Tag Archives: health care

Hogan’s Worst Nightmare: Trumpcare

By Barry Rascovar

May 8, 2017 – Maryland Gov. Larry Hogan’s worst nightmare is starting to come true. Trumpcare has passed the U.S. House of Representatives. If the Senate finds a way to give President Trump what he wants, it could spell a heap of trouble for Hogan in 2018’s general election.

The Republican Party’s mania with obliterating Barack Obama’s massive health insurance law has led the majority party in Washington to ignore common sense.

“Repeal and replace” is a GOP obsession – though an estimated 24 million people could lose their insurance, tens of millions more could be out of luck due to pre-existing conditions and medical programs for the poor could be cut 25%.

It also would damage the nation’s economy. That’s especially true in Maryland, where healthcare is one of the state’s biggest employers.Hogan's Worst NightmareIt is almost certain to be the No. 1 issue in the 2018 mid-term elections, even if the Senate approves a diluted Trumpcare bill.

What a devastating state of affairs for Republican Hogan. Until the House vote last week, he appeared in excellent shape to win a second term.

Now he has to figure out how to tiptoe around this explosive issue that already is proving highly unpopular.

Unfavorable Poll Numbers

A Washington Post-ABC poll last month found 61% of Americans opposed Trumpcare. A Quinnipiac poll the month before found Trumpcare support stood at just 17%.

Most Americans, it appears, would rather stick with the existing – though seriously flawed – Obamacare medical insurance program and fix parts that aren’t working well (“keep and improve” as opposed to the GOP’s “repeal and replace”).

Wait until the Congressional Budget Office issues its cost and impact analysis of the House-passed version of Trumpcare. It could expose the bill’s soft underbelly. Public resistance could grow louder.

For Hogan, House passage of Trumpcare might be the beginning of bad news.

He could be trapped in a nearly untenable position: A Republican who might have to disavow his own party leaders in Washington to survive.

Hogan won election in 2014 by promising “no new taxes.” Does that mean he will let Trumpcare’s 25% cut in federal Medicaid funds lay waste to Maryland’s health programs for the poor and near-poor? Where would he find hundreds of millions in state dollars to cover those unfunded programs?

How does he run for reelection with Trumpcare hanging over his head?

Justifying Republican Plan

How does Hogan justify to voters his party’s plan to let insurance companies charge outrageously high premiums – or deny coverage entirely – for people with “pre-existing conditions”? This could be anyone with acne, anxiety, depression, diabetes, obesity, cancer, pulmonary problems, asthma or even allergies.

How does he tell older working Marylanders that under his party’s plan their insurance premiums could jump an unaffordable 500%?

How does he explain a cut of $600 billion in taxes that supported Obamacare – a massive windfall for wealthy Americans, insurance companies and medical device companies?

How does he justify $880 billion in healthcare cuts to Medical Assistance for the poor?

Hogan & Company should be praying that the Senate junks the House bill and takes a few years to figure out what to do next.

Otherwise, the GOP across the country – including here in Maryland – could take a shellacking for its all-out effort to appease its conservative base.

Gift to Democrats

There’s no doubt Democratic candidates for Maryland governor will tie Hogan to Trumpcare.

Every candidate will be running ads with tales of how middle-class and working-class Marylanders would be hurt, how lives hang in the balance.

It is a gift from heaven for Democrats.

One Republican pollster called the GOP’s insistent quest to wipe out Obamacare “political malpractice.”

Until recently the notion of Democrats regaining control of the House by picking up 24-plus seats next year appeared wishful thinking. Thanks to House Speaker Paul Ryan’s determination to pass a draconian Trumpcare bill, that’s no longer the case.

Little wonder Democratic House leader Nancy Pelosi – the former Nancy D’Alesandro from Baltimore’s Little Italy – was practically giddy.

Every Republican will be vulnerable, unless he or she disowns the GOP’s No. 1 issue and risks losing support from Trump’s supporters. “This vote will be tattooed to them,” Pelosi vowed.

That includes Republican Hogan, who has made an extensive effort to distance himself from Donald Trump and his controversial comments and proposals.

That may not be enough to give him immunity from this highly contagious political disease.

When virtually every healthcare group – from the American Medical Association to the American Hospital Association to AARP – as well as virtually every insurance group vehemently opposes the Republicans’ “repeal and replace” crusade, smart politicians should pay attention.

Failure by the GOP to “listen and learn” could prove fatal come November 2018 – both in Maryland and nationwide.

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Hogan, Trump & Trouble?

By Barry Rascovar

March 13, 2017–Maryland’s Republican governor, Larry Hogan, Jr., has done all in his power to separate himself from the new, controversial Republican president, Donald Trump.

Given Trump’s unpopularity in Maryland – he lost by a whopping 25% in November – that wall of separation keeps Hogan in good stead with most voters in this top-heavy Democratic state.

His popularity remains sky-high and Hogan continues to skirt controversial social issues that could bring him trouble with liberal voters while losing the backing of GOP conservatives.

Hogan, Trump & Trouble?

MD Gov. Larry Hogan, Jr.

His prime objective is getting reelected in 2018 while dragging in with him enough Republican legislators to ensure a veto-proof state Senate.

Then Hogan would have more leverage and ability to help the state GOP turn the corner in Maryland and become a truly viable statewide alternative to Democrat hegemony.

But that scenario could blow up in Hogan’s face through no fault of his own.

Trump Referendum?

The 2018 election is looking more and more like a national referendum on Donald Trump’s manic, unpredictable presidency. If that become the case, Hogan’s continuation in office could hang by a thread.

The beginning of the end for Hogan may have commenced last week with House Speaker Paul Ryan’s rush to eliminate Obamacare and replace it with a haphazard health-care insurance program that punishes the lower-middle class, the poor and citizens nearing retirement age.

It also is sending the nation’s health-insurance industry into a prolonged period of chaotic uncertainty. The result could be a rapid pullout next year by insurers from what’s left of Obamacare to avoid gigantic losses caused by the program’s slow, agonizing demise mandated by Ryan’s legislation.

The Congressional Budget Office on Monday estimated a whopping 14 million Americans would lose their health insurance coverage next year under the Republican plan being rammed through the House of Representatives. That’s terrible for Republicans who have to run for reelection in the fall of 2018.

Cutting subsidies out from under Obamacare also would devastate state health budgets. Hundreds of thousands of Marylanders now receiving health insurance support or care through Medicaid could be cut off without the resources to afford health-care protection (CBO says premiums could rise 20 percent next year alone).

