September 15, 2003 - Illinois taxpayers pay $340 Million each year to pay for the medicines prescribed for the 240,000 state workers in the state and about the same for an equivalent number of local government employees. It, like many other states is saddled with a massive budget shortfall. One of Illinois’ primary sources of revenue is, of course, its state income tax. It is tied to the Federal Income Tax and the Republican tax cuts automatically cut Illinois’ revenue result. Coupled with the economic downturn the state’s budget was hard pressed on the revenue side while the State had to come up with the money for a massive pork-barrel spending plan - out-going Governor George Ryan’s Build Illinois program. While the 2002 election loomed and the State Treasury emptied out the scandal plagued Republican toured the state handing out checks to cover one project after another. It did not help his party in November. Democrats swept the election state wide. In control of the Governor’s office, every statewide office, both houses of the State legislature and the State Supreme Court the democrats have had to cut the State’s budget to the bone and still faces the deficit the Republicans bequeathed them. Governor Blagojevich is taking the heat for his predecessor’s profligacy and looking for ways to ease the pain without raising state taxes. He is looking north toward Canada and its pharmacies to save 30-50% on the state’s medicine bill.

While the Governor is looking north the Ashcroft Justice Department is trying to shut down a Chicago based business that has found a booming business facilitating individual citizens mail-order purchases from Canadian pharmacies. The drug industry is trying to protect its profits from the depredations of individual patients by limiting its shipments to the Canadian companies. The battle lines are being drawn between the pharmaceutical industry and the patients and the Illinois Democrats are choosing sides.

There is a problem with the proposal that Illinois buy from Canadian pharmacies. Illinois employees are primarily covered by HMOs wholly owned by the physicians that staff them. Many of the HMOs parent organizations have established their own pharmacies as a major profit center. A move to Canadian pharmacies with the power of the state’s purchasing power will cut into the HMO’s drug money by establishing what is, in essence, a single payer system for prescriptions. We will hear howls of socialism from the Republicans and threats from the HMOs to withdraw from the State’s employee health care system. It won’t be a pretty fight but the screams are likely to fall on deaf ears with patients hard pressed by drug costs and the state’s treasury empty.