Howard Co. Prescription for Health Care

HOWARD COUNTY, Md. - As Congress debates health care reform, officials in Howard County, Maryland may have already found the right prescription. This year, they launched an experimental program for the uninsured. It's the first of its kind in the country and it could be a model for the nation.

Matthew English works at a small bakery, delivering bread in one of the richest counties in the nation but he earns just $17,000 a year.

"There's not a lot of money in the bread business," English told FOX 5.

His employer doesn't provide health insurance and when he checked into buying his own, the cost was $200-$300 a month. He barely makes enough for rent, food, car insurance and school. Health insurance was just too expensive.

"Every time you're on the road and you jam on the brakes and you don't have health insurance, you think oh crap that could be it," English often thought while driving his delivery route.

Then he heard about a new program in Howard County, Maryland where he lives and enrolled in the Healthy Howard Health Plan.

As Congress debates health care reform, Howard County's program may be a model for the rest of the nation. On January 1, 2009 it launched an experimental program for the uninsured, the first of its kind in the country.

Since the program started, Howard County has helped more 2,000 people sign up for federal and state assistance and provided health care for hundreds of others. It provides health care to those who can't afford health insurance but make too much to qualify for Medicaid.

For a family of four to qualify, a family's income must be $32,000 - $66,000 a year. It is not insurance, but the plan does provide emergency and inpatient care through Howard county general hospital, six primary care visits and access to a network of specialists.

"Actually we've reduced the number of uninsured in the county by a very significant margin in the last eight or nine months. That's impressive," said Howard County Health Officer Peter Beilenson, MD, MPH.

Many who initially applied qualified for state or federal programs but didn't know. The county helped get them signed up for those programs and eventually ended up with about 400 members in the county's program. Members pay $50-$85 a month, depending on their income. Even at that price some still have trouble paying.

These same people could not afford health insurance even with the subsidies proposed in Congress.

"Those subsidies are grossly inadequate and there's no way with the current subsidies that are being talked about that we'll get anywhere near universal health coverage," said Beilenson.

He says the county's program has shed light on other issues impacting the national health care debate, too. First, it proves you can set up a comprehensive primary care, with referrals to specialists and discounted prescription coverage. He also says it shows a large number of uninsured in the country actually qualify for federal entitlement programs and the government must do a better job of informing people.

Beilenson also supports a public mandate, saying to work the pool of people must include younger healthier people to balance older people who often need more medical care.

"I believe health care is not also a right but a responsibility and there has to be an individual mandate for health coverage in the U.S. to work as the system is set up," Beilenson said.

One of the key components of Howard County's program is preventative.

Every person must agree to personal health coaching to improve their health, preventing the need for more costly medical care later. Patients like Matthew English are seeing results.

"I've lost 25 pounds so far. I really cut out sodas, I'm trying to eat leafy greens, stuff like that. They try to give you very attainable goals. And I do feel healthier," English said.

People who don't make and effort to comply with their health coaches risk being removed from the program, but health officials say no one has been removed so far.

The program has its limits. It does not provide care outside the area say if you're traveling and get sick. County health officials say the program could easily become a non profit health care cooperate or part of the public insurance option being proposed in Congress.

For details about the program go to: www.HealthyHowardPlan.org or call (410) 988-3737.