Ryan’s plan calls for Maryland and other states to receive far less to undergird their health insurance programs. Hospitals could be flooded by non-paying patients with nowhere else to go. Preventive health care, a key component of Obamacare, would disappear; people would show up at emergency rooms needing far more costly medical treatment.

Bad timing

For Hogan, the timing couldn’t be worse. By next year, Maryland’s entire health care network could face an unprecedented financial and medical crisis. Maryland’s health expenditures could balloon, and many of the state’s citizens could be panicking over the loss of their medical safety net.

That’s a recipe for problems at the polls.

Unfortunately for Hogan, this could be just the initial blow coming from Trump’s Washington.

Sweeping federal layoffs this year and next seem in the cards — the largest cutbacks since the end of World War II by one account.

Last week, Comptroller Peter Franchot wrote down state revenue estimates for the next 18 months by $33 million and warned of the likelihood of major job losses in federal agencies employing hundreds of thousands of Free State citizens.

The budgets for programs affecting all aspect of the Maryland economy are at risk, from housing assistance critical in poor communities like Baltimore and rural Maryland to severe reductions in funding for the Coast Guard that could hurt the state’s important maritime economy and policing of the Chesapeake Bay.

Maryland impact

Massive budget cuts in the space program, food and drug enforcement, agriculture, the Census Bureau, the Medicaid agency, education aid, medical research and environmental protection would reverberate ithrough Maryland, home to many of these agencies.

All of this is dreadful news for Hogan.

He’s got nothing to do with what Trump and his Republican allies are foisting on the American public. Yet he may end up paying the ultimate political price.

Let’s face it. Hogan’s 2014 election victory was a fluke, the result of a well-run campaign and exceedingly good luck: Democrats nominated a historically bad candidate (Lt. Gov. Anthony Brown, now a member of Congress) who ran one of the worst-ever gubernatorial campaigns.

Given Maryland’s 2-1 Democratic voter registration edge, Hogan’s re-election was always less than certain, even with his high poll numbers. Inflame the state’s Democratic voters and any Republican, even a popular incumbent, could have big problems.

So if Marylanders are infuriated with Trump & Friends; if hundreds of thousands are scared, angry and afraid of having little or no health coverage; if the state’s large federal workforce endures unprecedented layoffs and spending cuts, and if Democrats are so enraged they take out their fury on Election Day, Hogan had better prepare for the worst.

Déjà vu?

It’s happened before.

In 2006, Republican Gov. Bob Ehrlich enjoyed exceptionally high polling numbers right up till the general election. Most people said Ehrlich had done a pretty good job. Yet he lost by 6% – nearly 120,000 votes.

How could that happen?

Ehrlich’s loss was linked to the unpopularity of a Republican president, George W. Bush, saddled with a wobbly economy, a flagging war on terrorism, an unnecessary, trumped-up war against Saddam Hussein in Iraq and ineptness in the White House.

By the November 2006 election, Bush’s poll rating – which hit 90% after the 2001 terrorist bombings, had plunged to 38%. (It would continue to sink to a low of 25%).

Voters wanted to send Bush a message – and in Maryland the only way to do that was by voicing disapproval of the top Republican candidate on the ballot that year – Bob Ehrlich.

Hogan should be alarmed that Donald Trump’s approval rating as of two weeks ago was just 38% – identical to Bush’s low appeal in 2006. The Obamacare controversy and the new president’s angry Twitter insults, unsubstantiated allegations and inflammatory rhetoric could shrink Trump’s approval numbers to record lows for an American president.

Should 2018 turn into a “message” election, Larry Hogan’s “good guy” image and Marylanders’ lack of animus toward him may prove all but worthless.

He could well become, for state voters, Donald Trump’s surrogate on the ballot.

It could be 2006 all over again in Maryland.  ##  

Crunch Time for P.G. Hospital

By Barry Rascovar

June 13, 2016 – Here we go again: Another liberal-conservative showdown over a new hospital for Prince George’s County. Only this time, the confrontation isn’t between Republican Gov. Larry Hogan, Jr. and the Democratic legislature.

Instead, the tug-of-war is between a conservative political scientist from a Republican think-tank and Democrats in the county who control its hospital system.

Crunch Time P.G. Hospital

Proposed Prince George’s Regional Medical Center

The think-tank guru, Robert Moffit, was placed on the Maryland Health Care Commission by Hogan. It’s his second time around, having been on the panel before under Republican Gov. Bob Ehrlich.

Due to a quirk in the way the commission conducts its business, Moffit has life-or-death powers over the proposed $655 million Prince George’s Regional Medical Center. He’s been assigned to evaluate this project and if he’s unwilling to sign off, the panel won’t issue the essential certificate of need (CON) for construction.

Wring Price Concessions

At the moment, Moffit is playing hardball.

He wants to wring $112 million from the project’s cost by cutting the number of acute care beds and dramatically shrinking room size. Moffit’s modifications call for fewer inpatient beds, fewer operating rooms, fewer emergency room bays and no specialty wing run by the Mt. Washington Pediatric Center.

It would be a stripped-down model designed to break even with far fewer customers coming through the doors.

That’s in keeping with both conservative Republican manta (do more with less) and a trend in health care that stresses outpatient treatment over hospital admissions.

Moffit, who works at the Heritage Foundation, doesn’t want a white elephant – a hospital that is half-empty and unable to pay its bills or avoid red ink.

That’s been the sorry state of county hospitals for decades under Dimensions Healthcare System, which has shortchanged county residents through long-standing management incompetence, political cronyism and an inability to offer quality medical care.

Deal in Annapolis

A running battle in Annapolis finally led to an agreement in which the state and county governments would chip in for a brand-new regional medical center in Largo, replacing the run-down, 75-year-old hospital at Cheverly and consolidating county in-patient beds at one site.

What sealed the deal was agreement by county politicians to relinquish control to the University of Maryland Medical System (UMMS), which has a record of turning woebegone hospitals into winners for patients and the bottom line.

But Moffit doesn’t seem impressed with what UMMS brings to the table. He’s so focused on the financials that he may be missing key, unspoken elements.

First, Prince George’s County is a health care desert. It is bereft of a comprehensive medical center. No wonder sick residents go elsewhere for in-patient hospital care – to Southern Maryland, to Anne Arundel County, to Montgomery County and to the District of Columbia.

A gleaming, ultra-modern regional medical mecca at Largo, with all the bells and whistles patients and doctors demand, could reverse the out-migration of patients in a hurry.

Indeed, the combination of a cutting-edge, high-tech hospital run by a nationally ranked teaching hospital could result in a stampede of primary care physicians seeking office space nearby. The dearth of primary care docs has been a major shortcoming in the county – a situation UMMS already is working hard to fix.

