Health Care for All: The Time is Now

Illinois’ Governor Announces Historic Plan to Cover Everyone

Governor Rod Blagojevich’s State of the State and Budget message contained a bold and historic plan to repair the health care system in Illinois.  His highly credible mix of public and private sector strategies would offer comprehensive health care at an affordable cost to every Illinois resident, regardless of income level or prior medical condition.  Illinois Covered will result in increased stability and cost controls in the whole insurance market, which benefits everyone – the insured, employers who offer insurance and the uninsured alike.

The time for comprehensive health care is now, and the Governor’s plan is just in time.  There is deep anger and anxiety in virtually every household in Illinois over the cost of health care, the availability of health insurance, and ultimately access to good quality medical care. 

Medical-related debt is a top cause of personal bankruptcies, and most of those bankruptcies involve people who had insurance. People with insurance pay $1,000 more every year in premiums because of cost shifting needed to provide emergency care to the uninsured.  To manage the expense, employers are increasing the employee share, increasing the co-payments, reducing coverage, or dropping health insurance altogether. 

By offering coverage to everyone, the Governor’s plan will significantly reduce the number of people receiving care that do not pay, which will reduce or perhaps eliminate cost-shifting and upward pressure on premiums.  By making coverage affordable for everyone, the Governor’s plan ensures that on-average healthier employees will continue to participate in employer-sponsored plans.  This means those plans will have fewer claims per participant, further reducing the upward pressure on premiums. 

The Governor’s plan will emphasize prevention and maintenance care, which prevents or minimizes serious conditions.  Additionally, the Governor’s plan has an “employer assessment” that makes sure those employers of more than 10 who do not offer health insurance will help to pay for the health coverage system.  This evens the playing field for employers who offer insurance.

This system costs money, an estimated $2.5 to 3 billion when fully implemented several years from now.  But the current system also costs at least as much money (for emergency care, charity care, delayed care, lack of preventive care).  The Governor’s plan ultimately is about how and when to spend money on health care – not whether to spend it.  Reform costs money, and this means new revenue streams are needed.  Polling shows that people understand and expect this.

The Governor has proposed a “gross receipts tax”, which is a small percentage of all business income that replaces the corporate income tax.  Small businesses (under $1 million in gross receipts) are exempt, as are products sold for export and retail food and drugs.  The gross receipts tax has at least two main attractions:  it produces a reliable stream of revenue that is adequate to fund the health care system and other important state priorities; and it will grow as and in the directions that our economy grows, so it offers long term sustainability.

People who oppose health care reform because of the funding proposal will miss the point and become politically vulnerable.  Most voters want real health care reform and are willing to pay for. Political leaders shouldn’t question if we are going to create a system that works, the question is how we are going to do it.  The demand is clear: Find the money and consider that the true cost of inaction will be over $30 billion over the next ten years.

The Governor has done this. Those who see it differently should put their ideas on the table but keep in mind it is not an option to stand in the way of health care reform because of squeamishness about paying for it. 

The problem of health coverage concerns all-- those with insurance, and those without it. In addition to the human and social cost, bearing the expense of the uninsured is now a major part of the cost of doing business in Illinois. But no matter how steep the price of insuring all, the cost of doing nothing is greater than the cost of investing in the economic health of our state.