The idea of a single-payer health care system was lost in the debate over the much-amended national health care reform passed by Congress last year, but three Howard County delegates are co-sponsors of legislation in this year's General Assembly that seeks to bring the idea to fruition in the Free State.
The concept involves having everyone in the state get health care through one insurance pool to which everyone pays premiums. It eliminates the variety of insurance companies that now offer coverage only to those insured through an employer or who can pay.
The Senate version (SB 388) of the Maryland Health Security Act is scheduled for a hearing at 1 p.m. Wednesday in the Senate Finance Committee in Annapolis, and backers are planning a free event to help boost support at 1 p.m. March 12 at the Central Library in Columbia.
Dels. Guy Guzzone, Frank Turner and Elizabeth Bobo, all Democrats, are all co-sponsors of the House bill (HB 1035), and Democratic Del. Shane Pendergrass said she supports a single-payer system in concept, though she is not a co-sponsor because the bill would come before her subcommittee. Sponsors of the three-hour library event are Healthcare-Now! Maryland and Physicians for a National Health Program.
Organizers of the single-payer campaign, Stephen Dunbar and Dr. Eric G. Naumburg, say the bill has little chance of passage this year, but they believe that things may change in the future.
"The health system, the way it's going, cannot survive long term," said Dunbar, 68, of Columbia. He's an entrepreneur with a 43-year old son who was recently laid off from his job. His son, he said, had three open-heart surgeries as a child and needs continuous medical care that he might not be able to afford without employer-provided health insurance.
If the federal plan survives a Republican onslaught, it still leaves millions without coverage, and will be expensive. If Republicans succeed, Dunbar and Naumburg feel, the whole system will collapse, making single-payer the logical alternative.
Naumburg, 63, also of Columbia, is a former pediatrician who said he's retired from active medical practice to devote his life to promoting a single-payer system.
To advocates, the advantages seem naturally appealing. Instead of having multiple insurance companies with a wide array of rules and paperwork, there would be one standard for everyone. That means no need for advertising, huge billing and administrative offices, less confusion, and medical services dispensed as needed without a cost-driving fee-for-service system.
They are also aware that what they see as a logical solution to the still-rising costs of health care is seen by others as "socialized medicine" to be opposed at all costs. "We know we need support from the grass roots," said Naumburg.
Bobo said she never gives up on what she believes is a good idea, no matter the obstacles. "I think we need to get out there and just keep promoting it."
Kittleman on same-sex unions
State Sen. Allan H. Kittleman doesn't often stand out from the other baker's dozen of Republicans in the General Assembly's upper house, but his vote in favor of a bill legalizing same-sex marriage in Maryland changed all that.
The political fallout from that vote is uncertain, with some guessing it was a political move to position himself in liberal Howard County for a potential run at county executive in 2014. But Kittleman and others say it was an act of conscience in the tradition of his late father, former state Sen. Robert H. Kittleman, who joined the Howard County chapter of the National Association for the Advancement of Colored People before the civil rights movement caught on in the then-rural county.
Politically, he is risking a political backlash among his base Republican supporters, especially in the more conservative third of his district covering southern Carroll County.
"I had to do what I thought was right," regardless of political consequences, Kittleman said. "I've never changed my position." He had earlier promoted the idea of a civil union bill, but he gave up that concept for a lack of support.
"I certainly care about what voters think, but I've got to do what I think is right," he said.
David Bates, a member of the Howard County Republican Central Committee who delivered a strong religious-based attack on the legislation at the Feb. 23 delegation public hearing in Ellicott City, said he holds no political grudge against Kittleman, despite their very different positions."Not all candidates will have the same ideas," said Bates, whose wife is Republican Del. Gail H. Bates.
David Bates said Kittleman's vote did not surprise him, and that he remains a friend. "We just agree to disagree," he said.
Karen Winterling, former president of the Howard County Republican Club, said she feels the same way."He's still my senator," she said. "I love Allan Kittleman. I do understand his position and respect it," though she disagrees.
Others, like Carroll County Republican Central Committee Chairman Larry Helminiak, who is also second vice chairman of the state GOP, take a similar view: They oppose same-sex marriage but don't oppose Kittleman politically. "You can't agree with everybody 100 percent of the time," he said.
Helminiak's tolerant view, shared by several party leaders in Howard County, isn't shared by Del. Susan Krebs, the Republican who represents the third of Kittleman's district that's in Carroll County, though there could be another reason.
Helminiak, a Kittleman ally, ran against Krebs in the Carroll Republican primary last September and came within 100 votes of beating her.
"In the short term, people in my district are very, very angry," Krebs said, more because they felt Kittleman campaigned as a conservative but voted like a liberal on this issue. "Our side just wants honesty and integrity for our elected officials," she said.
Former Carroll state Sen. Larry Haines also felt the vote "will definitely hurt" Kittleman in Carroll. "I can't compare civil rights with gay rights at all," Haines said, referring to Robert Kittleman's record as a civil rights advocate.
Scott Hollenbeck, a former vice chairman of the Carroll County Republican Central Committee, was also sharply critical, as was Arundel Del. Don Dwyer Jr. Baltimore County Del. Patrick McDonough had mixed feelings about the political fallout.
Both Dwyer and McDonough are Republicans who vehemently oppose same-sex marriage.
Hollenbeck said he's "deeply disappointed" in Kittleman's vote, calling him "severely out of step with his constituents." Dwyer said, "I think it would hurt him really bad. I think he made a fatal mistake."
McDonough said it could prompt a primary challenge if Kittleman runs for re-election and district boundaries don't change much. On the other hand, McDonough said "he's very conservative in other ways" and is "a very nice man," so the political damage could be minimal. Former Carroll Del. Carmen Amedori also felt "people forget" and "I don't think people are going to hold it against the senator."
Loretta Shields, chairman of the Howard County Republican Party, said she doesn't see "anything affecting anything politically. I just don't see that at all. He's always been upfront" with his views. Joan Becker, party chairwoman through the last election, agreed. "I don't think it's a big issue for most people. This is a personal thing," she said.
Kittleman, meanwhile, is using another kind of denunciation that Republicans are more used to receiving to shore up support within his anti-union base.
He and the Maryland Senate Republican Slate are featuring a few remarks made Feb. 24 at a Lawyers Mall labor rally in Annapolis by Ernie Greco, president of the Baltimore Metropolitan Council AFL-CIO. In denouncing those who oppose unions across the country, Greco pointed to Kittleman's right-to-work legislation, which would make union membership and dues optional in Maryland.
"We in Maryland labor are going to target Allan Kittleman. Allan Kittleman, you're done," Greco said, accordingto a YouTube video of the event. On Thursday, Greco confirmed that he spoke at the rally and mentioned Kittleman, but said he didn't remember saying "you're done."