Different Fruits

Moffit also wrongly compares costs for the P.G. regional medical center to the new community hospital Washington Adventist Hospital is building in Montgomery County. The two have as much in common as apples and oranges.

The Largo project will be far more expensive because the demands for services are far greater in Prince George’s – and infinitely more complex.

The current Dimensions hospital in Cheverly is the second busiest trauma center in Maryland. With violent crime rising in the populous county, you can expect an even greater need for more emergency room bays and high-cost trauma medical care. That’s not factored into Moffit’s equation.

Nor does the commissioner take into account the enormous size of the county with a population that will hit 1 million in the not too distant future. Yet there’s a lack of even one high-caliber hospital.

That’s unacceptable.

Centerpiece of Change

Moffit concedes “a new general hospital campus in Prince George’s County is needed.”

What he doesn’t acknowledge is that this large, fast-growing subdivision with a huge minority population has always been short-changed. For too long, this populous region of Maryland has been denied a first-class regional medical center that can handle diverse and complex cases.

The last thing Prince George’s needs is a shrunken, run-of-the-mill general hospital.

Additionally, Moffit fails to take into consideration that a highly competent and experienced operating team from a premier teaching hospital will be running things.

Moreover, the mission isn’t just cost-efficient management of the new Prince George’s hospital. There’s a larger goal: to transform the county’s entire health care delivery system.

The centerpiece of that transformation is the new regional medical center.

Dumbing down the medical centerpiece denies county residents the kind of top-flight regional inpatient facility they deserve. It sets the stage for a penny wise/pound foolish decision from the Health Care Commission.

It also could lead to an angry response in Annapolis from dismayed Democratic legislators who are unwilling to accept a second-rate compromise.

They could demand sweeping changes in laws governing the Health Care Commission, reconstituting the panel and ensuring that one commissioner no longer gets to rule with near-dictatorial authority on hospital-construction projects.

There’s still time for a sensible resolution. Dimensions and UMMS have until Aug. 31 to respond to Moffit’s unreasonably stiff demands. It would be just as unrealistic to under-build as to over-build at Largo.

This is one decision the Health Care Commission had better get right.

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Hogan’s Cancer Awareness

By Barry Rascovar

Sept. 28, 2015 – We’re coming to the end of Childhood Cancer Awareness Month and Leukemia and Lymphoma Awareness Month and Maryland Gov. Larry Hogan, Jr., has played a big role in both campaigns.

Hogan's Cancer Awareness

MD Gov. Larry Hogan, Jr.

As most Marylanders are aware, Hogan was diagnosed with late stage 3 non-Hodgkins lymphoma in June. That’s an extremely serious but treatable disease in most cases.

Since then, he has undergone a series of exhaustive hospital stays that included three small surgeries, three spinal taps and 25 chemotherapy sessions. He’s got one more round of these arduous chemo treatments next month.

The good news is that 95 percent of his cancer has disappeared. The treatments – painful, uncomfortable and in every way disagreeable – so far seem to be working.

Throughout this ordeal Hogan has been an exemplary advocate for bringing awareness to cancer treatments and keeping spirits high among adults and children with cancer. The more people know about cancers, the more likely they will be to keep themselves healthy and react promptly when they suspect health problems.

They won’t look upon it as a certain death sentence, either.

No Secrets

Hogan, as a public official, recognized early on that he has a special responsibility to be forthright with Marylanders about his situation.

Unlike public officials of the past, he never tried to keep his illness a secret.

Indeed, he has gone out of his way to let people know about his lymphoma and his hospitalizations at University of Maryland Medical Center.

During those five-day stays, Hogan has taken upon himself the role of cheerleader, especially for cancer patients in the pediatric ward at UMMC. Brightening the day of these kids and letting the public know the governor of Maryland is on their side helps the kids and their parents immensely.

They no longer feel alone or that important government official don’t care.

Hogan also has scheduled plenty of cancer awareness appearances since June, including one at Oriole Park with baseball stars Rick Dempsey and Jim Palmer and others with pediatric cancer patients at Redskins and Ravens football games. He not only shows up but broadcasts these promotional visits on his Facebook page to spread the word.

Papal Encounters

Hogan took his cancer advocacy to a totally different level last week in making a big deal about his encounters with Pope Francis, first at an event at Catholic Charities in Washington and then at Joint Base Andrews in Prince George’s County.

He called his brief conversations with the pope “the experience of a lifetime.”

When Hogan, a Catholic, greeted the pontiff, he said, “Holy Father, may I ask that you please give a blessing to all those suffering from cancer around the world?”

What followed was dramatic to say the least. The pope placed his hands on Hogan’s head – bald from the chemo treatments – then traced the sign of the cross on his forehead and said, “God bless you.”

Hogan's Cancer Awareness

Pope Francis blesses Governor Hogan

At Andrews, Hogan and his wife, Yumi, stood in the receiving line as the pope boarded his customized jet, Shepherd One.

This time, according to the governor, Francis placed Hogan’s hands in his own and said, “I pray for you.”

This powerful episode will long be etched in Hogan’s memory. He took on the mission of representing all cancer victims before the pope rather than his own predicament.

Making Political Hay

There is clearly a political dimension to Hogan’s activities. That is unavoidable.

Hogan’s cancer diagnosis and treatment make him a sympathetic person even among Marylanders who strongly disagree with his actions as a conservative Republican governor.

Partisanship disappears, though, when people fall ill or experience personal misfortune.

There’s no doubt Hogan is benefiting from his Facebook page emphasis on cancer awareness and his own chemo treatments. His political aides have capitalized on this situation.

Yet other public officials might want to keep serious health conditions under wraps, to handle the chemo treatments, the unwelcome side effects and the personal problems that result as a private family matter.

Hogan isn’t giving the public a blow-by-blow account of this difficult journey he’s embarked upon. That’s only natural.

Still, he is being open, inclusive and transparent with Marylanders about his cancer. He is a role model for us in this regard.

It’s what true leadership is all about.

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MD’s Best in 2014

By Barry Rascovar

Dec. 29, 2014 — There’s no sense wrapping up the year without a traditional round of “bests” for 2014.

In this case, let’s look at some of the “worsts” as well, in politics and beyond.

2014-calendar

Best Catastrophic Recovery

Isabel FitzGerald and Carolyn Quattrocki

Remember when Maryland’s online health insurance exchange was a national joke in late 2013?

The state’s $261 million computer system crashed in its first hours of operation and never fully recovered.

Lots of finger-pointing ensued and the executive director was pressured to resign. The prime contractor was fired. It was a government nightmare.

