{ "id": 5474493, "name": "THE METHODIST MEDICAL CENTER OF ILLINOIS, Appellant, v. ROBERT L. INGRAM, Township Supervisor, Appellee", "name_abbreviation": "Methodist Medical Center v. Ingram", "decision_date": "1980-11-18", "docket_number": "No. 52982", "first_page": "511", "last_page": "524", "citations": [ { "type": "official", "cite": "82 Ill. 2d 511" } ], "court": { "name_abbreviation": "Ill.", "id": 8772, "name": "Illinois Supreme Court" }, "jurisdiction": { "id": 29, "name_long": "Illinois", "name": "Ill." }, "cites_to": [ { "cite": "406 N.Y.S.2d 272", "category": "reporters:state", "reporter": "N.Y.S.2d", "pin_cites": [ { "page": "274" } ], "opinion_index": 0 }, { "cite": "377 N.E.2d 725", "category": "reporters:state_regional", "reporter": "N.E.2d", "pin_cites": [ { "page": "727-28" } ], "opinion_index": 0 }, { "cite": "44 N.Y.2d 466", "category": "reporters:state", "reporter": "N.Y.2d", "pin_cites": [ { "page": "471" } ], "opinion_index": 0 }, { "cite": "19 Ill. 2d 204", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 2743243 ], "opinion_index": 0, "case_paths": [ "/ill-2d/19/0204-01" ] }, { "cite": "63 Ill. 2d 488", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 5427651 ], "pin_cites": [ { "page": "497" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/63/0488-01" ] }, { "cite": "56 Ill. 2d 70", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 5404912 ], "pin_cites": [ { "page": "78" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/56/0070-01" ] }, { "cite": "421 U.S. 773", "category": "reporters:federal", "reporter": "U.S.", "case_ids": [ 541902 ], "weight": 3, "opinion_index": 0, "case_paths": [ "/us/421/0773-01" ] }, { "cite": "73 S. Ct. 93", "category": "reporters:federal", "reporter": "S. Ct.", "year": 1975, "opinion_index": 0 }, { "cite": "97 L. Ed. 664", "category": "reporters:federal", "reporter": "L. Ed.", "year": 1975, "opinion_index": 0 }, { "cite": "344 U.S. 855", "category": "reporters:federal", "reporter": "U.S.", "case_ids": [ 11321701, 11321479, 11321545, 11321386, 11321321, 11321623 ], "year": 1975, "opinion_index": 0, "case_paths": [ "/us/344/0855-06", "/us/344/0855-03", "/us/344/0855-04", "/us/344/0855-02", "/us/344/0855-01", "/us/344/0855-05" ] }, { "cite": "412 Ill. 75", "category": "reporters:state", "reporter": "Ill.", "case_ids": [ 2663477 ], "year": 1952, "opinion_index": 0, "case_paths": [ "/ill/412/0075-01" ] }, { "cite": "98 L. Ed. 829", "category": "reporters:federal", "reporter": "L. Ed.", "year": 1952, "opinion_index": 0 }, { "cite": "347 U.S. 442", "category": "reporters:federal", "reporter": "U.S.", "case_ids": [ 11301312 ], "weight": 2, "year": 1952, "opinion_index": 0, "case_paths": [ "/us/347/0442-01" ] }, { "cite": "386 Ill. 360", "category": "reporters:state", "reporter": "Ill.", "case_ids": [ 2493401 ], "opinion_index": 0, "case_paths": [ "/ill/386/0360-01" ] }, { "cite": "268 U.S. 413", "category": "reporters:federal", "reporter": "U.S.", "case_ids": [ 13138 ], "weight": 3, "opinion_index": 0, "case_paths": [ "/us/268/0413-01" ] }, { "cite": "268 U.S. 39", "category": "reporters:federal", "reporter": "U.S.", "case_ids": [ 13067 ], "weight": 3, "year": 1925, "opinion_index": 0, "case_paths": [ "/us/268/0039-01" ] }, { "cite": "297 Ill. 303", "category": "reporters:state", "reporter": "Ill.", "case_ids": [ 5041091 ], "opinion_index": 0, "case_paths": [ "/ill/297/0303-01" ] }, { "cite": "387 Ill. 256", "category": "reporters:state", "reporter": "Ill.", "case_ids": [ 2497514 ], "year": 1921, "opinion_index": 0, "case_paths": [ "/ill/387/0256-01" ] }, { "cite": "388 Ill. 138", "category": "reporters:state", "reporter": "Ill.", "case_ids": [ 2501317 ], "year": 1944, "opinion_index": 0, "case_paths": [ "/ill/388/0138-01" ] }, { "cite": "403 F. Supp. 1355", "category": "reporters:federal", "reporter": "F. Supp.", "case_ids": [ 3834672 ], "pin_cites": [ { "page": "1364" } ], "opinion_index": 0, "case_paths": [ "/f-supp/403/1355-01" ] }, { "cite": "301 Minn. 229", "category": "reporters:state", "reporter": "Minn.", "case_ids": [ 