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Protest threat of city health clinic privatization

City clinic clients and community supporters will protest Tuesday against the threat of privatization at an event where Mayor Emanuel and Health Commissioner Bechara Choucair are speaking on “Transforming Healthcare in Chicago.”

Southside Together Organizing for Power and others – who stopped city efforts to close mental health clinics two years ago – will rally at 10 a.m., Tuesday, August 16, at the University Clulb, 76 E. Monroe.

Emanuel is said to be set to unveil a plan for the city’s health services next week [correction: it’s being released Tuesday, August 16].  In July he said he’d identified millions of dollars of savings by ordering city health clinics to partner with federally-qualified health centers, private nonprofits that operate clinics under federal grants and guidelines.

No details on how those savings would be accomplished have yet been forthcoming.

But last month, the city’s labor relations director wrote AFSCME Council 31 saying the city is considering contracting out services provided by its community health centers – and that job losses for union members could be expected.

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Pay Day Loan Reform — and Alternatives

Two members of the Illinois congressional delegation are offering competing legislation to address predatory pay day lending, and local consumer advocates are lining up in support of Senator Richard Durbin’s bill and against one authored by Representative Luis Gutierrez.

Meanwhile, community organizations that provide financial counseling say much stronger protection against predatory lending is needed — while community credit unions are pioneering affordable alternatives to pay day loans.

Gutierrez’s bill, HR 1214, would limit interest and fees to $15 on a $100 loan, but since that applies to a single pay period, it amounts to an annual rate of 390 percent for a two-week loan, advocates point out. Durbin’s bill, SB 500, would cap interest for all consumer loan products at a 36 percent annual rate.

The House Subcommittee on Financial Institutions, which Gutierrez chairs, will hold a hearing on HR 1214 tomorrow (April 2).

That bill would provide congressional authorization “to a product that is not good for low-income borrowers,” said Lynda DeLaforgue of Citizen Action Illinois. “It sends a signal that this is a legitimate product.”

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County health cuts opposed

The Emergency Network to Save Cook County Health Services is calling on the County Board to reject health cuts when it votes on a 2009 budget later this month.

Quentin Young and other leaders from the coalition of 70 groups will speak at a press conference Wednesday, February 18 at 9:30 a.m. at the County Building.

At recent public hearings on the budget, county leaders repeatedly stressed that the health system would not be touched, said Patrick Keenan-Devlin of Citizen Action-Illinois.

But at last week’s finance committee meeting, after commissioners approved a 4 percent across-the-board cut to the County Budget that exempted the health system — and after five commisioners had left the meeting — an amendment cutting the health budget by 2 percent (or $14 million) was approved. The vote was 8 to 4, with 5 absent.

“In this economy, with people losing their jobs and insurance, we can’t afford a county health system that is just getting by,” Keenan-Devlin said. “We need to be investing in health care services, not cutting back.”

He praised the work of the health system oversight board appointed in 2008. They’ve launched a “very thorough” national search for a new health and hospitals CEO and begun studying reimbursement issues (and asking for a functional accounting system), he said. The budget they submitted in December restored some cuts in ambulatory clinics and some nursing positions and restored cuts to Cermak Health Services at the County Jail, where the oversight board is seeking to address accreditation issues.

On top of the “draconian cuts in 2007,” Keenan-Devlin said, “the system cannot sustain further cuts.

“We believe the money is in the system, and there’s no need for cuts like this,” he said, pointing to County President Todd Stroger’s projection of a 25 percent decline in sales tax revenues this year, which he called unrealistic and inflated.

County Board’s health reform plan blasted

Reports that Todd Stroger is giving up control of Cook County hospitals may be overstated, according to a coalition of health care and civic organizations.

Among problems with a new County Board proposal for an independent health governance body, announced this week by Commissioner Gregg Goslin, are provisions for Stroger to appoint all its members and for the County Board to approve its budget.

The proposal for an advisory committee to suggest members for the new health board is no more than window dressing, said Patrick Keenan-Devlin of the Emergency Network to Save Cook County Health Services.  Stroger “would not be required to adhere to the committee’s suggestions,” he said.

Allowing the President of the Cook County Board to appoint all members of the new board “will leave it beholden to his interests,” said William McNary of Citizen Action/Illinois. “The Goslin plan would only continue the status quo, which is rapidly weakening America’s second-largest public health system.”