Gov. Martin O’Malley jumped in to help jerry-rig a temporary fix that involved dispatching his IT gurus, Isabel FitzGerald and Carolyn Quattrocki, to try to straighten things out.

It was a terrible mess, with inexcusably long waits for anxious Marylanders seeking health insurance.

Still, by the time enrollment closed last April, 263,000 people had received health insurance via the exchange – either through private insurance or Medicaid.

Enrollment for next year, which began in mid-October, topped 136,000 by mid-December. That number will grow considerably prior to the mid-February cut-off.

It wasn’t pretty – and it certainly wasn’t cheap – yet in the end the exchange achieved its purpose. A large chunk of Maryland’s uninsured or under-insured individuals have insurance policies, giving them peace of mind when it comes to health care.

FitzGerald and Quattrocki were handed a lemon of a computer system. They turned it into lemonade.

Best Bit of Chutzpah

Blaine Young

It took real gumption, and a public-be-damned attitude, for Frederick County Commissioner President Blaine Young to connive with fellow Republicans to appoint him to the county’s planning board as his term on the commission was coming to a close.

Frederick County finally is a home-rule county, with a county executive and council. Young tried to become Frederick’s first county executive but he angered so many with his land-use decisions that he lost to Democrat Jan Gardner.

That’s when Young decided to strong-arm his way onto the planning panel, where he could continue to promote his pro-growth, pro-business policies, be a thorn in Gardner’s side and remain politically newsworthy.

Too bad this outrageous bit of chutzpah was illegal, as Maryland Attorney General Doug Gansler wrote. Young was “ineligible for the position, and his appointment was ineffective from the outset.” Young also can’t hold two public offices simultaneously.

But Young’s chutzpah persisted.

He showed up at a later commission meeting and confessed to an 18-month affair with the county’s budget officer, who had recently been shifted to a lesser post by Democrat Gardner at a lesser salary. Young wanted a full-fledged investigation of his paramour’s $40,000 cut in pay.

As for confessing his ethically and morally dubious affair and causing his lover intense public embarrassment, Young never flinched. A wrong had been committed, he said.

No wonder voters showed him the door.

Best Vegas Bet

The Baltimore Orioles

Orioles Logo

Who woulda thunk it?

Oddsmakers pegged Baltimore’s baseball Orioles to finish last or next-to-last in the American League’s tough eastern division.

One prognostication group gave the team a 4 percent chance of winning the AL East. Another set the O’s odds at 16 percent.

How wrong they were.

The O’s won the AL East by a country mile, finishing a strong 12 games ahead of the rest of the pack. The team’s chemistry was a joy to behold.

Free-agent acquisition Nelson Cruz crushed more home runs than any other AL player. The bullpen proved miraculous, and the starting pitchers remained solid throughout the 162-game season.

Manager Buck Showalter was named Manager of the Year and General Manager Dan Duquette received honors as the AL’s top executive. Owner Peter Angelos has every right to take pride in his team’s accomplishment.

Now if only we could go back in time and place a bet in Vegas on the O’s winning the AL East this year!

Best Investment

Jim Davis

Once it was the world’s largest steel mill with 25,000 workers, but the sprawling Bethlehem Steel plant that dominated southeastern Baltimore County for a century was shuttered, its parts sold for scrap – until Jim Davis stepped in.

The co-founder of the highly successful Aerotek national staffing firm in Hanover (along with his cousin, Steve Bisciotti), Davis and his partners at Redwood Capital formed Sparrows Point Terminal, LLC, to buy the steel mill’s 3,100 acres for $110 million. He then negotiated a $48 million cleanup with the EPA.

What he got in return was the largest industrial-zoned parcel on the East Coast, with its own railroad line, proximity to I-95 and loads of deep-water access to the Port of Baltimore.

The strategic site – at the mid-point of the East Coast – is being developed as a hub for port-related, energy, advanced manufacturing and distribution uses.

Already, Federal Express is considering a giant warehouse on 45 acres in Sparrows Point. The Port of Baltimore, meanwhile, is eager to annex the former coal pier and surrounding land in anticipation of a shipping boom, thanks to the widening of the Panama Canal. The land is ideal for roll-on, roll-off cargo.

Davis could be sitting on a gold mine, producing at least 2,000 jobs for the region within five years, by one estimate.

Best at Blowing a Sure Thing

Anthony Brown

Think about this: In a state where Democrats outnumber Republicans 2-1, with a huge advantage in campaign funds, with a giant party infrastructure to get out the vote, and with all the benefits of holding statewide office for eight years, Lt. Gov. Anthony Brown got the stuffing beaten out of him by Republican Larry Hogan Jr.

Everything went wrong for Brown in the governor’s race.

He proved his own worst enemy. He hired terrible campaign advisors. He ignored on-the-ground reports of trouble from veteran Democratic politicians. He gave the little-known Hogan millions worth of free advertising in a shameful attempt to smear the Republican.

Brown thought the election was in the bag. He didn’t campaign some nights so he could be home with his kids. He avoided contact with the media. He rushed out of meetings to make sure he didn’t have to answer audience questions.

He gave voters little exciting or innovative to think about. He refused to aggressively defend his administration’s record. He never explained why so many taxes had to be raised. He stuck to his prepared remarks and his bland campaign speech.

He looked and sounded robotic. His strategy was wrong and his tactics proved disastrous.

It was the worst gubernatorial campaign of the century.

Perhaps there’s something to the Curse of the Lieutenant Governor’s Office after all.

Best Gambler

David Cordish

MD Live logo

Competition be damned!

The ultra-competitive David Cordish fought like a tiger to delay or prevent new gambling facilities from opening in the Central Maryland corridor.

Yet his Maryland Live! Casino now has a rival in Baltimore with another arising near the Potomac River.

It didn’t faze Cordish.

Maryland Live! continued its aggressive expansion and marketing, raking in more gambling dollars than any other casino in the Mid-Atlantic region — $605 million through November, of which the casino kept $304.5 million.

The opening of Horseshoe Casino Baltimore was expected to chop a third off Cordish’s receipts. Instead, Maryland Live!, with 4,200 slot machines and 198 table games, took in more this November, $53.8 million, than in the comparable month a year earlier.

Now Cordish is embarking on a $200 million expansion that includes a 300-room hotel and spa next to Maryland Live! to help ward off competition from the $1 billion MGM National Harbor that could open in mid-2016. He’s also building a $425 million casino in South Philadelphia.

The key? Huge amounts of free parking, Cordish says, for both suburban and urban patrons.

Best of Baltimore

War of 1812 Bicentennial Celebration

Sure, it was two years late (sort of), but Baltimoreans knew how and when to commemorate the epic defense of Fort McHenry that helped turn the tide against the British in the War of 1812.