888840 ], "weight": 2, "pin_cites": [ { "page": "235-37" }, { "page": "91" } ], "opinion_index": 0, "case_paths": [ "/minn/301/0229-01" ] }, { "cite": "324 N.Y.S.2d 10", "category": "reporters:state", "reporter": "N.Y.S.2d", "year": 1974, "opinion_index": 0 }, { "cite": "272 N.E.2d 524", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1974, "pin_cites": [ { "page": "527" } ], "opinion_index": 0 }, { "cite": "29 N.Y.2d 110", "category": "reporters:state", "reporter": "N.Y.2d", "case_ids": [ 2301356 ], "year": 1974, "pin_cites": [ { "page": "115" } ], "opinion_index": 0, "case_paths": [ "/ny-2d/29/0110-01" ] }, { "cite": "569 F.2d 1156", "category": "reporters:federal", "reporter": "F.2d", "case_ids": [ 1423231 ], "year": 1971, "pin_cites": [ { "page": "1161" } ], "opinion_index": 0, "case_paths": [ "/f2d/569/1156-01" ] }, { "cite": "38 Ill. 2d 231", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 2861664 ], "year": 1978, "pin_cites": [ { "page": "233" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/38/0231-01" ] }, { "cite": "77 Ill. 2d 287", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 5489662 ], "year": 1967, "pin_cites": [ { "page": "303" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/77/0287-01" ] }, { "cite": "230 So. 2d 913", "category": "reporters:state_regional", "reporter": "So. 2d", "case_ids": [ 9750803 ], "opinion_index": 0, "case_paths": [ "/so2d/230/0913-01" ] }, { "cite": "68 Ill. 2d 540", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 5809328 ], "opinion_index": 0, "case_paths": [ "/ill-2d/68/0540-01" ] }, { "cite": "25 Ill. App. 2d 79", "category": "reporters:state", "reporter": "Ill. App. 2d", "case_ids": [ 5784913 ], "opinion_index": 0, "case_paths": [ "/ill-app-2d/25/0079-01" ] }, { "cite": "75 Ill. App. 2d 222", "category": "reporters:state", "reporter": "Ill. App. 2d", "case_ids": [ 2577541 ], "year": 1960, "opinion_index": 0, "case_paths": [ "/ill-app-2d/75/0222-01" ] }, { "cite": "121 Ill. App. 2d 473", "category": "reporters:state", "reporter": "Ill. App. 2d", "case_ids": [ 1582648 ], "year": 1966, "opinion_index": 0, "case_paths": [ "/ill-app-2d/121/0473-01" ] }, { "cite": "7 Ill. App. 3d 278", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 2669463 ], "year": 1970, "opinion_index": 0, "case_paths": [ "/ill-app-3d/7/0278-01" ] }, { "cite": "78 Ill. App. 3d 944", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 5604857 ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/78/0944-01" ] } ], "analysis": { "cardinality": 1065, "char_count": 23701, "ocr_confidence": 0.851, "pagerank": { "raw": 5.197655540677664e-08, "percentile": 0.32579486294374693 }, "sha256": "01982a597389370c74f8238370795611a609d5d6125f70197cccbd0b51931b95", "simhash": "1:9fa7f5f0def5b4ad", "word_count": 3856 }, "last_updated": "2023-07-14T20:05:09.345663+00:00", "provenance": { "date_added": "2019-08-29", "source": "Harvard", "batch": "2018" }, "casebody": { "judges": [], "parties": [ "THE METHODIST MEDICAL CENTER OF ILLINOIS, Appellant, v. ROBERT L. INGRAM, Township Supervisor, Appellee." ], "opinions": [ { "text": "MR. JUSTICE UNDERWOOD\ndelivered the opinion of the court:\nPlaintiff, the Methodist Medical Center of Illinois (hereinafter referred to as the Center), brought this action in the circuit court of Tazewell County against Robert L. Ingram, supervisor of general assistance for Groveland Township, to recover charges of $3,545.80 for medical services which it provided to Robert L. Hunt III, a minor son of Robert L. Hunt, Jr. The circuit court granted plaintiff\u2019s motion for summary judgment. Defendant appealed and the appellate court reversed (78 Ill. App. 3d 944). We granted the Center\u2019s petition for leave to appeal.