Part 1 of A Health Plan for Maryland focused on the Affordability of a just healthcare plan. A huge cost for enrollees is prescription drugs, the last sacrosanct, unregulated bastion of the healthcare industry. How long can the pharmaceutical companies continue to dodge the cost control bullet? How many more times are we going to hear the industry mantra: we need to charge enough so that we can pay for our research? That sounds like the same thing we hear when the obscene quarterly oil company profits are posted and the companies say: we need the extra money for exploration.
   A tremendous amount of research is being performed at this second by NIH and our Medical Schools across the country with grants funded either by taxpayer monies or by private foundations. All of the results are posted on the NIH website which is available to anyone, including the drug companies. Of course, there are expenditures necessary for clinical trials, but it is time for the pharmaceutical companies to be held accountable for their prescription drug charges. The Medicare bill passed recently to allegedly address prescription drug costs not only avoided any cost accountability, but made it illegal to buy the same drug made by the same company in Canada at a reduced rate. That section should be repealed immediately and I urge Congressman Steny Hoyer to open the door for prescription drug accountability on a federal level.
   In Maryland, it is time to bring the drug companies under the same light as every other segment of the healthcare industry. Not long ago, I suggested to a conservative legislator that he should call for cost accountability for prescription drugs. You would have thought I committed a religious sacrilege. He said, “Oh, I couldn’t do that. That would be against free enterprise.” I replied that every other sector of the healthcare industry is controlled in some way, but he stuck to his position. Either way, folks, there can be no affordable health plan without prescription drug cost accountability.
   A just healthcare plan must have complete and unequivocal portability. Employer based plans have become a hindrance to the general public when someone is laid-off or loses his or her job for any reason. Not long ago, Congress sought to address that problem, but flubbed it again. They gave the employee the right to retain his or her health insurance, but the reality is that the premiums skyrocket. Most people simply cannot afford them and go without insurance. This is a tragedy and I hope that this new Congress will truly address one of the most serious domestic healthcare problems: Portability.
   Every citizen should have the right to keep his or her insurance when leaving a job at the same rate it costs while working. There should be no increase in the premium. Of course, this would not be an issue if a comprehensive fee-for-service plan was available to all at a reasonable cost. This new plan would not eliminate any other existing plan. Every HMO, PPO, and all of the other O’s would continue as before, but they most likely would need to downsize because this plan would catch on quickly. I firmly believe that Americans cherish their freedom and this type of plan would give them an opportunity to exercise that freedom. Imagine going to any healthcare provider licensed in the state. There would be no provider lists. There would be no prior approval. Fees would be controlled and the public could seek out care based on the provider’s ability, not because he or she is on some list sent out in a huge catalog.
   One more point must be noted about such a plan: executive compensation. Many healthcare plan executives have been drawing astronomical salaries, literally draining funds needed to cover the care they are required to render. In this plan, compensation for the person at the top should be capped at the level of any other cabinet member of the Governor’s staff. I constantly hear the corporations whine that they can’t attract quality executives without huge salaries. Baloney! The line of qualified people seeking the job would be quite long. And if the unions buy into this plan, the rest of the country would be forced to take notice. Why wait for Congress? Maryland can set a nationwide standard.