Baltimore was saved 200 years ago by the strategic blockade of the inner harbor, the savvy defensive lines thrown up in Patterson Park and the sure shots of Privates Daniel Wells and Henry McComas in targeting the British commander, Gen. Robert Ross, at North Point.

Charm City celebrated those events for months.

The long-forgotten history of that 1812-1814 military engagement was resurrected repeatedly at events around town. Francis Scott Key’s poem, now the National Anthem, was given more attention than ever before. The Battle of Baltimore, and other clashes of the war, were recounted in books and at historic re-creations.

A giant fireworks display highlighted Fort McHenry’s portion of the celebration, as did an impressive display of Tall Ships in the Inner Harbor.

It was an event to remember.

Best Losing Candidate 

Dan Bongino

He came within a whisker of knocking off the Democratic incumbent in a district re-drawn to favor the incumbent. Dan Bongino, a former Secret Service agent with a knack for publicity and relentless campaigning, almost succeeded in mining the discontent of Maryland voters to win a seat in Congress.

Bongino benefited from an outpouring of Republican and independent support in the Western Maryland portions of the Sixth Congressional District for GOP gubernatorial candidate Larry Hogan Jr. Both of them zeroed in on Maryland’s high taxes, high government spending and anti-business attitude. Bongino benefitted from anti-Obama sentiment.

Thanks to an exceptionally low turnout in the populous Montgomery County part of the district — where Democrats dominate — Bongino almost pulled an upset over first-termer Rep. John Delaney, losing by a little more than a percentage point.

Will Bongino try again in two years? Will the atmosphere then be just as conducive? Turn in to find out in 2016.

Most Pointless Power Play

Jack Young

Leave it to the Baltimore City Council — and especially President Jack Young — to top the list for ridiculousness.

Young maneuvered through two controversial bills and won council approval by near-unanimous margins. The only “nay” votes were cast by veteran Councilwoman Rochelle “Rikki” Spector.

That was too much for Young.

Spector not only had voted against his wishes but posed pointed and astute questions at Young: Why wasn’t there a separate hearing on the last-minute amendment to ban all plastic grocery bags from the city? Why not listen to the mayor’s objections?

Young, proving Spector’s point that he’s a bully, stripped her of all committee assignments.

It gets dumb and dumber in Baltimore’s legislative branch.

No wonder the City Council and its hapless presiding officer are the town’s laughingstock.

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Sharfstein’s Scarlet Letter

By Barry Rascovar

August 11, 2014 — For a 44-year-old, Josh Sharfstein has accomplished much: Baltimore City health commissioner, Maryland health secretary and chief deputy commissioner at the Federal Drug Administration.

Josh Sharfstein

MD Health Chief Joshua Sharfstein

Yet when Sharfstein leaves his state post at year’s end, his many achievements will be eclipsed by one giant failure: Maryland’s terribly botched health insurance exchange rollout.

This glitch-plagued rollout — the costliest debacle in Maryland state history — was a monumental disaster that should have been foreseen.

There were plenty of warning signs in the year leading up to the Oct. 1, 2013 enrollment opening. The exchange’s computer software immediately crashed — and remained dysfunctional for months.

Standing Tall

To his credit, Sharfstein shouldered the public blame for this immense fiasco. The other chief culprits, Gov. Martin O’Malley and Lt. Gov. Anthony Brown, deflected criticism to protect their political futures.

Even worse, they connived with legislative leaders to cover up the true story by avoiding an in-depth accounting of what went wrong until mid-2015. This intentional lack of transparency and accountability will remain an indelible blot on the O’Malley-Brown administration. It will haunt both of them in the years ahead.

Sharfstein took the fall at legislative hearings. He was the only one connected with this ill-fated project to apologize and take responsibility for a truly screwed-up rollout.

It is ironic this happened on Sharfstein’s watch because he’s known as a hands-on micro-manager who drives underlings crazy with his detail-oriented obsessions.

Loss of Control

This time, though, Sharfstein ran afoul of a bone-headed decision by O’Malley and Brown to set up the new Maryland health exchange as a separate, independent agency — instead of wrapping it neatly into Sharfstein’s health department.

That twist meant huge additional expenses — a separate set of backroom jobs had to be created and filled that could easily have been tacked onto existing services within the health department.

The biggest problem in giving the exchange its independence was loss of control.

MD Healthcare Connection

Sharfstein never gained direct authority over the health exchange because O’Malley set up the new agency outside the health secretary’s purview.

Yes, he co-chaired the oversight board with Brown, but that group served as a rubber-stamp for whatever Rebecca Pearce, the insurance executive hired to run the exchange, suggested. The panel didn’t challenge her assessments — a serious mistake.

Even worse, there were no traditional checks and balances to make sure the pivotal choice of technology contractors didn’t veer off-course (sadly, it did).

Nor were the health department’s seasoned computer experts in position to monitor the exchange’s faltering software development.

The department was left on the outside with no authority to intercede or blow the whistle on the prime contractor’s inept performance and failure to meet deadlines.

Righting the Ship

Sharfstein, a pediatrician whose entire career has been in government and public health, was ill-prepared to act as overseer of a highly complex information-technology project.

But as an experienced manager, and with a wealth of IT expertise available in his department, he probably could have avoided the computer crash that proved so costly.

To his credit, Sharfstein accepted responsibility for the disaster. He worked tirelessly to find a work-around and a fix (the first succeeded, the second didn’t). Now the old exchange system is being junked and a new one that is functioning well in Connecticut is being superimposed — at an enormous cost.

The health secretary will stay on to see if this latest stab at building a health insurance exchange works. He wants to walk away without leaving a health exchange headache on his successor’s desk.

That determination says a lot about Sharfstein’s commitment to righting the ship.

He can take pride in the fact that despite horrendous obstacles, over 400,000 people (mostly Medicaid recipients) signed up for health insurance through the exchange. If the Connecticut software system works in Maryland, that number should grow in Year Two.

Moving to Hopkins

We haven’t heard the last of Josh Sharfstein.

He’ll take up residency at Johns’ Hopkins’ Bloomberg School of Public Health as an associate dean with a full workload, but the urge to serve the public could lure him back, especially during a Hillary Clinton presidency.

If that’s the case, he’ll still have to explain what went wrong that led to Maryland’s costly health exchange snafu. It’s a scarlet letter he will wear, whether deserved or not.

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Cannabis, Politics & Public Health

By Barry Rascovar

May 27, 2014 — According to the mother of the man who recently crashed his stolen dump truck through the doors of WMAR-TV and stormed through the TV station claiming he was God —  her son was a heavy marijuana user and that’s what caused his latest  psychotic episode.

