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Rate issue is key, new medical society head says

Posted January 11, 2008 10:00 pm

Dean Olsen

Without a substantial increase in state payment rates to doctors, Gov. Rod Blagojevich's efforts to reduce the number of uninsured in Illinois won't bring better access to health care, the new president of the Illinois State Medical Society said last week.

"To enroll more enrollees in an unfunded program causes physicians a lot of concern," Dr. Rodney Osborn said during an interview at The State Journal-Register. "We agree with the governor that … we ought to be able to insure and provide health care for all, but how we get there is a major concern."

Without a boost in Medicaid rates - the money doctors receive for treating patients in the Medicaid, FamilyCare, All Kids and other programs - fewer doctors will accept new patients in the state-subsidized expansions favored by the governor, Osborn said.

Parts of the governor's Illinois Covered plan, which failed to win approval from the Illinois General Assembly in 2007, would provide state-subsidized insurance to many of the 1.7 million Illinoisans without health insurance.

The governor has pledged to put those parts of his plan in place even without legislative approval.

The other major piece of his plan, a state-regulated pool of affordable insurance plans, would require legislation, Blagojevich aides have said.

Osborn, a Peoria anesthesiologist who will serve a one-year term as head of the 13,000-member association - a powerful lobbying force in Springfield - said he and others from the Chicago-based group will push again for a Medicaid increase.

The society also will try to drum up public support for the state's current caps on medical malpractice awards while those caps are challenged in front of the Illinois Supreme Court, Osborn said.

Success on both fronts will help preserve patients' access to care, he said.

He noted that the state's Adequate Health Care Task Force supported a 78 percent increase in Medicaid rates in 2006.

In recent years, rates have risen in some cases for doctors treating children in the All Kids program, but Osborn said more is needed for those doctors, and increases are needed for doctors who serve adults.

Blagojevich earlier this year proposed a $90 million increase in Medicaid rates for health-care providers in the first year of Illinois Covered and up to $480 million more annually by fiscal 2011. Half of those costs would be covered by the federal government.

About half of the $90 million would go to doctors, giving them an average 17 percent rate increase, with the increase totaling 35 percent by the second year, according to Ruth Igoe, spokeswoman for the Illinois Department of Healthcare and Family Services.

"It's important to note that in the previous administration, rates for doctors, dentists and other specialists were cut by nearly 6 percent," Igoe said.

Deputy Gov. Sheila Nix told The State Journal-Register in November that Blagojevich plans to keep pushing state lawmakers for Medicaid rate increases as part of his attempts to expand health coverage.

"As we continue to expand, we want to work with the providers," she said.

The state medical society opposed the "gross receipts tax" on business that the governor proposed as a partial funding source for Illinois Covered, but widespread opposition killed that option.

The governor now plans a downsized Illinois Covered, funded totally with a 3 percent payroll tax on all employers of 10 or more that don't contribute at least 4 percent of their total payroll toward health insurance.

The medical society hasn't taken a stand on that funding source.

"There isn't a good mechanism to fund the uninsured, and it needs to be a balance between private and public," Osborn said.

On the issue of caps on malpractice awards, Osborn said he believes the current law, passed by the legislature in 2005, is constitutional despite a November ruling by a Cook County circuit judge overruling the caps.

Osborn said he hopes Illinois Supreme Court justices also consider public opinion and the law's effect in easing what had been skyrocketing malpractice-insurance rates.

"We believe this court, if it's objective and if it really evaluates both how the law is written and how it benefits the state, that they'll sustain the law and overturn the ruling of the circuit court," he said.

The 2005 law included a $500,000 cap on non-economic damages, such as pain and suffering, that victims can receive in malpractice cases against doctors, and a $1 million cap in awards against hospitals.

Dean Olsen can be reached at (217) 788-1543.

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