Letter to the Editor

There was a time in my life when I agreed with so many people about individuals on Medicaid and who should be paying. However, today, in my Lawndale community I see mothers and fathers working two and three jobs, wanting a piece of the American dream for their children, with Medicaid or no insurance at all. Many of you are missing the real issue. In Illinois some people are dying and others are getting sicker because of our Medicaid system.

I am the first, American-born child of Italian immigrants. I grew up in the inner-city of Cleveland, in a neighborhood that was a cross between Little Village and North Lawndale. My father had two and sometimes three jobs to go to everyday except Sunday, when our family went to church. The bottom line is that we had very little money to live on, and I couldn’t wait to get out!

Getting out wasn’t close to being easy, but since then life has been good to me. Over time, I must have forgotten my past and considered myself better than the people I grew up with. Eventually, I, too, believed I paid high taxes. I had no idea what Medicaid was, and I didn’t understand why I had to pay for someone else’s free ride.

Today, however, I see mothers and fathers in my community still working two and three jobs with Medicaid or with no health insurance. I see kids growing up like I did, wanting to get out of their neighborhoods to succeed. Do they want to be on Medicaid or state assistance? For the majority the answer is no.

Yes, the State of Illinois has a spending problem, and, yes, it is a difficult challenge to fix the mess that has been building for years, and, yes, it must get fixed quickly.
But what about the other issue, the people of Illinois, the hard-working families in my community and communities similar throughout the state? It’s easy to say make the hard decision and cut healthcare because at the State Capitol these cuts/decisions don’t have a face. It’s easy to make financial decisions when you can’t see the face of pregnant women, developmentally delayed children, chronically mentally ill adults, and persons with disabilities who cannot care totally for themselves and don’t have anyone to care for them. The real fact is in Illinois people are dying because of our Medicaid system. Yes, that’s correct, some people are dying and others are getting sicker! I see it time after time from where I stand today.

Some, not all, hospitals don’t want to treat Medicaid recipients because of the relatively little they receive from the State in reimbursement for the costs of treatment. Some hospitals will treat a token handful of Medicaid patients but not 60 percent, 50 percent, or even 30 percent of their patient volume. Hospitals want patients with commercial insurers that reimburse them 100 percent or 122 percent of their costs. Physicians want the same. After paying their malpractice, office staff, rent, and other expenses, they cannot afford to treat Medicaid patients. It just doesn’t pay. The Director of Healthcare and Family Services knows this because she has been quoted in the papers as being concerned that physicians are moving away from treating Medicaid patients.

Is the system fair? No, and I don’t expect it will ever be. But let’s not forget the human lives we are dealing with. If I could afford to hire all private physicians and treat the members of my community off of what Medicaid pays and still give my employees an annual three percent cost of living increase, update equipment, cover the increase in employee benefits cost, utilities and other expenses, it would have already happened.

This is not about legislators, the Governor, the HFS Director, or me. Let’s remember the face behind the issue. This is about families, parents, and children living in a country that takes care of others who are less fortunate until they can rise up again. Having Medicaid is not an insurance plan you would expect or desire to have; for those who have it, it is a necessity to live.


Guy A. Medaglia
President and Chief Executive Officer
Saint Anthony Hospital
Chicago, IL

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