Md. County's Model Health Program For The Uninsured Faces Some Obstacles

One Maryland county's tiny new health care programs for the uninsured could be a model for providing care nationwide, National Public Radio says in an ongoing series. The program is cheap, effective and heavy on preventive care, Howard County's health commissioner, Dr. Peter Beilenson says. The program, called Healthy Howard, provides care for families of four earning up to $66,000 a year, and patients are required to pay $50 to $85 a month. But some of the enrollees are running into trouble. 

In return, they get six or seven primary care visits a year, access to cheap drugs and receive pro bono hospital services. The upfront costs guarantee that people prioritize their health care and are active participants in the program. However,  Beilenson was concerned that about 10 percent of patients may be automatically disenrolled from the program because "the debit cards they had given us have been overdrawn or their credit card had exceeded its credit limit."

When Beilenson considers the reform debate in Washington, his reaction is that an individual mandate would require patients like the ones he treats to pay up to five times as much for basic coverage. Before the program, he said he and his colleagues were in an "ivory tower" and failed to appreciate how strapped many low-income people seeking health care really are: "They're bumping up against a financial ceiling, even with this very modest amount of outlay required each month"  (Siegel, 7/16).

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