Healthy Howard

Advocates for Howard County's innovative health access plan are mounting an aggressive campaign to win County Council approval of another $500,000 in scarce public dollars next fiscal year to head off criticism from Republican Councilman Greg Fox. Fox has argued that the experimental program for uninsured people with limited incomes has not met stated enrollment or finance goals and the county should reduce or eliminate public funding for it....

Howard County's fledgling health access plan for the uninsured could change into a regional nonprofit health insurance co-op for limited-income working families, the plan's chief architect said. Under the recently passed federal law that requires everyone to have health insurance by 2014, Healthy Howard cannot survive in its current form, its creator, Dr. Peter L. Beilenson, said last week.. That is because the innovative health access plan for Howard County residents is not insurance, and it relies heavily on doctors and hospitals providing free care, he said.

During the presidential debates, Tom Brokaw asked, "is health care a right, a privilege or a responsibility?" It was the right question, but the candidates' ducked it. When it comes to health care reform, we correctly hear a lot about "rights." As the debate goes forward, however, Congress and the president need to also confront the issue of responsibilities. Americans have been clear that they are concerned about the costs of medical care -- both directly and through insurance.

Healthy Howard, Howard County's health access program for the uninsured, is requesting another $500,000 infusion of county funds for the fiscal year starting July 1. The program is also getting a new $150,000 grant from the Horizon Foundation. Horizon President and CEO Richard M. Krieg said the foundation is also giving $100,000 to Chase Brexton Health Services in Columbia, the nonprofit that provides primary medical services to the Healthy Howard program. Horizon provided $500,000 to help Healthy Howard get started in January 2009.

A member of a well-known Howard County Republican family announced Monday she is running for county executive. Trent Kittleman, widow of state Sen. Robert Kittleman and former head of the Maryland Transportation Authority in the administration of Gov. Robert L. Ehrlich Jr., indicated she will focus her campaign for the county's top elected position on government spending. "What politicians have forgotten is that the money government spends comes from the labor of thousands and hundreds of thousands of people," she said.

One of the most frightening financial burdens Howard County government is facing perhaps gets the least attention - the cost of future employees' retirement health benefits. Created by a change in federal accounting rules several years ago that require every state and local government in the United States to put aside cash for those costs up front instead of paying them as they occur, Howard's initial estimate of the county government's bill as County Executive Ken Ulman took office in late 2006 was a whopping $477 million.

A social action group composed mainly of church members is planning a door-to-door campaign to help find people who need the health care available through Howard County's unusual access plan. The group, People Acting Together in Howard, is also considering a suggestion from County Executive Ken Ulman that would help achieve another major goal - helping working families reduce high interest costs. Ulman wants the group to help push the General Assembly to change Maryland law to allow installment payments for people forced to buy vehicle insurance from the Maryland Automobile Insurance Fund.

Even if lawmakers can agree on how to overhaul the nation's health care system, the hope of universal coverage could crumble if individuals can't afford their share. Take Howard County. Less than five months into an innovative program to give low-income people access to medical care for as little as $50 a month, nearly one in 10 participants is at risk of being cut off because they can no longer afford the cost. Howard officials say their fledgling program, called the Healthy Howard Access Plan, provides a cautionary lesson for federal policymakers battling over how to re-imagine the nation's health care system and extend insurance to some 47 million Americans.