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Medicare Drug Plan: More Trouble

With a new round of difficulties expected when the new Medicare Part D drug program’s transitional period ends April 1, consumer advocates have launched a “Campaign to Fix the Part D Disaster” and released a study showing that Illinois seniors and taxpayers could save billions of dollars if Medicare was allowed to negotiate prices with drug companies.

Meanwhile, service providers in the Make Medicare Work Coalition, consisting of hundreds of public and nonprofit agencies which have been counseling seniors and people with disabilities regarding drug plan options, will hold a summit meeting March 31 in Oak Brook.

On April 1 the plan’s transitional period ends and insurance companies will stop paying for drugs not on their formularies. “We expect to see a spike in issues when people realize their plans don’t cover all the drugs they take,” said John Coburn of Health and Disability Advocates, one of the conveners of the Make Medicare Work Coalition.

Many will have to undertake the effort of filing for appeals and exceptions, and some of these will end up in federal court, said Lynda DeLaforgue of Citizen Action/Illinois, which is spearheading the Fix Part D coalition.

“So we’re back in an HMO-type situation, with insurance companies overruling doctors’ prescriptions and making medical decisions for patients,” DeLaforgue said.

Also in April, thousands of seniors who qualify for Medicare’s “extra help” program will be automatically enrolled in drug plans, potentially repeating the chaos that ensued from automatic enrollment of low-income seniors in January.

DeLaforgue said many seniors are now experiencing “sticker shock” and finding themselves in the plan’s “donut hole” — where they pay for 100 percent of drug costs — much sooner than they expected.

Us. Representatives Jan Schakowsky (9), Danny Davis (7), and Dan Lipinski (3) joined groups representing consumers, seniors, and labor at the launch of the Campaign to Fix Part D on March 27. They released a report by the Institute for America’s Future which says Congress’s failure to provide a Medicare-administered drug plan option and its prohibition on negotiating drug prices will cost Medicare beneficiaries and taxpayers in Illinois $32 billion over the next decade.

Most of that amount comes from higher drug prices, said Jeff Cruz, co-author of the report. The current program “does nothing to keep prices down, in fact it encourages them to raise prices,” Cruz said, noting that the Congressional Budget Office has projected drug price increases of 8 percent a year, more than double the rate of inflation. Negotiated prices would keep increases closer to the rate of inflation, he said.

Cruz cited a Consumer’s Union report projecting that by next year, the average Part D participant who had no previous drug coverage will be paying more out-of-pocket for drugs than they did in 2003 without the plan.

The Campaign to Fix Part D is calling on Congress to require Medicare to negotiate drug prices, establish a Medicare-administered plan as an alternative to private plans, and prohibit insurers from dropping medications from their formularies during enrollment terms. The group is calling for extending the deadline for enrollment and closing the “donut hole” in Part D coverage.

DeLaforgue notes bipartisan concerns about Part D raised in the recent congressional budget debate, with resolutions passed by the Senate advocating extending enrollment and negotiating prices. She said President Bush has opposed extending the deadline and House leadership has “dug in their heels” on any changes in the plan.

“We will be working in Illinois congressional districts this summer,” she said, listing Mark Kirk(10), Jerry Weller (11), and Speaker Dennis Hastert (14) as “members of congress who especially need to hear from us.”

Meanwhile, hundreds of service providers are signed up for the Make Medicare Work Coalition’s 2006 summit, 9 a.m. to 3:30 p.m. on Friday, March 31 at the Doubletree Hotel in Oak Brook. The coalition is a collaborative project of Health and Disability Advocates, Progress Center for Independent Living and the Suburban Area Agency on Aging.

So far Part D is a good deal for people who didn’t have coverage previously, said HDA’s Coburn. “It’s better than paying 100 percent yourself,” he said. For people who had coverage, especially low-income people and people who are sick or have disabilities, “the transition is extremely rough,” he said. “It’s the most vulnerable who have been impacted most negatively.”

For Coburn, one “untold story” is the role of social service agencies who have been consumed with counseling seniors and people with disabilities. While Medicare has provided some agencies with funding for counseling, many nonprofits have taken on the task without funding.

“We all had full workloads before this,” he said. “At one point we were doing more than just counseling people on drug plans.”

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