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."
Howard County Executive Ken Ulman "should be applauded," said Rep. C.A. Dutch Ruppersberger, a Democrat and former two-term Baltimore County executive. "Things just take so long on a federal level. In local government, you have got to come up with creative solutions."
Ulman and his health officer, Dr. Peter L. Beilenson, described the plan as a broad effort to improve health by allowing uninsured residents to pay a small fee for access to primary health care instead of being forced to use hospital emergency rooms. They are planning to announce details next month.
"You know we have a broken system. Everybody knows that," Ulman said.
"Ken set a very audacious goal. Everybody has a right to have access to health care," Beilenson said about the plan, which they intend to serve as a national model.
The idea drew bipartisan praise for Ulman's willingness to tackle an issue that has been debated at the state and federal levels for years, though several state legislators raised questions.
"I believe county action is appropriate and necessary because of inaction of the federal and state governments. It's an ambitious endeavor, but I applaud the county executive," said Anne Arundel County Executive John R. Leopold, a Republican. Ulman is a Democrat.
"We all want to make sure everyone has access to health care. My point is that if we can work something where people can voluntarily donate money and it can work -- I'm all for that," Kittleman said.
Although financing details have not been released, Ulman said funding mainly would come from money already in the health care system.
Howard County has an estimated 18,800 to 27,000 uninsured residents.
Gov. Martin O'Malley and legislative leaders are facing a complex fiscal dilemma as they try to eliminate a predicted $1.5 billion revenue shortfall next year while working to extend health insurance coverage to more families.
"I was really surprised to hear it, when you look at all the responsibilities that counties have, and the cost of health care," said Sen. Thomas M. Middleton, the Senate Finance Committee chairman, who will oversee work on proposals to expand state Medicaid coverage next year.
"If counties are willing to step up to the plate and take responsibility, more power to them," said Middleton, a Charles County Democrat. "Look at health care versus providing pensions for teachers," which are now state-funded. "It makes more sense for counties to pick up that piece [pensions]," he said.
Del. Shane E. Pendergrass, a Howard Democrat and a specialist on health legislation, called Ulman's plan "fabulous. I'm so pleased that health is on everyone's radar screen." She is the newly appointed vice chairwoman of the Health and Government Operations Committee, which will work to expand health coverage statewide.
Ulman's experiences with cancer -- his younger brother Doug Ulman and both his parents have had the disease -- gives him valuable insight, she said. "I think it makes him exceptionally ready to be ahead of the curve on this issue."
U.S. Rep. Elijah E. Cummings, a Democrat whose district stretches from central Baltimore to western Howard County, said Beilenson's experience as a former Baltimore health commissioner will help.
"If anybody can pull this off, Ulman and Beilenson can do it. [Beilenson] has been in a system where he saw a lot of the uninsured and the effects on the community."
Another aspect of the problem struck Del. Dan K. Morhaim, an emergency-room physician and chairman of the Joint Committee on Health Care and Finance. "A lot of money is spent on health care, but our health statistics are getting worse, and it's becoming unaffordable. We've also got to make it work for providers," said Morhaim, a Baltimore County Democrat.
Del. Guy Guzzone, a Democrat and ally of Ulman's, said the state's efforts at best "may touch another 150,000 to 200,000 of the nearly 800,000 uninsured state residents. That's what makes what Ken is doing so very important."
Bill Innanen, a Columbia resident since 1972 who lives near Howard County General Hospital, said he hopes Ulman's plan works.
"I've always felt remotely guilty about my wonderful health care when there are so many neighbors that are going without or are descending on our county hospital's emergency room," he said.