The presence in our community of so many uninsured people—88,000 in Montgomery County alone--is an ethical scandal, a fiscal drain due to inappropriate use of emergency room treatments, and a public health danger to us all. If we include people who are considered “underinsured,” there are more than 1.6 million Marylanders who lack a proper relationship to primary health care. The vast majority of these people belong to working families and disproportionate numbers are non-white. In 2002-2003, a shocking 61% of Hispanics, 35% of African Americans, and 31% of "other" ethnic minorities were uninsured, compared to 20% of non-Hispanic whites. Furthermore, people who cannot afford insurance and get sick live in constant danger of financial disaster: over 50% of bankruptcies in America follow upon the heels of unexpected and overwhelming medical debts. I have met people out on the campaign trail bankrupt and desperately unhappy all because of an uninsured illness or injury that spins out of control.

The haphazard character of our system leaves us with health care results inferior to what we are capable of as a community. Of the states, Maryland ranks 4th highest in per capita income, but behind 29 states in countering death from cardiovascular events and behind 33 states in lowering infant mortality. This is a state with the University of Maryland, Johns Hopkins University, Montgomery College, many other great universities and colleges and some of the finest hospitals, doctors and nurses in the world. We can do a lot better than this; we are a lot better than this.

Universal health coverage is a moral imperative and, in an age of virulent and fatal disease, a public health necessity. Massachusetts’ recent adoption of universal health coverage demonstrates that states committed to this principle can find a strategy that works. Massachusetts’ model, patterned after auto insurance schemes, may not be right for Maryland. But, as a Senator, I will push for public hearings on the spectrum of available options, including a single-payer plan and the Universal Health Care bill that was offered last session by Senator Paul Pinsky.

I will then work to build a statewide political consensus that, whatever design we come up with, health care should be available and affordable to all of our people. At a minimum, we must begin by making certain that all children in Maryland have medical and dental care. We must explore mechanisms for negotiating better drug prices and for correcting the continuing consolidation of health insurers, which creates dangerous anticompetitive practices.

Personal privacy and autonomy in medical decision-making are crucial values at every stage of the health care process and I would defend them passionately when it comes to reproductive choice and the growing constellation of complex end-of-life issues.

But public health today must mean much more than hospital care. I advocate an accelerating investment in a public health infrastructure that focuses on preventive medicine and wellness practices. Indeed, I would like to support community wellness clinics that promote healthy nutrition, expanded treatment of depression and other mental illnesses, drug prevention, exercise, community volunteerism and walking rather than driving. Moreover, we need to link our health plan to broader policies that enhance the quality of life here: aggressive environmental protection, civil rights enforcement, energy conservation, pro-family living-wage policies, and excellent public education that empowers young people to make good civic and personal decisions.