Health Care: A Road Map for the Future

All Marylanders deserve the right to quality affordable and accessible health care. Even before the Affordable Care Act, Maryland successfully expanded access to affordable health care to hundreds of thousands of its citizens.

It’s time to push toward a single payer system that provides health care for all. It is essential for fairness, equity and so that more Marylanders have the long-term security that they deserve.

With a Congress that’s especially dysfunctional about health care, states across the country will be called on to implement new and innovative solution to lower health care costs and expand access. That includes creating a contingency fund to ensure that children in Maryland have health care if the federal government does not fund CHIP. And, we may need a statewide mandate to replace what the Republican-controlled Congress removed from its Tax Bill.

In Maryland, the health care sector is innovating every day. It’s time to convene a state-wide commission – including doctors, nurses, hospitals and patients – to find workable solutions for more quality and affordable health care for all Marylanders. We need to reward preventative care services that lower costs and create a healthier population. We need to work with schools to ensure that children are being cared for and develop healthy habits.

Healthcare is a big driver of both the federal and Maryland’s budgets. These budgets – and, our lives – depend on high quality care. And what we are doing isn’t working for many people.

Currently, the United States spends more than twice per capita on healthcare than any other nation in the world and yet with regards to healthcare quality on a population level, we rank well below many developed, Western nations on basic health metrics.

Today, about 400,000 Marylanders are uninsured or underinsured. While uninsured, many are getting the most expensive health care in emergency rooms after ambulance rides. The cost of providing uncompensated care is paid by the rest of the population by increased health insurance premiums. To meet the need, it has become apparent to thinking people that universal health insurance coverage, perhaps in the form of Medicaid for All on the state level, is morally correct and fiscally responsible.

For prescriptions, the State should leverage its purchasing power to drive down prescription drug prices for Medicaid beneficiaries and State employees. Reducing prices will benefit all. Maryland has shown its willingness to tame pharmaceutical excesses by passing legislation to control price gouging efforts, starting last October. Now is the time to build on this success and take further action to drive down drug prices affecting Medicare recipients.

On the delivery side, Maryland can do better providing financial incentives that reward physicians for providing appropriate levels of care. Maryland should extend the Health Services and Cost Review Commission’s All Payer Single Rate Setting authority to all ambulatory and outpatient settings so as to realize the proven cost-saving and disparity-reducing benefits that have been found in the inpatient setting. Standardizing pricing for health care services across all settings of care will introduce transparency, accountability, and affordability for premium-payers and tax-payers.

Maryland will benefit from a Medicaid for All public option healthcare plan that will be provided on a sliding income scale. Individuals making up to 138% of the Federal Poverty Line (FPL) would continue to get coverage at no cost to them. Individuals, for example, who earn up to 300% FPL would be eligible to buy into this public option for perhaps $100 per month which would be more affordable than purchasing a comparable commercial plan in the open market for perhaps $500 per month.

Publicly administrated healthcare plans have been consistently shown to have significantly lower overhead costs (Centers for Medicare and Medicaid Services averages about 3%) than commercial plans (averaging 18%).

Congressional inaction on healthcare reform need not incapacitate Maryland from ensuring that Marylanders continue progressing towards higher value healthcare. We should not be satisfied until every single citizen in Maryland has access to quality and affordable care.

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