for payment.

   We get a lot of attitude, a lot of “it will take weeks and weeks to get one to you,” etc. etc. They make us feel like our request is a major imposition on them. When we call a private hospital, the turn around time is usually less than 24 hours.

   There is a lot of money out there the county could be collecting for their health system. They need to eliminate those with bad attitudes and get some folks in there who can start professionally billing.




7. - Danny Boy - Thursday, Dec 20, 07 @ 11:57 am:

   I have a question about the Gov’s plane flights. Flight Aware used to track all his flights, as well as IDOT’s plane fleet. Since all the debate about all the state air travel the proverbial beacon is nonexistent on Flight Aware. Does anyone know why? Did the administration pressure IDOT to stop filing flight plans? If that is the case, isn’t there a safety issue in not having a flight plan?




8. - Snidely Whiplash - Thursday, Dec 20, 07 @ 11:58 am:

   Stop ragging on the Dept. of Health employees! You’d better believe they work! They’re all out walking precincts and putting up signs! Do you think it’s easy trying to stay awake and look busy on the “job” when you’re spending your nights and weekends doing political work for two months every other year???

   That’s the whole point behind do nothing jobs.




9. - Rich Miller - Thursday, Dec 20, 07 @ 12:00 pm:

   Flight Aware is a private service. You can block your own plane’s tracking. Relax.




10. - cermak_rd - Thursday, Dec 20, 07 @ 12:02 pm:

    If the cost-benefit analysis shows that it is worth more to set up a billing system to collect from those who can pay or have insurance than it will cost to set such a system up, then yes, that would be a good decision.

    Another good thing they could do is screen patients for identification and deny non-emergency treatment to non-Cook residents.

    As for pension plans–absolutely if the state robbed pension plans (and it did) in the past then it has a moral and legal obligation to pay that back–even if it causes a tax increase. Robbing pension funds is just a case of pay me now or pay me later.

    While I agree with closing schools with declining enrollment, I find it odd that Duncan is citing their numbers (you need a critical mass to sustain a school) at the same time that his Ren2010 program is starting up a bunch of small schools.




11. - Likes small schools - Thursday, Dec 20, 07 @ 12:36 pm:

    My kids go to a small school with a total enrollment around 250. It is great. The smaller teacher to student ratio makes a huge difference. Particularly if your child has special needs or other challenges. The kids still do everything they do in a larger school, from PE and team sports to arts and music, to foreign language. Duncan’s unspoken agenda is that he’s in a volume business where he hopes economies of scale can save him some money. I’m glad my kids are not anonymous entries in a huge student body with 30-1 or higher teacher-student ratios. I’m paying extra to avoid that kind of “efficiency”.




12. - simon - Thursday, Dec 20, 07 @ 4:45 pm:

    why doesn’t anyone complain about “people dying” in other counties with no county hospitals much less three?




13. - Beancounter - Thursday, Dec 20, 07 @ 9:01 pm:

    Ahhhh, Cassandra. I try so desperately hard not to take your rants personally, as you surely must be a reporter for a tabloid. Your frequent use of words such as “lavish” and “lush” give you away. But I simply cannot ignore your most recent post: “the huge inequity between publicly and privately employed citizens in this country with respect to access to health care.” I am a State Worker. I have good benefits, I cannot deny. Thankfully, however, my spouse is Privately Employed. And his benefits kick my benefit’s butt. FREE dependent coverage, including for myself. That is, anything my insurance does not cover, his does. He is fully vested in a defined benefits plan. He also has a 401K to which the company contributes, whether he chooses to or not (he does). My son is covered, even though his biological father has coverage on him. My stepdaughter is covered (medical, dental, vision), even though she does not live with us. Even when the state sent a letter to his insurance stating that my husband was required to provide only medical coverage for his daughter, his insurance company replied that that was not a problem, but they would continue to provide dental and vision coverage as well. My husband works in a skilled trade. His job requires a great deal of technical knowledge (as does mine), and can also be very dangerous. His terrific benefits are the direct result of recent federal regulations that have guaranteed that skilled workers such as him will become increasingly scarce. So I have it good; he has it much better. We are truly (as a family) blessed.




14. - Pancake House - Wilmette - Thursday, Dec 20, 07 @ 10:51 pm:

    So if Rezko expense diggs are in foreclosure. Where does Mr. Moneybags living these days, thought was under house arrest to boot.

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