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For instance, one of the oldest maneuvers in the political playbook is to assert no new taxes are necessary because I swing a mean ax and I'm chopping out all the fat and waste. Rauner pulled this maneuver and the Tribune swooned. Said the editorial celebrating the governor's vigorous intentions:
Rauner asserts that if Illinois transforms how it does business, it'll have enough revenue to meet its needs: "How we spend drives how much we spend," he said early on, adding later, "We get these structural reforms done, and we'll have a lot of money." . . . With the savings, "think about how much more help we can give to our developmentally disabled, think how much more we can put into our schools, think how much more we can put into our help for our low-income kids, early childhood education."
Did it strike anyone on the board that this had the ring of chutzpah, this big talk about throwing money at programs that always get the short end of the fiscal stick and that you, the new governor, just said you want to gut? A few days later the Tribune would run an article in which providers of some of these services that Rauner wants to whack called the proposed cuts a good way to squander money in the long run. Take mental health. Illinois had already trimmed that expense by $187 million from 2009 to 2012, the Tribune reported, and now Rauner wants to cut $82 million more.
Providers of outpatient services told the Trib these cuts would drive their patients "to hospitals, nursing homes, prisons and jails, where treatment costs are higher." The CEO of Community Counseling Centers of Chicago reasoned that "you’re just going to move people from one system that's relatively cost-effective and inexpensive into a more expensive system."
I’m not saying it was the place of the editorial board to hold up a hand and say to Rauner, "Your so-called economies are bullshit." But did this thought flutter through anyone's head: "And so, for now, in the name of the greater good, the ones who always get screwed get screwed some more"?
Rauner's conversation with the editorial board turned to Indiana, whose business-friendly policies, the Tribune tells us, are eating Illinois's lunch.
Believe me, I am going to rip—try to rip—the economic guts out of Indiana. I am one of the baddest, you know, enemies anybody can have. And when I set a goal, we do it. I don't care what the headline is. I want the results. And we're coming after Indiana big time.
But no one talks out loud that way during a honeymoon.
And a day or two later, when Rauner told the Daily Herald that Illinois's supreme court judges—the ones who will soon decide if desperately needed changes in the state pension system are constitutional—are part of a "corrupt system" and he didn't trust them to be "rational," I wondered if any of those Tribune editorialists entertained the notion that this guy might be his own worst enemy and again felt the unease common to honeymooners who have just begun to entertain the possibility that they married a maniac.
Last month the Tribune ran an intriguing editorial that urged the governor to stay his hand. It was written on behalf of Lurie Children’s Hospital, though it began with a declaration that "this isn’t our special pleading for Rauner to go easy on one unhappy provider." No, said the Tribune, this is "a parable of how all providers can help a badly stressed state government reinvent how it spends money." Lurie, said the Tribune, "should be a model of how providers who rely on state dollars can look for ways to stretch fewer dollars."
What had the hospital done that delighted the Tribune? It had introduced a new way to oversee the care of children on Medicaid who require intense treatment and careful monitoring. Lurie was hiring "care coordinators"—that is, nurses and social workers—to keep close tabs on these children as they circulate among hospitals, clinics, and doctors, making sure that the kids and their families—to quote from the applauding Tribune editorial—"get the right care at the right time." Once up to speed, this program would oversee as many as 20,000 children, and Patrick Magoon, the CEO of Lurie, told the Tribune it would save the state as much as $53 million over the next five years. But those savings would be enjoyed tomorrow. If Illinois makes the Medicaid cuts Rauner has called for today, Lurie won't be able to afford care coordinators and there will be no program.
Short-term savings would be bought at the cost of sicker kids and greater long-term expenses. "The big picture here," said the Tribune, "is that managed care providers get paid to coordinate medical care and keep people healthy, reducing those expensive emergency-room visits and hospital stays: to save the cash-strapped state money and improve patient outcomes."
Maybe we shouldn't call it special pleading, but the Tribune bought what Magoon was selling. I can think of a few reasons for this:
The first is that he was selling a smart new program that deserves public support. The second is that Lurie flattered the Tribune. A hospital spokesman told me the Tribune had put out a call for new ideas for saving public money, so Lurie called the Tribune and said we've got a good one—check it out! The third is that a new program is a lot more exciting than an old one. Advocates of mental health programs also say slashing their budgets will cost Illinois more in the long run; but mental health advocates have been around forever and are easily tuned out.