Candidates differ over how to fund health care

By Rick Pearson, Tribune political reporter. Tribune staff reporter Ray Long contributed to this report

With health-care costs for the poor and elderly taking up a larger share of the tight state budget, the candidates to become Illinois' next governor face a difficult task in reconciling need and cost.

In responding to the fourth in a series of Tribune questionnaires on issues facing the state, the contenders for governor on the Nov. 7 ballot offer vastly different views on state-financed health care, which is now taking up more than a quarter of the state budget.

The incumbent Democratic governor has expanded availability of services. His Republican challenger wants to curtail costs. And the Green Party candidate advocates a universal single-payer system, run by the government, for all Illinois residents.

Gov. Rod Blagojevich has sought to make health care a signature issue of his first term, from expanding availability of care to women and seniors to his All Kids state-subsidized plan for affordable health insurance for children.

"All Kids makes comprehensive health insurance available for all children--regardless of family income--with parents paying monthly premiums and co-payments for doctor's visits and prescription drugs at affordable rates," he said.

But Republican Judy Baar Topinka contends that All Kids is an example of Blagojevich expanding programs at a time when the state lacks the revenue to pay for them. She has proposed continuing the program but instituting a family income limit for eligibility.

"It is not fair to ask families making $30,000 to subsidize the health care of families making $150,000," Topinka said. "I support a $100,000 income cap to ensure state dollars are used for those who truly need help."

Blagojevich, however, opposes any form of "means testing" because the program is aimed at helping uninsured children regardless of family income.

Richard Whitney, the Green Party candidate, said he found it difficult to be objective about All Kids because "the genuine good intentions underlying the program have become so intertwined with shameless political self-aggrandizement."

Rather than trying to address what he contends are shortcomings in All Kids, Whitney said a patchwork of health programs is "misguided and administratively inefficient" and should be replaced with a single-payer system that still allows individuals to choose their own provider and services.

Topinka and Whitney contend their plans to raise state revenue would generate funds to help deal with a huge backlog of payments owed to health-care providers under Medicaid, the state and federally funded program for the poor and elderly.

Topinka has proposed a land-based Chicago casino and expanded gambling at existing casinos to generate more money, while Whitney backs a "tax swap": higher income taxes and a cut in local property taxes.

Blagojevich contended that Topinka's actions as state treasurer to try to block his transfer of earmarked dollars to Medicaid has exacerbated the large debt he inherited from his predecessor.

"We are committed to paying Medicaid providers and providing health care to those who need it," Blagojevich said.

Topinka is alone among the three in proposing steps to reduce Medicaid expenditures by $2.9 billion. She has called for tightening eligibility for the program and seeking block-grant funding from the federal government to provide more leeway to make Medicaid changes. She has said her plans would not toss currently eligible residents off Medicaid rolls.

"My plan will ensure Medicaid patients continue to be served, keep costs under control through better management, ensure providers are paid on a timely basis and deliver better care," she said.

Blagojevich called Topinka's plan "devastating" and warned that her proposal to shave costs would end up with thousands of people being "cut off from vital service next year."

Whitney called reducing Medicaid eligibility "a horrible idea" and noted that "low-income uninsured folks already have a hell of a time getting through the wringer to qualify as it is."

Blagojevich defended his decision to allocate $15 million in state funds over the past two years to embryonic stem-cell research without direct legislative approval, saying that "if you truly believe in something, you have to use all of the tools at your disposal to do so."

Topinka said she supported state funding for embryonic stem-cell research but only if the money was available and was "obtained through a transparent budgeting process," not "deceptive tactics."

Whitney said he questioned the propriety of Blagojevich's unilateral actions and said he wanted to consult the medical research community to determine whether embryonic stem-cell research should be a priority for state money.

Topinka said she supported the recent decision by the Illinois Supreme Court to write rules for a 1995 state law that required parental notification before a teenager could obtain an abortion that was held in abeyance. She said the issue "is about the safety of children."

Whitney said he was concerned that the requirements could delay and "compromise the safety" of abortion procedures. He said he opposed parental notification laws.

Blagojevich said he considered the timing of the high court's action to be "somewhat unusual" in taking up the issue 11 years later, but said he is working with the attorney general's office to review the rules written by the court.

See the candidates' responses in their own words at chicagotribune.com/politics.

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