\nThe issues in this case arise in connection with the operation of this State\u2019s system of providing aid to the medically indigent as set forth in article VII of the Illinois Public Aid Code (Code) (Ill. Rev. Stat. 1977, ch. 23, par. 7 \u2014 1 et seq.), which requires townships and other local governmental units to assist those unable to finance necessary medical care. Eligibility for assistance is determined in accordance with statewide standards established by the Department of Public Aid (Department) (Ill. Rev. Stat. 1977, ch. 23, pars. 7 \u2014 1, 7 \u2014 2). Section 7 \u2014 2 of the Code also requires that in determining eligibility the amount which the applicant can contribute to the cost of necessary care is to be computed according to departmental standards. For those eligible, assistance can then be given in an amount equal to the difference between the amount which the applicant can contribute and the amount to which the hospital is entitled pursuant to a per diem rate determined by the Department. That per diem rate is at the heart of this controversy. It is apparently computed by the Department pursuant to the provisions of sections 5 \u2014 5 and 5 \u2014 7 of article V of the Code (Ill. Rev. Stat. 1977, ch. 23, pars. 5 \u2014 5, 5 \u2014 7). It is used, however, as a basis for payment of all in-patient hospital care furnished under the Code. A separate computation is made annually for each hospital from data contained in the annual reports filed by each hospital; these reports may be amended quarterly if desired. The per diem rate so computed is somewhat lower than the hospital\u2019s usual and customary charges. Inflation, coupled with the fact that the rate is based upon the hospital\u2019s costs for the preceding year, widens the gap between the per diem rate and the hospital\u2019s customary charges. Aggravating the problem, it is said, is the absence from the article VII system of payments of the year-end two-way reconciliation of accounts which occurs under article V. Federal funds are used and Federal regulations apply to assistance given under article V, which concerns medical care for those already receiving financial assistance under other programs. Those regulations require the Department, in cases where the operating costs of the hospital have not been met, to reimburse the hospital for any deficit (apparently the difference between the per diem rate and a rate sufficient to pay the operating costs). Conversely, if the hospital has been overpaid, it must refund the overpayment to the Department. Under article VII, however, State and local funds are used; if the hospital is overpaid, refund to the State is required; but, if the per diem rate payments are insufficient to cover the actual operating costs of the hospital, no additional reimbursement is made. The resulting deficit spawned this litigation and other litigation pending in other courts of this State.\nArticle V of the Code is captioned \u201cMedical Assistance.\u201d It is referred to in the briefs as providing a State \u201cMedicaid\u201d program, and its stated purpose is \u201cto provide a program of essential medical care and rehabilitative services for persons receiving basic maintenance grants under this Code and for other persons who are unable, because of inadequate resources, to meet their essential medical needs\u201d (Ill. Rev. Stat. 1977, ch. 23, par. 5 \u2014 1). It seems to be undisputed that sections 5 \u2014 5 and 5 \u2014 7 of article V authorize the Department\u2019s per diem rate for use in connection with medical care and services furnished under that article. Article VII is captioned \u201cLocal Aid To The Medically Indigent.\u201d It does not contain the express authority found in section 5 \u2014 5 to \u201cdetermine the quantity and quality of the medical assistance for which payment will be authorized\u201d (Ill. Rev. Stat. 1977, ch. 23, par. 5 \u2014 5) nor the authority to negotiate fees and rates contained in section 5 \u2014 7 (Ill. Rev. Stat. 1977, ch. 23, par. 5 \u2014 7). It is plaintiff\u2019s position that the per diem rate computed pursuant to the authority contained in article V cannot be applied to hospital charges for care furnished under article VII in the absence from the latter article of the express authority contained in the former. We do not agree.