Crime and Safety


   Health Care



Doug Barry

Historian, Political Philosopher, Veteran


Let's start with the premise that everyone is entitled to health care. It was unacceptable that the United States was the only westernized country that did not provide for health care coverage for all of its citizens. Let's also stop the myth that uninsured people aren't costing us anything. Uninsured people are much more likely to go to the emergency room for standard medical treatment, because hospitals are required to treat them. Uninsured people are also more likely to wait until a minor problem becomes a major problem, adding thousands, sometimes tens of thousands of dollars to the cost of treatment. When they don't pay for that treatment, which is frequently the case, that cost has to be absorbed somewhere. We pay through higher medical and insurance costs. Anyone that thinks we are saving money by leaving people uninsured, is not looking at the whole picture.


  • Re-examine Maryland's implementation of the Affordable Care Act to correct mistakes and fix problems
  • Provide tax credits to individuals and businesses
    to offset insurance costs
  • Work with insurance companies and medical professionals to determine the best way to correct health coverage

Having said that, implementation of the Affordable Care Act in Maryland was less than stellar. The General Assembly has scrambled this year to patch holes in the system. The problems we are left with are likely to continue into 2015 and beyond. In 2014 the legislature is being reactive. In 2015, we need to become proactive. We need to examine the entire system to improve cost efficiency and reduce the expense to businesses and individuals.

Why Is Health Care So Expensive?

The United States has the most expensive health care in the world. We spend more money out of pocket. We are more likely not to purchase prescriptions because of cost. The medical bills charged to our insurance are higher.

There are multiple reasons for this. Uninsured Marylanders add significant costs to our health care. This will be remedied some once we get the new system working properly in Maryland, but we need to educate the public as we insure them. There are segments of our population that have developed the habit over decades, of using emergency rooms for their primary care. They need to be taught the financial and practical benefits of changing their habits.

We have insurance-driven health care, instead of the other way around. Medical decisions are made based on what insurance will cover. The system also allows for fraud, abuse and unnecessary tests and treatments that add significantly to the cost. We have liability-driven insurance. The cost of medical care must be sufficient to cover increases in malpractice insurance, and doctors order numerous unnecessary tests because they are afraid of being sued if they don't account for even the most unlikely scenarios (I had a case about 5 years ago, where an emergency room doctor was going to send me for an x-ray for a choking incident, after we had already determined there was no longer anything caught in my throat, which would have added hundreds of dollars to the bill for no reason).

We have higher prescription costs than the rest of the world. The federal government has allowed the prescription drug industry to take advantage of government assistance, without requiring enough in return. This must be fixed at the federal level, but Maryland and other states can push the federal government to act. We also have higher administrative costs than the rest of the world. Ideally, this should be handled at the federal level as well, but the state can compel medical providers to improve administrative efficiency and standardize systems to reduce costs.

Health Costs: How The U.S. Compares With Other Countries