Questions about health care, both on national policy and on Howard County's home-grown Healthy Howard program, produced sharp divisions among candidates at two forums last week.
At Wednesday morning's Chamber of Commerce event at a Columbia hotel, Republican District 5 County Councilman Greg Fox, the most vocal critic of Healthy Howard, was up against his Democratic opponent, Dr. Zaneb Beams, the Clarksville pediatrician who worked to help enact national health care reform and to help the local program find more participants.
Beams conceded that the program hasn't attracted as many people as expected, but said it is "providing a safety net in a county able to do that." The program will become obsolete when federal reforms take effect anyway, she said. Fox has consistently criticized using county funds to pay for part of the cost of Healthy Howard as a publicity grab by county executive Ken Ulman and the program's architect, county health officer Dr. Peter L. Beilenson.
"This is something we shouldn't have done," Fox said. "We should be focused on experience, not experiments," he said.
"It's not a PR program," Beams shot back. "It's about trailblazing and innovation," and "staying ahead of the curve." She criticized those who "Stick their heads in the sand" and resist change. Fox was not impressed.
"Do you want to keep trailblazing with your dollars?" he asked the more than 150 people in the audience.
The discussion at an Oct. 9 forum sponsored by the African American Coalition of Howard County included congressional, General Assembly and Howard County government candidates, who decide on local funding for Healthy Howard. It is the five County Council members who control the county's annual $500,000 contribution to the local program, which County Executive Ken Ulman, running for re-election, wants to continue until federal health care reform puts it out of business in 2014.
Healthy Howard survived in May on a 3-2 County Council vote to approve the money. Next month's election could shift the support on the council.
Excluding Ellicott City Democrat Courtney Watson, Democrats supported the local health access plan for the uninsured while Fox, the only Republican, was sharply critical. Last spring, Watson and Fox, who did not attend the Oct. 9 forum at the Ridgely Community Center, voted against continued county funding, while the three other council Democrats supported it. Beams, Fox's Democratic opponent, said she strongly supports both national and local health care programs and worked to help achieve both.
But Fox is a popular incumbent in the western county. If he wins re-election and Republican Dennis R. Schrader succeeds in winning the District 3 council seat from Democrat Jen Terrasa, the vote could swing to 3-2 against Healthy Howard next spring, potentially killing the program.
"Healthy Howard sounds great in theory," but if the program is not ended, "we're going to bankrupt the county," Schrader said. "We're going down a slippery slope that we're going to regret; $500,000 is scratching the surface."
He called the program's idea to provide low-cost access to health care, though not insurance, to uninsured county residents "a pipe dream." The program now has about 1,000 members, while several thousand other uninsured residents have found they are eligible for existing health insurance programs through healthy Howard's unusual electronic screening application process.
Terrasa said she remains a "strong, strong supporter" of Healthy Howard. "It's a safety net, a bridge" for lower-income residents of the county who can't get health care elsewhere. When the plan is superseded by federal changes, Beilenson hopes to convert it into a regional nonprofit insurance co-op providing lower-priced premiums to lower-income people.
Watson said she supported using county money for the program at the outset as an experiment, but in view of the recession, she voted against the county funding it this fiscal year. "I felt that kind of program should be funded by a nonprofit like the Horizon Foundation." Horizon did provide $500,000 at first, but cut that to $150,000 this year. "I felt it was unaffordable" for local government, Watson said.
Watson's opponent, Republican Robert L. Flanagan, said, "The difference between Mrs. Watson and me is that I would have never voted for Healthy Howard." At the Chamber event, Flanagan referred to Beilenson as "a liberal rock star."
Democrats Calvin Ball and Mary Kay Sigaty also told the African-American forum attendees that they remain strong supporters. Reginald Avery, Ball's Republican opponent, did not say whether he would support it, though later he said he would. Tom D'Asto, Sigaty's GOP opponent, did not attend either event.
"We stepped in and filled a need," Sigaty said. "I'm not going to take health care away from people" by withdrawing funding for the program.
Both of Howard's Democratic members of Congress, Reps. John Sarbanes and Elijah E. Cummings, told a sparse crowd of spectators at the coalition event that they support the national health care reform law approved in March. Sarbanes' Republican opponent, James J. Wilhelm, opposes it, questioning whether the Constitution allows the government to run a health care system, though as a military veteran, he's eligible for government health care.
Sarbanes pointed out that the new law allows seniors to get annual wellness examinations without a co-payment, eliminates pre-existing conditions as a way for insurance companies to avoid risk, and is beginning to close the "donut hole" on seniors' drug coverage, and allows young people up to age 26 to remain on their parents' insurance.
Cummings put the choice in stark terms. "People died without health care," he said. "Democrats are the party of compassion," he said. "What are we supposed to do, just let people die?"
Democrats in the General Assembly who attended the session also supported health care reform and Healthy Howard, while Republicans criticized it.
"It has been an abject failure. They couldn't find people to be in it," said state Sen. Allan H. Kittleman, a Republican, referring to Beilenson's early claim that the program would enroll 2,200 people the first year.
In contrast, Del. Shane Pendergrass noted that she gave a $1,000 personal donation the day the program was announced in October 2008. "I put my money where my mouth is," she said.