Commentary: A lesson from Illinois on health care changes
This article first appeared in the St. Louis Beacon, Aug. 16, 2009 - They came from sharply different perspectives, but somehow they managed to engage each other on health-care reform in Illinois without ending up in the hospital.
No flying fists. No kicks in the head. No blood or bruises. No death threats. No comparisons to Hitler. No swastikas and demonizing of serious proposals as "downright evil." No badgering. No raucous flexing of free-speech rights to smother those of others. None of the belligerence and foment that's been seen on the national health-care front.
They talked with - not at - those who disagreed with them. They confronted their differences civilly. They gave ground to gain ground. Through a series of often frustrating but ultimately fruitful negotiations, they fashioned and advanced legislation to empower consumers, cut paperwork for small business owners and bring more transparency to the insurance industry without the aggressive regulation it feared.
The measure, expected to gain final approval in the Illinois House this fall, would:
- Expedite the appeal process when insurance companies deny coverage to a policyholder for a procedure or treatment and broaden the authority of the state's Department of Insurance to reverse rejections.
- Require insurance companies to submit every six months - more often than in any other state - income and expenditure reports for posting on the department's website.
- Facilitate application for health insurance by replacing the current hodgepodge of forms with a uniform document - a move especially helpful to businesses seeking to compare prices without the headache and cost of completing widely varying questionnaires.
The announcement of the agreement among the disparate interests received scant notice. After all, it came as the General Assembly entered the final days of the spring session still grappling with a horrendous budget situation and intense pressure to sanitize state government. Moreover, the measure did not come close to approximating in scope, cost, impact and controversy the federal health-care proposals that merit enlightening discussion and probing evaluation in town halls instead of town brawls.
But the mayhem we are witnessing in cities and states throughout the land makes the pact reached in Springfield more - not less - relevant. It shows what people can accomplish if they do not succumb to viperous ministers of disinformation, rabble rousers across the ideological spectrum and political strategists who see partisan potential in polarization.
Initially, health-care advocates had sought to limit how insurance firms could spend their income, and they wanted even greater consumer clout to contest coverage decisions. Insurers prepared for war, while other businesses feared cost-shifting if the advocates prevailed. But Senate President John J. Cullerton and House Speaker Michael J. Madigan prodded the competing interests to work toward an accord.
Even before sitting down with the consumer advocates, insurers had to resolve differences among themselves. So did business representatives. However, aided by outcome-oriented legislators and the state's insurance chief, the diverse groups produced a solid product that cleared the Senate with overwhelming bipartisan support.
"It was a long, arduous process, but at the end of the day this was a significant accomplishment," said Mark Denzler, vice president of the Illinois Manufacturers' Association.
"After a number of meetings and negotiations, it felt really good for AARP and the other health-care advocates to stand with the business and insurance industries and not be against each other one more time as a legislative session ended," enthused Jennifer McDermott, who lobbies for the senior citizens' organization.
Although Denzler and McDermott will continue to have differences, they will attest that sensible policy can result when frequent adversaries seek ways to unite as well as fight.
It sure beats a kick in the head.
Mike Lawrence retired Nov. 1, 2008, as director of the Paul Simon Public Policy Institute at Southern Illinois University. He is returning to his journalism roots as a twice-monthly columnist.