Politics                                                        

When the best is the enemy of the good By CHARLES N. WHEELER III

Years ago, a shrewd and seasoned veteran of the legislative wars offered a rookie reporter this sage advice: The best is the enemy of the good. More than two decades later, that aphorism remains sound counsel. As the legislature gears up for what its leaders hope will be the final month of the spring session, the quest for perfection could pose a threat to lawmakers' ability to reach agreement on a number of high-profile issues.

Consider, for example, perhaps the most vexing question before the legislature — how to fund medical care for the poor. For the last two years, the linchpin of Medicaid funding has been an assessment program that levies a tax on hospitals and nursing homes and uses the proceeds to leverage additional federal dollars. The program has been a fiscal success, helping to produce some $1.3 billion to spend on health care for poor people this budget year, after which it's scheduled to end.

But it's also been very controversial because providers serving few welfare recipients generally pay in more than they get back, with the losses passed on to private-pay patients. For nursing home residents, that can mean as much as $2,300 a year in additional costs, dubbed a "granny tax" by scornful lawmakers.

Next year's budget is counting on some $1.4 billion from a similar program, but includes no details on how the state share will be raised. Instead, Gov. Jim Edgar wants to see if the Clinton administration will grant states greater leeway in raising matching dollars for Medicaid. Under the best of circumstances, of course, Washington would grant Illinois' fondest wish — approval for an assessment program that guarantees that every hospital and nursing home gets back at least as much as it puts in.

Federal approval for a hold harmless program is unlikely, however, so whatever plan lawmakers and the governor devise seems certain to contain a Robin Hood aspect — some will pay more, but receive less benefit, than others. In that case, the best funding source — assuming that health care for the poor is a broad societal responsibility — would be a general tax, rather than one imposed only on health care providers and largely borne only by their private pay patients. Indeed, that's the approach favored by some lawmakers who've proposed restoring the state sales tax on food and drugs, or expanding its base to include a host of services, as a replacement for the detested "granny tax." But the governor has promised to veto any general tax increase — in the unlikely event one were to reach his desk — and legislative committees have rejected proposals broadening the sales tax base.

With the "best" solutions thus out of reach, lawmakers must be willing to settle for the "good." That means keeping the current program, perhaps modified to ease the burden on nursing home patients. Whatever its flaws, the provider tax is still preferable to the catastrophic impact the loss of $1.4 billion in Medicaid funds would have on hospitals and nursing homes caring for the poor.

Medicaid funding is not the only issue, of course, where devotion to an impossible best can thwart an achievable good. Indeed, one suspects that lawmakers at times choose the best merely to block the good. That scenario could be developing in the case of another key issue this spring, ethics legislation.

A spate of newspaper reports detailing ethical lapses helped produce more than 70 reform measures this session, the most introduced in many a year. Moreover, majorities in both the Senate and the House promised to support ethics legislation, according to Illinois Common Cause, a citizens' watchdog group which collected signatures from 60 current House members and 33 current senators for its "Anti-Corruption Pledge."

Yet as the deadlines passed for committee action in each chamber last month, there was a real possibility that significant reform might be stymied by lawmakers intent on strengthening the

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The proposals are good government ideas, to be sure, but all have their detractors. When they're piled together into one bill, its chances of reaching the governor's desk are greatly reduced.

In the House, meanwhile, only vehicle bills — ones making no substantive changes but available for amendment — survived the committee round, with Democratic leaders pleading more time was needed to review the various ethics proposals.

The lone bright spot in the early going came when the Senate Executive Committee voted to tighten the state's current lobbyist registration act, so loophole-ridden that lobbyists for the Chicago casino complex reported spending less than $24,000 last year to woo lawmakers, even though developers said they spent more than $5 million to push the plan. Under terms of the reform legislation, registration and reporting requirements would be expanded to provide a more accurate picture of the role lobbyists play in influencing state decisions. As noteworthy as the strength of its provisions was the measure's bipartisan political support, auguring well for its future prospects.

A month or more remains, of course, for lawmakers to hammer out legislation that provides meaningful reform yet can command legislative majorities in other ethical areas, such as campaign financing and state contracting practices. A package that's too strong to pass, however, is nothing but a public relations stunt, an example of how the search for a perfect answer can leave the question hanging. *

Charles N. Wheeler III is a correspondent in the Springfield Bureau of the Chicago Sun-Times.

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