Healthy Howard

Our view: Health care plan for the uninsured could be a model for other local governments

October 06, 2008

If you don't have health insurance and you need to be treated in an emergency room, things can quickly go from bad to worse. Even if your illness isn't life-threatening and your hospital stay is relatively short, you can still end up with a bill you won't be able to pay. But if you don't pay it, collection agencies start dunning you and your credit rating takes a nose-dive.

Howard County officials thought there had to be a better way for the more than 20,000 uninsured residents. What they needed was a program aimed at keeping people healthy, one that gave them access to doctors, hospital care and prescription drugs as well as an alternative to rushing to the emergency room for routine, preventable illnesses.

Healthy Howard, unveiled last week, is not a health insurance plan. The program is available only at hospitals and clinics in the county, is limited in scope and doesn't cover county residents who are injured or become sick elsewhere in the state.

But it does provide access to basic medical and preventive health care that people need to remain healthy, and makes it available to residents who otherwise couldn't afford many of the benefits of private health insurance.

Prevention is the key. After enrolling, residents are assigned a "health coach" as well as a primary care physician, who plan their treatment and assist them in overcoming the kinds of barriers to better health many people struggle with. Since complicated surgical procedures and extended hospital stays are a major factor in soaring health care costs, it makes sense to attend to patients' health needs before they become so ill they start showing up in emergency rooms.

The $2.8 million program is funded in part from the county and patient fees that range from $50 to $115 a month, depending on family size. The rest is being solicited from foundations and private donors, though only about a third of the $1.5 million has been raised so far.

It's admittedly a stopgap measure, not a substitute for health insurance, let alone a solution to the country's health care crisis. But with the prospects uncertain for state and federal health care reform, and nearly 800,000 Marylanders without insurance, the county's effort is a creative, collaborative approach to helping its citizens stay in good health.

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