Uninsured

The plight of the public charity hospital is a familiar one around the country - struggling to care for the uninsured, surviving with hefty subsidies from local governments. So there was a familiarity to the announcement this week that Prince George's Hospital Center and other facilities in the Dimensions Healthcare System might shut down in 60 days because of a financial squeeze blamed on care for the uninsured. What's different, however, is that Maryland was supposed to have beaten the charity hospital problem, through a unique-in-the-country system that lets all hospitals bump up their rates to pay for uncompensated care.

The state's hospital rate-setting commission yesterday approved a plan to spread the $400 million-a-year cost of caring for the uninsured more evenly among all hospitals in the state, a move that should better position urban hospitals to compete for managed-care business.The Health Services Cost Review Commission voted to increase the rates for all hospitals by three-quarters of 1 percent, to create a fund for the hospitals that provide a disproportionate amount of care for Marylanders who lack health insurance.

HACKENSACK, N.J. - Pfizer Inc., the world's largest pharmaceutical company, will soon offer its medicines at discounts to the country's uninsured. Pfizer officials said in announcing the move yesterday that the program would give people without drug coverage the same access to prices leveraged by health maintenance organizations, major corporations and other entities with substantial buying power. The program, to begin next month, will be available to the uninsured population regardless of age or income, although people who make more money will receive less-extensive discounts.

WASHINGTON -- A new study shows that the number of Americans lacking health insurance is rising every year and may now exceed 39 million -- a number immediately seized on by Clinton administration officials as evidence of the need for health care reform.The number of uninsured Americans under 65 -- the age when they become eligible for federally subsidized Medicare coverage -- rose from 36.3 million in 1991 to 38.5 million last year -- an increase of 2.2 million, according to the study released yesterday by the Employee Benefit Research Institute, a respected non-partisan organization in Washington.

In the wake of severe funding cuts, a Maryland health care program that aids uninsured residents will curtail its operations this month. The University of Maryland's fleet of traveling health clinics won't make stops anymore in Glen Burnie, Cumberland and in a few locations on the lower Eastern Shore. In all, the budget for the School of Nursing's Wellmobile will be cut in half. "We're going to work to design a program that fits within the budget constraints," said Wellmobile's director, Susan Antol, who's still not sure of all the changes.

WASHINGTON -- Legislation that would double the excise tax on handguns and earmark the proceeds for a fund to help pay for the treatment of uninsured gunshot victims may reach the House floor months earlier than expected.A House Ways and Means panel yesterday considered attaching the measure, sponsored by Rep. Mel Reynolds, D-Ill., to a miscellaneous tax bill that could be put to a House vote within a couple of weeks. The action puts the bill on a fast track for approval by circumventing the usual committee hearings that can delay legislation.

When lawmakers convene this month, Maryland could see the biggest change in care for the uninsured in the three decades since the state crafted a system that pays for uncompensated hospital care. With the number of uninsured large - 780,000 in the latest Census Bureau estimates and growing - momentum to find solutions is building, especially after last year's bruising fight over the so-called Wal-Mart bill. The bill, aimed at forcing the giant retailer to spend at least 8 percent of its Maryland payroll on health insurance, was passed over the governor's veto, only to be blocked by a federal court.

In November, the staff of the Maryland Health Care Commission floated an innovative plan for health coverage - covering nearly all of the uninsured, guaranteeing generous benefits, offering substantial premium subsidies for low- to moderate-income families, and giving every insured person or family a choice of plans. While elected officials worked on more incremental plans, the commission set out to cost out its plan. Yesterday, the bill was presented: $2.5 billion a year in state funds.

James Patrick O'Conor Jr., principal counsel to the Maryland Uninsured Employers' Fund and a Glen Arm resident, died Saturday of pancreatic cancer at Stella Maris Hospice in Timonium He was 57. Mr. O'Conor - the eldest of eight - was born in Baltimore and raised in Towson. He was the grandson of Herbert Romulus O'Conor, who had been Maryland attorney general and governor from 1939 to 1947, when he resigned after being elected to the U.S. Senate. Mr.

Sun follow-up Howard County's plan to provide health care to all its uninsured residents without a large infusion of public money prompted praise and surprise, with a touch of caution, from elected officials yesterday. "I think every time somebody takes this on, they're going to help surface the issues we have to solve at all levels," said U.S. Rep. John Sarbanes, a freshman Democrat whose district covers a portion of eastern Howard. "I think the county executive understands the leadership that a place like Howard County could take because it does have the resources."