Maryland officials must get new cash for health reform

February 06, 2007

You've got pretty good health insurance through your employer and you're not a cigarette smoker. So is there really any reason to care about the Maryland General Assembly's plan to cover more of the uninsured?

Absolutely. The proposal now being pushed in the legislature would be funded by a $1-per-pack increase in the cigarette tax.

For some smokers, this will be the final straw and they will quit, reducing the revenue stream. Still others - young people, we hope - will never start, further shrinking the amount of revenue available.

But that drop in revenue won't happen immediately. In the meantime, an expansion of Maryland's Medicaid program will be under way.

Once begun, it will be darned difficult to trim back. At some point, the lawmakers will have to seek other sources of cash.

But not attempting to cut the number of uninsured is not a viable strategy. Del. Peter Hammen, D-Baltimore, told The Associated Press that in just four years, the number of the state's uninsured has grown from 600,000 to 800,000.

With no insurance, people don't get routine check-ups that could detect illnesses in their early stages. When the insured are so sick they can no longer avoid care, they come to hospital emergency rooms, where the cost of caring for them is added to everyone else's insurance costs.

To top it off, MedChi, the Maryland State Medical Society, is asking lawmakers to look at what its officials call an "impending crisis" of a doctor shortage.

There are two possible solutions to these related problems. For a General Assembly not eager to start this term with a tax increase, now is the time legalize slots, which could provide new funds just as cigarette tax revenues start to lag.

And the state could help young doctors pay off their student loans in return for spending some time in clinics for the indigent.

Yes, that would cost money, but it would certainly be a whole lot cheaper to treat a cold in a clinic than to deal with a case of pneumonia in the emergency room.

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