Psychotic man crashes dump truck into WMAR-TV

Psychotic man crashes dump truck into WMAR-TV

The near-calamity brings new focus to the marijuana legalization debate in Maryland’s June 24 gubernatorial primary.

One candidate, Democrat Heather Mizeur, champions marijuana legalization. She claims its use “is less harmful to the body than alcohol or tobacco.”

A Maryland with legalized, regulated, and taxed marijuana will mean safer communities, universal early childhood education, and fewer citizens unnecessarily exposed to our criminal justice system,” her campaign website states.

Del. Heather Mizeur

Del. Heather Mizeur

Note the one area Mizeur does not mention — the impact legalization might have on public health.

The WMAR incident is only the most glaring example of what might happen in the public health arena under cannabis legalization.

Marijuana Concerns

As luck would have it, the most recent issue of Columbia Magazine from Columbia University arrived in the mail recently with a lengthy article on pot legalization and what the university’s researchers have to say.

Writer Paul Hond raised these questions: “What are the harms to individuals from using cannabis? Will legalization lead to more use? Will the roads be less safe? And what about the kids?”

All those concerns require careful examination before entertaining Mizeur’s desire to make pot legal in Maryland.Columbia Magazine

Hond first spoke with Margaret Haney, who has run Columbia’s Marijuana Research Laboratory for 15 years.

When chronic marijuana smokers were asked to quit as part of the lab’s studies, here’s what occurred:

“Sleep disruption is one of the most robust withdrawal symptoms,” Haney says. “The smokers had trouble falling asleep. They woke up in the night. They woke up early. Their mood, too, reflected classic drug-withdrawal symptoms: irritability, anxiety, restlessness. Food intake dropped precipitously. The first two days, they consumed up to a thousand calories less than they did under baseline conditions.”

Haney continues, “The consequences of dependence are not as severe as with alcohol, cocaine, and other things. . . . However, once you’re a daily smoker, your ability to stop becomes as poor as cocaine users’.” Haney notes that “only 15 to 17 percent are able to maintain abstinence.”

Impact on Teens

Haney is most concerned about the consequences of teens who smoke marijuana regularly. “There’s going to be a cost for teenagers doing that. . . . I do worry about the developing brain and the effect of heavy marijuana use on the brain’s cannabinoid receptors” that affect mood, memory and stress.

Herbert Kleber, director of Columbia’s Division on Substance Abuse and former deputy drug czar under President George H. W. Bush (Bush the Good), is alarmed about another aspect: Today’s tokes are loaded with much more of the potent psychoactive compound THC.Marijuana Plants

In this complex, high-pressured world, Kleber understands “a lot of people are looking for escape.” But this isn’t the marijuana of your father’s days.

Back when the Beatles’ John Lennon called marijuana’s effects “a harmless giggle,” the amount of THC in a joint was about 2 percent, Kleber says.

Enhanced Potency

“Now, the THC level of the average DEA [Drug Enforcement Agency] seizure is about 12 percent. At the dispensaries in California and Colorado, it’s 15 to 30 percent. . . It’s a very different drug. A very, very powerful drug.”

In previous interviews he has ticked off the public health hazards — “increased likelihood of cancer, impaired immune system, and increased chance of other drug problems, such as addiction to opiates. . . . Recently, substantial evidence has been published linking marijuana use to earlier onset of schizophrenia and other psychoses.”

Kleber is concerned as well about the impact pot has on the young.

Teen smoking marijuana “Marijuana does affect the brain. The younger you are when you start using it, the greater the risk that it will cause brain damage that will be with you the rest of your life.”

True, smoking weed isn’t as dangerous as a drug addiction, concedes John Mariani, director of Columbia’s Substance Treatment and Research Service. “Marijuana problems tend to be less dramatic — you’re not as ambitious, you perform less well. You probably stay home, watch TV, and eat ice cream. The disorder is about the absence of things — what doesn’t happen.”

Is that the brave, new world that awaits Maryland in a Mizeur governorship?

Pot and Driving

Another accusation is that marijuana legalization will dramatically increase highway accidents. Guohua Li, director of Columbia’s Center for Injury Epidemiology and Prevention, is studying that question. His findings indicate the alarmists are correct.

“First of all. . . the use of marijuana doubles the risk of being involved in a crash. The risk is not as great as with alcohol, which increases crash risk thirteenfold. But when a driver uses alcohol and marijuana, the risk of a fatal crash increases about twenty-four fold. So marijuana in combination with alcohol doubles the risk.”

Li’s 12-year study (1999-2010) of traffic fatalities found that marijuana involvement with car crashes tripled during that time.

Li also took on Mizeur’s main legalization thrust — that marijuana does less bodily harm than  alcohol. “If you argue that because alcohol is worse than marijuana. . . then marijuana should be legalized, that’s a race to the bottom, rather than a race to the top.”

Backlash to Legalization?

Even one of legalization’s supporters at Columbia, Carl Hart, a neuropsychopharmacologist, author and director of the Residential Studies and Methamphetamine Research Laboratories, worries these public safety and public health issues will lead to what Hond calls “a spirited backlash to legalization in the near future.”

Columbia University Prof. Carl Hart

Columbia University Prof. Carl Hart

In the past year, we’ve witnessed in Maryland a stampede among some politicians in Annapolis to give a younger generation of voters what they want — legal pot — even before they examine the possible consequences.

What we’re missing is a frank discussion of the wide-ranging ramifications legalization could have on society. The scientific results from Columbia University are not encouraging.

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Obamacare Accountability — Oregon, not MD, Got It Right

By Barry Rascovar

March 31, 2014–Today’s the deadline for folks in Maryland to start the application process for health insurance under the Affordable Care Act. If you miss this deadline, you face a tax penalty next year.

The good news is that tens of thousands of people have health insurance who couldn’t — or wouldn’t — obtain it before.

The bad news is that Maryland’s health exchange has been an unmitigated disaster — a painfully small number of people actually applied and paid their initial insurance bill.

MD Healthcare Connection

MD Healthcare Connection

Those responsible for this stupendously costly debacle aren’t going to be held accountable.

Those at the top of Maryland’s political food chain still stonewall this issue hoping it fades from public view.

State legislators have ordered a slow-motion assessment of the damage by their own analysts. It’s doubtful this will be a detailed, CSI-style examination of what went wrong.

By the time the report surfaces in mid-summer it will be too late: The decision on what comes next — most likely connecting Maryland to Connecticut’s software system — will be made (as early as this afternoon).

