Democratic gubernatorial candidate Ben Jealous released a plan Wednesday calling on Maryland to take the plunge and create a universal health care system without waiting for the the federal government to take the lead.
The release of Jealous' outline of a statewide "Medicare for all" plan comes as he was planning a Wednesday night rally at the Notre Dame of Maryland University with 2016 presidential candidate Sen. Bernie Sanders, a supporter of single-payer health care who has endorsed Jealous' candidacy.
"The time for Medicare for all for Maryland has come," Jealous told The Baltimore Sun
Jealous said in the summer, shortly after he announced his candidacy in the June 26 Democratic primary, that he wanted to establish what would be the nation's first state-based single-payer plan. He is among eight Democrats who have announced bids to unseat incumbent Republican Gov. Larry Hogan.
The former NAACP president's 19-page plan fleshes out his intentions of the issue — but leaves unanswered such questions as how much it will cost and whether Marylanders would have a choice of participating.
Jealous contended in an interview with The Baltimore Sun that Maryland is in a better position than any state has ever been to create a state-based version of the federal Medicare program that would serve people of all ages. He said his proposed MD-Care program would build on Maryland's unique "all-payer" health care system, which requires that all insurers pay a standard rate for hospital services.
The system, which has support in both parties, saved an estimated $429 million between 2013 and 2016 and held the growth of Maryland health care costs below the national average, according to the state Department of Health. Jealous said his plan would build on that system.
Jealous' proposal flies in the face of skepticism about whether a single state can achieve the economies of scale necessary to set up a single-payer system on its own. Even in politically liberal California, with a population more than six times Maryland's, efforts to set up a Medicare-for-all system have stalled in its Democratic-dominated legislature.
In Sanders' home state of Vermont, Democrat Peter Shumlin won the governorship in 2010 on a promise to set up a single-payer system. But in 2014, he abandoned the plan, saying the tax rates Vermonters would have to pay for such a system would be "staggering."
According the the Department of Legislative Services, it has conducted no recent studies of what it might cost to set up such a system in Maryland.
Jealous insisted Maryland, with a population about 10 times that of Vermont, has a large enough economy to go it alone in setting up a system of its own. He said Marylanders would pay less in state taxes to establish such a system than they are now paying in insurance premiums because overhead costs would be much lower.
A Medicare-for-all system would also have advantages in negotiating with "Big Pharma" for lower prices for medicines, Jealous said. He said while federal law prevents the U.S. government from using its market power to negotiate lower rates, state and local governments are not covered by the ban.
Jealous' MD-Care plan calls for services that go well beyond traditional Medicare and Medicaid service. He would include, among other things, comprehensive mental health care benefits, as well as vision and dental care.
To devise such a system, Justice said he would bring together various stake holders to establish an advisory council that would recommend details such as how to pay for the system and whether participation would be mandatory.
Among the funding sources he said the panel would consider are premiums charged to employers, the sales tax and income taxes.