Howard care

The Baltimore Sun

In a more perfect world, a subsidized health care program to provide basic services to the uninsured wouldn't be designed and run county by county. But in the absence of federal or state action to ensure that no one is denied access to regular medical care, Howard County's move to meet the needs of its citizens is most welcome.

With a lot of hard work and even more luck, county officials may be able to provide a model that can be copied across the state and around the country. They expect it to be more expansive than a similar program launched recently in San Francisco.

Other communities could be forgiven, though, for coveting the assets Howard County brings to such an experiment: an average household income level that ranks third-richest in the nation and a relatively small group of residents who lack health insurance, estimated at 18,800 to 27,000. Baltimore, for example, has too many needy people to make such a program work.

As reported last week by The Sun's Larry Carson, details of the plan to be unveiled next month by County Executive Ken Ulman are still sketchy, but the goal is to make primary care available through participating doctors and clinics to uninsured legal residents for a small fee.

The county's health officer, Peter L. Beilenson, who held a similar post in Baltimore for many years, is a key architect of the plan. He stresses that it is not an insurance program but a combination of primary and preventive care services that will help patients gain access to other government benefits, such as low-cost prescription drug coverage. Financing is expected to come from participants, foundations, medical institutions and county taxpayers.

Making access to health care universal - at least in Howard County - has been a top goal of Mr. Ulman since he took office late last year. His sense of urgency is understandable. Congress has been grappling in vain for more than a decade with how to provide health care to an uninsured population that now numbers 47 million. No solution can be expected at least until after next year's presidential election.

Prospects look brighter at the state level, where Gov. Martin O'Malley and the General Assembly may move within the next year to expand Medicaid coverage to include more of the working poor. But that outcome is far from certain - so it may well fall to Howard County to lead the way.

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