And by the time that legislative report appears, the June 24 primary will have come and gone — and with it any danger Lt. Gov. Anthony Brown’s gubernatorial campaign might be fatally damaged by the findings.

It’s also possible any legislative report will be sanitized by House and Senate leaders so as not to embarrass Brown (by then he could be planning his inaugural) and Gov. Martin O’Malley, who has national aspirations.

What a shocking lack of accountability to the public.

The Oregon Way

It stands in stark contrast to the way another liberal, Democratic state, Oregon, handled its own Obamacare calamity.

Oregon, like Maryland, has a two-term Democratic governor, John Kitzhaber. It has Democratic majorities in both houses of its Legislative Assembly.

But unlike Maryland, Oregon has a strong second party. Republicans hold 26 of 60 House seats and 14 of 30 Senate seats.

With such a potent countervailing force, it’s no wonder Governor Kitzhaber wasted little time launching an independent probe of his state’s dysfunctional health exchange, known as Cover Oregon.

Oregon Gov. John Kitzhaber

Oregon Gov. John Kitzhaber

Its Oracle-based software crashed so badly on Day One that all applications were done by hand. Yet Oregon still signed up more people for health insurance than Maryland.

What the independent review in Oregon found is likely to be mirrored in Maryland — if there’s ever a similar third-party critique.

Among the Oregon findings:

–“There was no single point of authority on the project.”

–The governance structure “was not effective.”

–There were “competing priorities and conflicts between [state] agencies.”

–Cover Oregon failed to hire a prime contractor or a system integrator.

–The governor and others were repeatedly warned by Cover Oregon’s quality assurance firm, Maximus, that the project was seriously off-track. These warnings started years ago and were ignored.

–In 2011, Maximus wrote that the state was acting as its own prime contractor and thus was assuming “more of the overall project risk.” How true.

–There was no Plan B as required by federal law — but there was a backup plan in case the lights went out.

–Cover Oregon picked off-the-shelf software; Oracle claimed it required only 5 percent customization. The actual number was 40 percent.

–The selected software “was not stable” and to this day “more items are breaking than are being repaired.”

–Top state officials “did not understand or acknowledge the significance of the website issues” until it was too late.

–There was a lack of “a consistent, cohesive enterprise approach to management of the project.”

–There was “no authoritative direction.”

–There was “Ineffective and at times contentious” communications and a “lack of transparency.”

Cover Oregon

The Oregon report is highly critical of the Executive Steering Committee leading the project — similar to Maryland’s oversight panel co-chaired by Brown and Health Secretary Joshua Sharfstein:

–“Oversight authority was inconsistent and at times confusing or misinterpreted.” This led to “unclear or incorrect understanding about the true state of the project approaching the Oct. 1, 2013 deadline.”

–The steering group lacked “formal meeting notes and decision tracking and documentation.”

–Perhaps worst of all, the Oregon project did not have “a single enterprise decision-tracking tool to document and manage decisions across entities.”

When Kitzhaber received the damning 77-page report in March, he cleaned house.

He fired the state’s top health official — a longtime friend and ally — who had been running the exchange since January. The chief operating officer and chief information officer of Cover Oregon also got the heave-ho. (The exchange’s original leader had been forced out in December.)

The Maryland Way

Don’t expect such drastic action in Maryland. It doesn’t fit the image O’Malley and Brown want to project going forward. Accountability is giving way to practical political considerations.

Still, the Oregon autopsy rings many familiar bells in Maryland. What happened in Oregon seems to have happened here.

Here’s what a forensic analysis of Maryland’s failed healthcare sign-up effort is likely to show:

*O’Malley and Brown created the exchange as an independent agency unshackled from the state’s formal procurement process. Support services and the normal chain of command within state government were lacking.

*Brown and Sharfstein never gave the project the intense oversight and strong, authoritative leadership it needed.

*They hired the wrong contractor — a minor-league player in the world of healthcare IT — who then quarreled bitterly with the sub-contractor it hired to do the IT project’s heavy lifting.

*No one was riding herd on the contractor.

*The state’s IT gurus picked off-the-shelf software to save money and time, software that never had been used in this way.

*There was no back-up plan in case Plan A failed (as it did).

Quality assurance and system integration were lacking. There was no general manager and no effective tracking system.

*There was no exhaustive trial period built into the schedule. 

*There was a lack of clear and honest communication up and down the line. Transparency continues to be a problem.

What Citizens Deserve

That pretty much sums up what went wrong in Maryland — even without an impartial investigation by outside experts.

But it is worth considering whether Maryland citizens deserve the same type of no-holds barred forensic autopsy Oregon conducted into its health insurance debacle.

In a lopsided one-party state like Maryland, that may prove far too embarrassing for those in power to let it happen.

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MD’s Quarter-Billion Dollar Healthcare Fiasco

By Barry Rascovar

Feb. 16, 2014 — ACCOUNTABILITY is sorely lacking when it comes to Maryland’s botched rollout of Obamacare. Lt. Gov. Anthony Brown  is nowhere to be found when tough questions are asked. Gov. Martin O’Malley deflects “who’s at fault” inquiries, focusing instead on getting the deeply flawed software partly operable.

The computer system’s main contractor, Noridian Healthcare Solutions, blames its prime subcontractor, who in turn accuses Noridian — a healthcare services company, not an IT firm — of incompetence and conning the state. Given that Noridian has received $65 million to construct a failed system, the subcontractor may have a point.

No Probe Planned

Perhaps Health Secretary Josh Sharfstein will decide in April or May to pull the plug on this IT horror show and start all over with a proven system from another state or join the federal healthcare sign-up exchange. That will cost a pretty penny.

But no one seems in a hurry to find out who screwed up.

Governor O'Malley explains IT fixes to Maryland's healthcare rollout.

Governor O’Malley explains IT fixes to Maryland’s healthcare computer rollout.

Democratic state lawmakers have put off till the summer a Department of Legislative Services analysis of what went wrong. That fits nicely with their support of Brown’s campaign to succeed O’Malley. It will be a long time after the June 24 primary before that DLS report surfaces.

Lt. Gov. Anthony Brown

Lt. Gov. Anthony Brown

Those same lawmakers tried to ignore the ongoing scandal during the current General Assembly session, but public pressure led to a series of hearings that deal with fixing the system rather than assessing blame. This helps Brown immensely, since he’s most likely to be fingered as the state official who was asleep at the switch.

First District Rep. Andy Harris wants the Department of Health and Human Services to probe Maryland’s waste of a quarter-billion federal dollars on a nearly inoperable system but that’s a political stunt by a tea party Republican who is becoming a nattering nabob of negativism.