\nIn this case Robert L. Hunt III, a resident of Groveland Township, received medical care, part of which was of an emergency nature, at the Center from December 26, 1977, to January 12, 1978. His father, Robert L. Hunt, Jr., applied for assistance in paying his son\u2019s bill. The Center forwarded the application to Supervisor Ingram, who determined that the Hunts were qualified for assistance under article VII of the Illinois Public Aid Code (Ill. Rev. Stat. 1977, ch. 23, par. 7 \u2014 1 et seq.), that the 17 days of care at the Center should be reimbursed to the extent of $2,747 (which is, to the nearest dollar, 17 times $161.60, which Ingram believed to be the \u201cper diem\u201d rate specified for the Center in the Department regulations) and that Hunt had \u201cavailable\u201d resources of $2,156. Ingram tendered the Center $591 in full payment of the bill, after deducting the $2,156 which the Center could obtain from Hunt pursuant to section 11 \u2014 13 of the Code (Ill. Rev. Stat. 1977, ch. 23, par. 11 \u2014 13). Section 11 \u2014 13 bars a supplier who accepts a direct Department payment on behalf of an aid recipient from recovering any additional payment except the amount which the Department\u2019s regulations specify is to be met from the aid recipient\u2019s \u201cavailable\u201d income and resources. The Center refused to accept Ingram\u2019s payment and instituted this action.\nPlaintiff has cited in support of its position only four cases: Sisters of the Third Order of St. Francis v. Groveland Township (1972), 7 Ill. App. 3d 278; Pekin Memorial Hospital v. Shilling (1970), 121 Ill. App. 2d 473; St. John\u2019s Hospital v. Town of Capitol (1966), 75 Ill. App. 2d 222, and Rockford Memorial Hospital Association v. Whaples (1960), 25 Ill. App. 2d 79, none of which discusses the issue here. Plaintiff apparently refers to these four cases because they involve judgments for the full amount of the hospital charges. That is totally unpersuasive, however, for the hospital services in each of those cases were furnished long prior to November 1, 1971, the date upon which use of the per diem rate was apparently first required. Nor do we regard Bio-Medical Laboratories, Inc. v. Trainor (1977), 68 Ill. 2d 540, as indicating the absence of departmental authority to adopt the challenged regulations. We there held the Director of the Department could not suspend vendors from participation in the medical assistance program because of the total absence from the statute of any indication of an intent to confer such authority and the presence of provisions delegating enforcement responsibilities to others.\nNeither the parties nor amici, the State of Illinois, the Illinois Hospital Association and St. Mary\u2019s Hospital of East St. Louis, Illinois, Inc., have cited, nor have we found, any Illinois authority on the precise issue before us. Consequently, its resolution must depend upon the legislative purpose and intent to be gleaned from the statutory language.\nThe pertinent sections of article VII demonstrate the General Assembly\u2019s intent to therein provide for only such assistance as may be necessary to provide needed care for those eligible persons whose financial resources are inadequate and who are not receiving assistance under some other public program. Section 7 \u2014 2 is particularly relevant to our issue. It provides:\n\u201cThe person shall be given such care as may be necessary and proper, including transportation, and if he dies he shall be decently buried.\nThe amount and nature of the care provided shall be determined in accordance with a uniform standard of eligibility established by the Illinois Department and its rules and regulations. However, the amount and nature of any such care is not affected by the payment of any grant under the \u2018Senior Citizens and Disabled Persons Property Tax Relief Act\u2019. The standard shall include provision for determining what, if any, portion of the income, property or other resources of an applicant or recipient is available to meet the cost of necessary care. However, a local governmental unit not receiving State funds for purposes of this Article may prescribe a uniform standard of eligibility according to local conditions. Such locally prescribed standards may be less, but not more, restrictive than the uniform standard of eligibility established by the Illinois Department.