Bravo, Gov—we hope ...

Editorial - November 2005

Some things we know about health care and kids: •  253,000 children in Illinois lack health insurance.

•  Kids who do not have health insurance are less likely to get preventive care and regular checkups.

•  Kids who don’t get regular health care are more likely to get sicker and end up in the emergency room.

•  Sicker kids are more likely to miss school and less likely to do well on standardized tests.

•  Parents of uninsured kids are more likely to miss work to care for that child and struggle to pay for medical care.

•  Health care costs are a leading cause of bankruptcy among middle-class families.

This is a vicious circle that must stop.

We think Gov. Blagojevich has come up with a way to halt this downward spiral into illness and financial ruin: affordable, state-sponsored health insurance for every uninsured child in Illinois, including children whose families make too much money to qualify for government assistance but not enough to pay the medical bills.

It’s a great idea. No question. And at a time when other governors are kicking people off Medicaid, we applaud Blagojevich for making health care a priority. He doesn’t have to do it. Who cares if he gets political points because Illinois would be the first state to provide, in essence, universal health care coverage for kids? He deserves it if these kids get health care.

We think that’s great. Good for him. It takes a leader to say kids are important.

But it also takes leadership to get people to rally around a cause, and Blagojevich has done a lousy job of getting the public health and government communities on board.

We have a lot of questions because we are not sure of the details of his plan. No one is.

The theory is the Medicaid families would move into "primary care case management." That jargon means low-income families would get a family doctor—not an HMO—and preventive care. The idea is to keep them from ending up in the emergency room with an untreated health emergency. The governor projects this would save $56 million in the first year—$45 million of which would be used to cover middle-class kids who have been uninsured for at least six months. Their parents would still pay premiums on a sliding scale based on their income, but at a livable cost.

Again, that’s the theory. But as to the practice, our questions include:

•  What’s the plan to make sure low-income families who switch health care providers understand the new system? Without the necessary education, they could revert back to their expensive old standby: the hospital emergency room.

•  What about community health centers? Are they going to take a hit under this plan and not get reimbursed when they do what they have been doing for years—providing a safety net for low-income families?

• 253,000 children in Illinois need health insurance—a number that could grow if the Bush administration proceeds with its threatened Medicaid cuts. Will this plan cover all these kids? And, if Medicaid is cut, would that undermine the funding for this program?

The governor’s "All Kids" plan is before the legislature’s fall veto session as we go to press. While we are not fans of slamming major programs through the short veto session where discussion is at a minimum, it seems to be the only way Big Idea Issues get passed in Illinois.

We believe this program should be approved. Its goal—to provide health insurance to every child in Illinois, regardless of income—is our goal.

So, Governor, details, please give us details and answer the questions of the health policy experts who worry your proposal to insure middle-class kids will come at the expense of low-income families who depend on Medicaid.

And to those experts, agencies and advocates questioning the plan, we say: Questions are great. But start working with the governor to figure out how to make this plan work and support it.


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