U.S. Rep. Andy Harris

U.S. Rep. Andy Harris

Meanwhile, the O’Malley-Brown healthcare exchange continues to limp along with 29,000 Marylanders enrolled in private health plans — just one-sixth of the way to Brown’s previously stated goal of 180,000 and one-fifth of the way toward O’Malley’s 150,000 sign-up goal.

It’s a mess, the worst waste of taxpayer dollars in memory. Yet no one is launching a probe. It’s all being handled with kid gloves and diplomacy so as not to hurt Brown’s election bid or O’Malley’s longshot run for the White House.

Impartial Report

What’s needed is the equivalent of the Preston Report. Back in 1985, Maryland suffered a calamitous collapse of its privately insured savings and loan industry. It cost the state and S&L depositors hundreds of millions of dollars.

Gov. Harry Hughes and lawmakers created the Office of Special Counsel to probe “all aspects of the events” leading up to the S&L crisis. A prestigious Baltimore attorney, Wilbur (Woody) Preston, and a small team of his associates produced a package of legislative reforms and a 450-page report that detailed what went wrong and why. It was a honest and thorough assessment.

Special Counsel Wilbur Preston delivers his S&L report in 1986 (Baltimore Sun)

Special Counsel Wilbur Preston delivers his S&L report in 1986 (Baltimore Sun)

That’s what’s required now — an impartial dissection of this costly embarrassment by someone willing to lay out the facts without worrying about whether the blame falls on the lieutenant governor, the governor, the health secretary or the IT vendors.

How much of the blame belongs to O’Malley, who ultimately is responsible for what goes on in his administration? This was, after all, the most important initiative the state has undertaken in ages.

How much of the blame for this healthcare fiasco sits on Brown’s shoulders?

e’s made a big deal of his leadership on this reform, though he’s recently tried to weasel out by claiming he was only in charge of the legislation (also severely flawed) setting up the exchange.

Brown clearly was a figurehead leader — a general who showed up for the public meetings but left everything to his underlings. Even when he said he learned of the computer snafus, he apparently failed to sound the alarm.

Bleak Outlook  

Since Democratic lawmakers aren’t willing to ask the tough questions before the gubernatorial primary, and the governor has shown no eagerness to create a special panel to probe this scandal, we may never learn enough to reach a conclusion.

Even the DLS report is likely to be scrubbed of any finger-pointing at state leaders. That’s especially true if Brown wins the June 24 Democratic primary. Top Democrats in the legislature will circle the protective wagons around the presumptive governor.

What a mess.

We will glean quite a bit about the exchange’s IT failures from the competing lawsuits filed by Noridian and its prime subcontractor, EngagePoint. But that won’t lift the fog surrounding actions of healthcare exchange leaders, the governor and the lieutenant governor.

Sadly, this is one mystery that may never be solved.

 

 

 

 

 

Brown’s Healthcare Albatross

By Barry Rascovar for MarylandReporter.com

January 20, 2014 — MARYLAND’S LIEUTENANT GOVERNOR, Anthony Brown, has a problem that won’t go away — his still unexplained leadership role in the state’s disastrous Obamacare rollout.

This is the biggest sticking point in Brown’s run for governor. It could become an insurmountable obstacle if public attention remains focused on those computer glitches and poor sign-up results.

Week One of the General Assembly session brought no relief.

Brown testified before two panels on a Band-Aid measure to rescue perhaps thousands of Marylanders who couldn’t sign up for health insurance because of the state’s horribly dysfunctional software product.

Lt. Gov. Brown testifies on healthcare bill

Lt. Gov. Brown testifies on health care bill

Reading from a prepared text is one of his strong points. Answering questions isn’t. Brown ducked the few hard queries tossed his way and headed for the door without fully admitting his responsibility for Maryland’s $170 million embarrassment.

He left Health Secretary Josh Sharfstein behind to make a heartfelt apology, give an explanation of what went wrong and take the heat.

What Wasn’t Asked

This left a number of key questions hanging:

  • Was Brown a figurehead leader of the health care insurance rollout?
  • What did Brown know about the behind-the-scenes fiasco that was building over the past year?
  • When did he know it?
  • Why didn’t he roll up his sleeves and get fully engaged in the administration’s most important project for which he was the designated point man?
  • Why was he left out of the loop?

We may never get complete answers.

While a few legislative committees will poke around in the state’s Obamacare closet, this won’t be a Watergate-style investigation.

Too many Democrats already have endorsed Brown for governor. They will take care not to make the lieutenant governor look bad.

Questions Won’t Go Away

Yet unless the sign-up numbers improve dramatically — not likely — the public will receive constant reminders of Maryland’s health care belly-flop during the General Assembly session.

And once the legislature goes home, the governor’s race will heat up, with Brown the center of attention.

Attorney General Doug Gansler, his chief rival, will spend most of his $6.3 million treasury reminding voters of Brown’s leadership role in the state’s biggest disaster since the savings and loan collapse in the 1980s.

Televised debates between the gubernatorial candidates could provide a flashpoint. It may be the only time Gansler gets to directly point a finger at Brown for his culpability in the health care disaster and demand an answer.

Thanks to the Washington Post, we have a picture of the chaos and astounding incompetence that surrounded Maryland’s ill-fated launch of its health insurance exchange. (A grand total of four people signed up that first day.)

And thanks to the Baltimore Sun, we have a reminder of how screwed up the health care debacle remains. (Inadvertently directing people trying to sign up to call a Seattle pottery shop. The snafu continued for four months. A day after The Sun alerted state officials, the poor Seattle shop owner was still getting calls from frustrated Marylanders.)

Then today, the Post and  The Sun reported another screw-up. Up to 1,078 informational packets, containing the new Medicaid sign-up’s name, date of birth and Medicaid ID number, were mailed by the state to the wrong addresses — exposing those people to possible identity theft and delays in receiving medical care. The state blamed it on a “programming error.”

If people’s health weren’t at risk, these human absurdities would make a hilarious “Seinfeld” episode.

Brown’s Dilemma

The self-identified leader of this healthcare reform, Anthony Brown, remains all but invisible as the situation unravels.

How is he going to explain all of this?

At last week’s legislative hearings, he refused to apologize for what happened. He pretty much pointed an accusatory finger at everyone else for hiding the cold, hard truth from him.

Still, Brown appears well positioned to capture the governorship.

He’s got the establishment’s political endorsements. He’s got Gov. Martin O’Malley doing everything he can to ease his path to victory. He’s got more money to spend on his campaign than Gansler.

Yet it might not be enough if Anthony Brown continues to wear that conspicuous health care albatross around his neck.Albatross hung around his neck

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You can read Barry Rascovar’s other columns at www.politicalmaryland.com