\u201d (Ill. Rev. Stat. 1977, ch. 23, par. 7 \u2014 2.)\nThis section contemplates that eligible persons be given \u201csuch care as may be necessary and proper,\u201d i.e., proper under the uniform standard the section requires the Department to formulate. The Department\u2019s standard is to determine \u201c[t] he amount and nature of the care provided.\u201d The statement, \u201cThe standard shall include provision for determining what, if any, portion of the income, property or other resources of an applicant or recipient is available to meet the cost of necessary care\u201d indicates that the standard is to include, but is not to be limited to, income limits of eligibility. Rather, section 7 \u2014 1.2 indicates that one means by which the Department may regulate the \u201camount and nature of the care provided\u201d pursuant to section 7 \u2014 2 is by defining the \u201ccost of necessary care\u201d:\n\u201cThe money, property, or other resources available to the person, including support available from legally responsible relatives, must be insufficient to meet the costs of necessary care, as defined by standards established in accordance with Section 7 \u2014 2 of this Article. The eligibility of any applicant for or recipient of public aid under this Article is not affected by the payment of any grant under the \u2018Senior Citizens and Disabled Persons Property Tax Relief Act.\u2019 \u201d Ill. Rev. Stat. 1977, ch. 23, par. 7 \u2014 1.2.\nThe word \u201cdefined\u201d can be reasonably read as referring only to \u201ccosts of necessary care,\u201d the nearest words. It would be a strained reading of the section to do otherwise. The regulatory scheme provided by article VII is that the local governments will provide \u201caid\u201d in meeting \u201ccosts of necessary care,\u201d as that term is defined in regulations of the Department pursuant to section 7 \u2014 2, in order that all eligible persons in the State be given \u201csuch care as may be necessary and proper\u201d under statewide supervision by the Department.\nArticle XII of the Illinois Public Aid Code (Ill. Rev. Stat. 1977, ch. 23, par. 12 \u2014 1 et seq.), which deals more generally with the Department\u2019s responsibility for the administration of the Illinois Public Aid Code, also indicates that the Department has authority for the challenged regulations. Section 12 \u2014 3 states:\n\u201cAs provided in Articles VI and VII, Local Governmental units shall provide funds for and administer the programs provided in those Articles, subject, where so provided, to the supervision of the Illinois Department.\u201d (Ill. Rev. Stat. 1977, ch. 23, par. 12 \u2014 3.)\nAlthough we have found authority for the Department\u2019s regulation within article VII itself, we note that the section 12 \u2014 3 phrase \u201cwhere so provided\u201d should not be read to restrict the Department\u2019s supervision to matters expressly committed to that supervision in articles VI and VII, particularly in view of the section\u2019s two preceding phrases \u201c[a] s provided in Articles VI and VII,\u201d and \u201cprovided in those Articles.\u201d If the legislature had wished to limit the supervision as plaintiff suggests, it would have repeated one of those two earlier phrases. Plaintiff\u2019s restrictive reading of section 12 \u2014 3 is also completely at odds with the broad authority conferred upon the Department with respect to article VII aid by section 12 \u2014 21.17, which states in part:\n\u201cThe administration of public aid by local governmental units under Article VII shall be subject in all instances to the supervision and rules and regulations of the Illinois Department.