NEWS CONFERENCE 647

In Maryland, within the limits that we can control, we intend to
try to make the pieces fit together — not by force but by analysis and
sensible alteration. This, of course, cannot be accomplished without
the total cooperation of the executive branch, the Legislature, local
governments, and the private health interests.

Maryland has now reached a crisis requiring identification of the
problems involved in its State Health Program. The crisis appears
primarily as one of cost, but beneath are even more serious problems
related to people and their present expectations from their communi-
ties. The crisis is substantially aggravated by a woefully inadequate
organizational structure to deal effectively with the many problems.
The following points identify major problems:

1. The present health program has grown in the direction of meet-
ing the special needs of various groups and not in accordance with a
planned health structure; therefore, both organizationally and func-
tionally it is in need of review and modernization.

2. Pressures are mounting for additional programs to be under-
taken by the State. Examples are: care of alcoholics, pollution control,
mental retardation.

3. Federal programs are forcing action within the State, not in
accordance with an overall State plan, but on the basis of special
health interests. For example: The Heart, Cancer, and Stroke Pro-
gram; Medicaid; Comprehensive Service Planning; Community Men-
tal Health.

4. The public has developed an attitude of high expectation for
health service. A new element of high cost demands is prevalent.

5. Broadened care and suddenly increased labor rates have sharply
escalated costs — beyond public willingness to sustain them through
taxes, insurance premium increases or private payment.

Functionally, the health program of the State must articulate solu-
tions within these principal areas of concern:

1. Easy access by the individual to needed health care, and pro-
tection of the community by adequate health regulations.

2. Efficient cost control to insure that only fair and reasonable pay-
ments are made by government and individuals for medical services.

3. Proper planning for needed physical facilities and control over
wasteful duplications of expensive equipment and services.