What is the greatest health care challenge facing Maryland today, and how do you plan to address it?
The immediate health care challenge is Covid-19 and having a sufficient hospital workforce to not only deal with it, but future outbreaks, as well as all of the hospital work regardless of Covid-19. The common element is people (doctors, nurses, and support staff) and the willingness to provide them with the financial resources and time so that they can do their best. The General Assembly can and should provide robust budgets (for example, the Hospital Workforce Fund) so that personnel are not only paid fairly, but perhaps more importantly, enough personnel can be hired so that current personnel do not face burnout. The MHA appropriately had as its top priority to strengthen Maryland's hospital workforce and the General Assembly did pass a bill to establish a Commission to "study" the health care workforce crisis in Maryland. We already know that there is a crisis and while a study will provide support for what we already know, we need action by the General Assembly and--with my background in health care and finance--that is what I will provide if elected.
Maryland’s hospitals operate under a unique contract with the federal government that promotes community, equity, and value. It also contributes significantly to Maryland's economy. How do you plan to support the continued success of the Maryland Model?
The Maryland Total Cost of Care Model has become a model for other states. While so far it has been implemented only in Maryland, as Gerald Kominski, a health policy scholar at the University of California Los Angeles, stated: ""Maryland is doing more and providing better incentives than any other individual state.”
I support the continued success of the Maryland Model and anticipate that when CMS decides in December 2024 to expand the model, that it will be a positive decision and that there will be no need to remove Maryland’s unique waiver authority to set the prices that Medicare pays for hospital care in the state. The benefits of the incentives for reduced medical spending, enhanced quality of care, and improved population health are too important to forego.
Maryland is experiencing a shortage of health care practitioners, especially nurses, that we project will worsen in the years ahead. How do you plan to address the immediate crisis and what will you do to make sure we have a robust and sustainable health care workforce pipeline?
The General Assembly has established the "Commission to Study the Health Care Workforce Crisis in Maryland," which will "examine certain areas related to health care workforce shortages in the State, including the extent of the workforce shortage, short-term solutions to the workforce shortage, future health care workforce needs, and the relationship between the Maryland Department of Health and the health occupations boards." The Commission is required to submit a final report of its findings by December 31, 2023. That is not a typo! A crisis will have a report over a year after this year's election! Since the General Assembly is out of session until 2023, it is too late to change the 2023 date in a meaningful way, but what can be done is to not wait until the final report to respond to the crisis, but to take steps now (in coordination with the MHA) to be prepared to implement the Commission's recommendations before the final report is issued.
How would you increase availability of and access to health care for Marylanders?
Approximately six percent (or about 350,000) of Maryland residents are uninsured, which is lower than the national average of 9 percent. So Maryland is better than the rest of the nation, but still has room for improvement. That can be accomplished by automating and streamlining enrollment into coverage. For example, people can now sign up for health care when they file state tax returns or claim unemployment benefits. Almost 70% of those individuals who are not insured in Maryland qualify for Medicaid or federal help to buy private health insurance. Improved outreach to those individuals will dramatically increase health care access.
What policies will you pursue to improve health for all Marylanders? Please also consider the social determinants of health?
As stated by the National Center for Environmental Health (part of the Centers for Disease Control and Prevention or CDC): ""The environment is everything around us: the air we breathe, the water we drink and use, and the food we eat. Additionally, the chemicals, radiation, microbes, and physical forces with which we come into contact. Our contacts with the environment are complex and not always healthy. At the National Center for Environmental Health (NCEH) we work to prevent illness, disability, and death from contacts between people and the environment. We are especially committed to protecting the health of vulnerable populations — children, the elderly, and people with disabilities – from certain environmental hazards.""
Thus, one of my policies that I will pursue is to improve the environment (land, air, and water), which will have the beneficial impact of improving ones health.
How do you plan to address consumers' growing exposure to health care costs, such as high deductible health plans and rising prescription drug prices in Maryland?
Just as ones health is linked with the environment, so too are health care costs linked to the economy. A holistic approach is needed to ensure that Maryland's economy is strong and jobs are readily available to provide sufficient income for not just health care costs, but other costs essential for daily living. Inflationary pressures occur at the national level and depend upon monetary and fiscal policies that are outside the control of the General Assembly or the public. Notwithstanding these limitations, some steps can be taken, such as the greater use of generic drugs and working with our federal legislators and the Food and Drug Administration (FDA) to lower the cost of drug prices by permitting importation of drugs at a lower cost that maintain the requisite safety protocols. The Affordable Care Act (Obamacare) can lower monthly premiums with a Bronze or Silver plan or lower out-of-pocket costs with a Gold or Platinum plan.
Maryland’s worsening medical liability climate, as noted in a recent independent report, threatens access to, and affordability of, health care services in Maryland. Plaintiffs’ attorneys typically take 40% of a medical malpractice judgment. Do you support limiting attorneys’ fees so that the affected individuals can receive more of their settlement or judgment? What additional reforms would you support that balance supporting individuals and families harmed by medical malpractice with ensuring continued access to services in a community?
Plaintiffs' attorneys do typically take as much as 40% of a medical malpractice judgment, but that is if the case goes to trial. However, approximately 90% of all medical malpractice cases end in an out-of-court settlement, in which case a typical contingent fee percentage is 33% and not 40%. In either case, it usually takes over two years to resolve a malpractice claim. Arguably it would be more beneficial (both in money and in time) to those individuals and families harmed by medical malpractice to use either mediation or arbitration to settle their issues. In all likelihood, a seasoned arbitrator will probably not gouge doctors and their insurance carriers for millions of dollars, but instead reach a fair conclusion both for the families and for the doctors.
What are your priorities should you be elected, not confined to health care?
1. Support our kids.
I have taught in Baltimore County schools since 2015 as a substitute school teacher (grades K-12) and have been endorsed by the Teachers Association of Baltimore County and the Education Support Professionals of Baltimore County. I am also an adjunct professor of finance at the University of Maryland Global Campus. The Blueprint for Maryland's Future (Kirwan Commission) charts a path for Maryland to excel for our children's educational future, which will position them for success in life.
2. Protect your money.
We do not need higher taxes; we do need effective use of the taxes that are raised. My background at the Centers for Medicare & Medicaid Services (CMS) was as a Supervisory Accountant. My recent responsibility at the Health Resources and Services Administration was to ensure the payment integrity of the $193 billion of the Provider Relief Fund, Covid-19 Coverage Assistance Fund, and the Covid-19 Claims Reimbursement for the Uninsured Program. My educational background (MBA--Finance and Investments and JD-Tax and Environmental Law) combined with my financial expertise will ensure that your taxes will be wisely spent.
3. Improve our environment.
As noted in my answer to Question 5, ones environment is inextricably connected with ones health. Just as Maryland is a leader in the nation by its Total Cost of Care Model, it should also be a leader in improving its environment, from the Eastern Shore and the Chesapeake Bay to the Appalachian Mountains. As climate change becomes more and more noticeable, it makes the case easier for sustainable development, which will also be good for the economy with Green jobs and expanding employment opportunities while also reducing air and water pollution.