\u201d Ill. Rev. Stat. 1977, ch. 23, par. 12-21.17.\nThe challenged regulations adopted by the Department are as follows:\nPO \u2014 105, which provides in part:\n\u201cAll provisions of this manual are binding on all local governmental units in which Aid to the Medically Indigent is administered by the Department. All other local governmental units must comply with all provisions of this manual unless they have written alternative manual provisions and have received approval of such alternative provisions from the Department.\u201d (Ill. Gen. Assist. Man. PO \u2014 105.)\n(It was stipulated by the parties the Groveland Township has no \u201cwritten alternative manual.\u201d) PO \u2014 1115.1(e), which provides in part:\n\u201cPayment for in-patient hospital care in participating hospitals is made at the all-inclusive per diem rate established by the Department.\u201d (Ill. Gen. Assist. Man. PO \u2014 1115.)\nBoth the earlier-quoted statutory provision and these regulations evince a legitimate concern with the costs of medical care. An obvious purpose of the per diem rate is to insure that public funds will not be dissipated by the payment of unnecessarily or unreasonably high charges for medical services. While the hospitals represented here are not-for-profit corporations, that fact does not guarantee the reasonableness of their operating costs or the efficiency of their operations. Given the quoted statutory provisions, the purpose of article VII, and the State\u2019s interest in efficiently and economically operating its huge medical assistance program, we believe the Department has not exceeded its authority in applying the per diem rate developed under article V to the article VII aid to the medically indigent program. The regulations requiring such action are directly related to, and serve to implement, the legislative intent to limit the expenditure of public funds to only such as may be required to provide necessary care. Use of the per diem rate is the Department\u2019s method of defining the costs of necessary care as authorized in section 7 \u2014 1.2.\nSt. Mary\u2019s Hospital argues as an amicus curiae that the Department\u2019s regulations fixing the plaintiff\u2019s article VII remuneration at the per diem rate fixed by the Department under article V is unconstitutional. The argument is that this regulation, combined with section 11 \u2014 13 of the Code (Ill. Rev. Stat. 1977, ch. 23, par. 11 \u2014 13) and the provisions of \u201cAn Act requiring hospitals to render hospital emergency service ***\u201d operates to deprive hospitals of property without due process. That act, hereafter referred to as the Emergency Services Act, states:\nEvery hospital required to be licensed by the Department of Public Health pursuant to the Hospital Licensing Act, approved July 1, 1953, as now or hereafter amended, which provides general medical and surgical hospital services shall provide a hospital emergency service in accordance with rules and regulations adopted by the Department of Public Health and shall furnish such hospital emergency services to any applicant who applies for the same in case of injury or acute medical condition where the same is liable to cause death or severe injury or serious illness.\u201d (Ill. Rev. Stat. 1977, ch. 1111/2, par. 86.)\nIn this case an undisclosed portion of the medical services given were of an emergency nature. St. Mary\u2019s indicates approximately 30% of its patients are given emergency care, although how many of these qualify for aid to the medically indigent is not disclosed. In terms of the effect of the per diem rate, a distinction can probably be drawn between emergency and nonemergency patients, in that longer-term care is generally given the nonemergency cases which comprise the substantial majority of hospitalized patients. (See Joyner v. Alton Ochsner Medical Foundation (La. App. 1970), 230 So. 2d 913.) As to non-emergency patients the