House District 59 candidates voice opinions on Medicare

Health care reform is certainly on the minds of the five candidates running for the House District 59 seat.

They agree the state costs for Medicaid are out of control, and late payments are making life difficult for providers.

Democrats state Rep. Carol Sente of Vernon Hills and Buffalo Grove Village President Elliott Hartstein and Republicans Dan Sugrue and Mohan Manian, both of Green Oaks, and Cynthia Hebda of Vernon Hills agree something needs to be done, but differ on what.

Democrats Sente and Hartstein say they are taking a wait-and-see position. Both candidates say the jury is out as to whether money could be saved by privatizing patient services.

"There are conflicting accounts about whether or not large amounts of money can be saved from moving the Illinois Medicaid system to a managed-care structure," said incumbent Sente, 48. "I believe it is the duty and responsibility of the General Assembly to address this issue head-on when we return to session. The legislature needs to make a determination and then move in the direction that brings the most savings to the state."

Hartstein, 61, says the idea of health care reform has merit but worries about the quality of care when profit is the bottom line.

"I do have a concern that some private providers are going to be more concerned with their bottom line than in providing comprehensive, good care at reasonable cost," Hartstein said.

"If explored, I believe participation needs to be optional with provisions to insure enrollees in a private option get comparable coverage and do not incur more out-of-pocket costs than in regular Medicaid programs."

On the Republican side, Sugrue, 46, says there are ways to reform Medicaid without sacrificing quality care.

"We can implement a managed-care system where reimbursement to providers is tied to performance and outcome," Sugrue said. "We can move away from high-cost, state-operated institutions for long-term care toward lower-cost community care. We can contain pharmacy costs by expanding purchasing pools. We could also look at reallocating much of Medicaid spending into vouchers for low-income individuals to allow them to purchase their own insurance. An income-based voucher program could eliminate the massive bureaucracy involved in providing Medicaid services right now."

Manian, 45, proposes a four-pronged approach to solving the Medicaid issue. "The state of Illinois should provide services only required by federal guidelines. There is no need for any other coverage. Also, recipient eligibility should be determined yearly by the department," Manian said. "Each recipient should be required to have an ID card with their photo, programs eligibility and expiration date in order to avoid confusion and misuse and abuse of the programs. Officials need to also enforce the $2 or $3 co-pay requirement in order to avoid the misuse."

Hebda, 53, says there is a potential savings in privatizing some services, but the state needs real action, not just talk on the issue.

"The legislature must do more than just embrace the rhetorical advantages of contracting and privatization and must pay close attention to the reality of contracting in a questionable economic and managerial environment," Hebda said. "Accountability must be a key considered factor. There are numerous examples of managed-care costs exceeding those of state programs. Specific services need to be evaluated against experiential results from other states and only those that have favorable cost performance under a managed care approach should be undertaken."

Hebda's position on the ballot is in jeopardy after a petition challenge. An appeals court will decide whether she remains on the ballot.

The primary is Feb. 2. The winner of the Democratic primary will face the winner of the Republican primary in the November general election.

The 59th District includes portions of Buffalo Grove, Green Oaks, Gurnee, Indian Creek, Lake Bluff, Lake Forest, Lincolnshire, Long Grove, Mettawa, Mundelein, Northbrook, North Chicago, Park City, Riverwoods, Vernon Hills, Waukegan and Wheeling.