Public health experts at Johns Hopkins University and University of Maryland, as part of the Maryland Citizens' Health Initiative organization (MCHI), proposed an unprecedented universal health care plan for the state of Maryland.
The $15.5-billion initiative is being led by Hopkins Public Health Professor and MCHI President Vincent DeMarco. Hopkins Professors Lisa Dubay, Margaret Ensminger, Bradley Herring, David Holtgrave, David Jernigan, Hugh Waters, Jonathan Weiner and Hopkins graduate students all helped craft the universal health care plan.
"We've been working for more than two years on a plan that makes quality health care affordable for all, particularly small businesses and families, in a way that is politically viable and fiscally responsible," DeMarco wrote in an e-mail.
MCHI proposed a set of comprehensive state tax increases to help finance the system, including increases in alcohol and tobacco taxes and a new tax on employer payrolls.
If passed, the proposal named Maryland Health Care for All (MDHCFA) would drastically reform the current health care system by lowering insurance premiums and mandatorily covering everyone who is currently not insured.
DeMarco expressed optimism that the proposal would pass in the near future.
"Maryland General Assembly goes into session from January through April.?We will propose our plan then but it is not likely to pass in 2009. We will build a powerful coalition over the next couple of years that will achieve this goal soon," DeMarco wrote.
According to the official MCHI Technical Advisory Committee Report on the proposal, the theme of the plan is choice.
Those who want to participate in MDHCFA could choose from different health care policies offered by the plan based on their income level.
"For families with children and total family income up to 200 percent FPL (Federal Poverty Level), they can choose to enroll in Medicaid [offered by MDHCFA] with no cost or receive a subsidy toward private coverage," the Report explains.
"Once I graduate and my parents stop paying for my health insurance, it'll be great to have universal health care in Maryland," freshman Aisley Amegashie said.
From the MDHCFA pool, small business employees would be able to choose a private policy that fits them from a variety of options.
"[Employees] who wish to elect a basic plan could choose between lower cost sharing versus fewer restrictions on care to match their preferences, and employees who wish to obtain more generous plans with lower cost sharing and fewer restrictions on care would pay the additional costs for those options," according to the Report.
The coverage would protect the insured citizens from extremely high medical bills with an automatic 10 percent drop from everyone's premiums once they sign up.
"This new plan allows our friends, family members and neighbors who are uninsured to get much-needed coverage," DeMarco wrote.
Furthermore, small businesses would also be beneficiaries of this plan.
While employees could choose to stick with their current health insurance, MDHCFA calls for the creation of a government-like insurance pool that would offer medical health coverage for small business owners and employees who don't have insurance or want to change their policies.
"Too many businesses right now are having trouble keeping up with escalating health care costs," DeMarco wrote.
According to the MCHI Report, the plan ensures that despite financial difficulties, certain procedures will always be covered.
"Maryland Health Insurance Pool merges individual and small group markets."
Its purposes are to "serve as a clearinghouse for individual private insurance companies," to cater to small businesses and to regulate which basic benefits should always be covered in an insurance policy for employers and employees in small businesses.
Public Health Professor David Bishai, who is not directly involved with the plan, agrees that MDHCFA is a sound health care plan.
"This plan is a very thoughtful approach to solving the health care problem ... Health insurance pools function more efficiently when they are large, and this plan proposes the largest and most inclusive approach," Bishai wrote.
Other aspects of the MDHCFA plan include the creation of the Maryland Institute of Clinical Value, which would promote both health awareness in the state and cost-effectiveness in the health care industry by giving incentives to hospitals that adopt electronic health records.
Another aspect is the implementation of the Catastrophic Reinsurance benefit that covers 75 percent of all the health care expenses over $35,000 for all residents.
The technical advisory committee of MCHI estimates that the proposed new health care system would cost the state over $15.5 billion in a five-year window.
Efforts to pay for the plan would include increases of the excise tax to $1.16 per gallon for beer, $2.96 per gallon for wine and $10.03 per gallon for spirits and liquors. State taxes for cigarettes would rise to $2.75 per pack.
MCHI also proposed a two-percent employer payroll tax on wages under the current FICA cap set to 102,000, starting in 2010.
The payroll tax would include all private employers in the state of Maryland and in local and state governments.
"Ensuring all residents have access to affordable [health] coverage requires the shared responsibilities between individuals, business, providers and government," according to the Report.
Over 150 organizations throughout Maryland have already endorsed the universal health care measure.