Emergency Services Act imposes no duty upon hospitals to provide care. The relevance of this is that what facts we have before us would seem to indicate that the underpayment complained of by plaintiff arises principally in connection with the care of long-term, nonemergency patients whose care is not compelled by the statute. While we agree that the combination of underpayment for compelled services rendered indigents can be cast in due process terms, we do not agree that it has been established that the circumstances here attain that stature. If the rate of remuneration is judged annually by the hospitals to be adequate to cover costs of article V patients, we believe that the plaintiff cannot, without more, argue that the application of those rates to article VII patients amounts to a deprivation of property without due process.\nAs earlier noted the purpose of the per diem rate is to promote economy and efficiency in the provision of medical care to the recipients of assistance under the statute, a legitimate State interest. Since we have held use of that rate was authorized in measuring the reasonable cost of medical care under article VII, plaintiff bears the burden of overcoming the presumed validity of that use. (Polyvend, Inc. v. Puckorius (1979), 77 Ill. 2d 287, 303; North Shore Post No. 21 v. Korzen (1967), 38 Ill. 2d 231, 233.) Absent a specific showing of the extent to which the deficits complained of are attributable to the emergency care of article VII patients, an arguable due process claim is simply not presented. (See Massachusetts General Hospital v. Weiner (1st Cir. 1978), 569 F.2d 1156, 1161.) As to the nonemergency article VII patients, there exists no State-created compulsion to provide care, and plaintiff\u2019s remedy may well be \u201cthe choice of either making [its] operation more efficient or not accepting [article VII] patients\u201d In re Sigety v. Ingraham (1971), 29 N.Y.2d 110, 115, 272 N.E.2d 524, 527, 324 N.Y.S.2d 10, 14 see also LaCrescent Constant Care Center, Inc. v. State (1974), 301 Minn. 229, 235-37, 222 N.W.2d 87, 91; Briarcliff Haven, Inc. v. Department of Human Resources (N.D. Ga.), 403 F. Supp. 1355, 1364.\nSt. Mary\u2019s cites five railroad- and utility-rate cases in support of its argument. We find them readily distinguishable. Fleming v. Illinois Commerce Com. (1944), 388 Ill. 138, Illinois Central R.R. Co. v. Illinois Commerce Com. (1944), 387 Ill. 256, and Mt. Carmel Public Utility & Service Co. v. Public Utilities Com. (1921), 297 Ill. 303, all involved challenges by railroads and a utility to rates for separable branches of their businesses (suburban service in Fleming and Illinois Central and heating service in Mt. Carmel) which had been set with reference solely to income statistics for their entire systems, when those statistics did not accurately reflect the situation of the branches. These cases turned on the separate character of the services involved. Similarly in Northern Pacific Ry. Co. v. Department of Public Works (1925), 268 U.S. 39, 69 L. Ed. 836, 45 S. Ct. 412, and Banton v. Belt Line Ry. Corp. (1925), 268 U.S. 413, 69 L. Ed. 1020, 45 S. Ct. 534, the United States Supreme Court had occasion to consider rates of separate traffic (log traffic wholly within the State of Washington in Northern Pacific and transfer passengers on a street railroad in Banton). In the present case, even if we believed the situation of railroads and utilities to be apposite to the situation of hospitals, which we do not, there has been no showing by plaintiff that article VII patients can properly be considered a separate branch of the hospital\u2019s business. Rather it appears that article VII patients use the same facilities in the same manner and to the same extent as the rest of the hospital\u2019s patients.