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State health care woes need a separate debate

April 17, 2007

Frustrated by their inability to pass some individual initiatives in 2007, leaders of the Maryland General Assembly are thinking about putting together a something-for-everyone bill in 2008.

Under this approach, those who want an expansion of health care would have to support the legislation of slot machines, a change in the state's tax structure and possibly a tax increase.

On Monday, The (Baltimore) Sun quoted Sen. Thomas M. Middleton, D-Charles, as saying that including a health-care expansion with a tax increase would make it an easier sell.

If this sounds familiar, it's because it's what the U.S. Congress does all the time - coupling bills that wouldn't pass on their own with more popular measures.

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We don't favor this approach, although we can understand why frustrated lawmakers are looking for some way - any way - to make progress.

Proposals to increase the number of Marylanders with health care failed when Senate President Thomas V. Mike Miller opposed funding it by doubling cigarette taxes to $2 per pack.

Miller wants a more comprehensive approach to the state budget and told The Sun a special session might be be necessary to work on that prior to 2008.

Whatever happens, there is little doubt that Maryland needs to improve health-care funding for its low-income residents. The threatened closing of Prince Georges Hospital, which serves many uninsured citizens, is just one symptom of the problem.

Last month The (Baltimore) Daily Record reported that there are 800,000 uninsured Marylanders, 135,000 of them children.

The paper also reported that while Maryland covers 120,000 children and pregnant women under the Maryland Children's Health Program, to be eligible for Medicaid, adults in the state can make no more than $5,000 per year.

This is a problem for all citizens, because those with no access to affordable health care tend to wait until their illnesses have progressed before they go to the emergency room.

At that point, they are treated, whether or not they have the ability to pay. The cost of that treatment is then shared with all other patients, driving up the cost of everyone's health care.

And if the Prince George's Hospital system closes because of funding, the 180,000 patients it treats each year will have to go elsewhere.

The Sun reported last month that the Prince George's problems were made worse because of the closing of D.C. General Hospital, which also treated a higher number of uninsured citizens.

The health care problem is complicated. One obstacle to increasing the income limits for eligibility is the fear that some workers will drop coverage they have now to get cheaper state coverage.

Those issues need thorough exploration and a solution of their own, as opposed to being thrown into a catch-all bill in hopes that the objective of better health care for children will make it easier to swallow the pill of increased taxes. Those children and the state's taxpayers deserve a better, separate solution.

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