\nIn focusing on its due process argument, plaintiff and amici have almost completely ignored the broad scope of the State\u2019s police power in the area of health. That power is sufficient to justify, in proper circumstances, uncompensated deprivation of personal liberty as well as deprivation of property. (People ex rel. Baker v. Strautz (1944), 386 Ill. 360.) The States have wide regulatory power with respect to the practice of health care professions. (Barsky v. Board of Regents (1954), 347 U.S. 442, 98 L. Ed. 829, 74 S. Ct. 650; Klein v. Department of Registration & Education (1952), 412 Ill. 75, cert. denied (1952), 344 U.S. 855, 97 L. Ed. 664, 73 S. Ct. 93. See also Goldfarb v. Virginia State Bar (1975), 421 U.S. 773, 44 L. Ed. 2d 572, 95 S. Ct. 2004.) Although this court has found foreign-educated doctors had property rights in their State \u201chospital permits,\u201d the termination of those rights has been upheld against a challenge based on the due process clause:\n\u201cThe fact that the plaintiffs possess property rights and are entitled to due process protection, however, does not mean that those rights cannot be affected by State legislation. ***. The demands of due process are proportional to the weight of the interest being protected in balancing that interest against the countervailing interests of society. (Powell v. Jones, 56 Ill. 2d 70, 78.) If, after balancing these interests, the State\u2019s exercise of its police power is deemed to be reasonable, the legislation in question must be upheld.\u201d (Rios v. Jones (1976), 63 Ill. 2d 488, 497.)\nThis court has also indicated that the State\u2019s police power to exclude persons from engaging in a particular business generally includes the power to permit the activity on conditions reasonably related to protection of the general welfare. (City of Decatur v. Chasteen (1960), 19 Ill. 2d 204.) In our judgment the scope of the State\u2019s police power clearly encompasses the power to impose on hospitals licensed by it conditions reasonably designed to promote public health and safety. The New York Court\nof Appeals has even indicated the \u201clegitimate legislative purposes of promoting public health, welfare and safety\u201d could authorize the imposition of direct cost regulations upon hospitals in order to control health care costs which were escalating more rapidly than almost any other component of the cost-of-living index. People ex rel. Whalen v. Woman\u2019s Christian Association (1978), 44 N.Y.2d 466, 471, 377 N.E.2d 725, 727-28, 406 N.Y.S.2d 272, 274.\nWe accordingly hold that use of the per diem rate is authorized for article VII patients, and that, considering the scope of the State\u2019s police power, the circumstances before us do not establish the use of that rate to constitute a denial of due process to the involved hospitals.\nThe judgment of the appellate court is affirmed. Judgment affirmed.", "type": "majority", "author": "MR. JUSTICE UNDERWOOD" } ], "attorneys": [ "Westervelt, Johnson, Nicoll & Keller, of Peoria (James D. Broadway and William E. Defenbaugh, of counsel), for appellant.", "Bernard L. Oltman, of Pekin, for appellee.", "Rex Carr, of Cohn, Carr, Korein, Kunin, Schlichter & Brennan, of East St. Louis, for amicus curiae St. Mary\u2019s Hospital of East St. Louis, Illinois, Inc.", "Harry L. Kinser, Kenneth C. Robbins and Jeffrey W. Maysent, of Chicago (McLaughlin, Kinser & Bryant, of counsel), for amicus curiae Illinois Hospital Association." ], "corrections": "", "head_matter": "(No. 52982.\nTHE METHODIST MEDICAL CENTER OF ILLINOIS, Appellant, v. ROBERT L. INGRAM, Township Supervisor, Appellee.\nOpinion filed November 18, 1980.\nWestervelt, Johnson, Nicoll & Keller, of Peoria (James D. Broadway and William E. Defenbaugh, of counsel), for appellant.\nBernard L. Oltman, of Pekin, for appellee.\nRex Carr, of Cohn, Carr, Korein, Kunin, Schlichter & Brennan, of East St. Louis, for amicus curiae St. Mary\u2019s Hospital of East St. Louis, Illinois, Inc.\nHarry L. Kinser, Kenneth C. Robbins and Jeffrey W. Maysent, of Chicago (McLaughlin, Kinser & Bryant, of counsel), for amicus curiae Illinois Hospital Association." }, "file_name": "0511-01", "first_page_order": 523, "last_page_order": 536 }