Anthony Brown has seen firsthand the challenges of providing medical care for the poor. As a kid growing up on Long Island, N.Y., Brown watched his father, a doctor, struggle to maintain a practice committed to serving people who couldn’t pay for their treatment. The practice folded in just three years.
It’s an experience that made a lasting impression on Brown. As Maryland’s lieutenant governor since 2007, he has focused not only on addressing inequalities in primary care but also on the lack of resources that fuel them. That led Brown to spearhead a health policy initiative unlike anything else in the nation.
The new program, which Brown helped shape and push through the state legislature, came to life in January. The Health Enterprise Zones project provides $16 million in grants, tax breaks, loan assistance and other incentives to five health organizations in targeted areas around the state. It’s an approach that was familiar to Brown, a former Maryland House delegate since 1999 who had worked to strengthen development in economically depressed areas.
Brown’s initiative is modeled after economic enterprise zones, as well as the Harlem Children’s Zone project in New York, which provide intense, laser-focused resources to specially designated communities that need help. Applying that idea to medical care was an important innovation in a state like Maryland: Despite ranking among the highest states in primary-care physicians per capita, Maryland’s African-American residents are far more likely to die as infants, lack prenatal care or suffer from costly illnesses such as diabetes and heart disease.
“I’m more inclined to support an incentive than a mandate,” Brown says of the Health Enterprise Zones. “Although I understand the importance of mandates, I think if we can incentivize conduct and behavior we’ll get more people to buy in to what we’re trying to accomplish.”
Indeed, Brown has led much of Gov. Martin O’Malley’s health reform efforts, working with the legislature to pass Medicaid expansion and create a state-based insurance exchange for residents to purchase private coverage. In addition, he’s worked to curb domestic violence, improve services for veterans and boost access to higher education. “There is no one who has been as active in the policy arena as a lieutenant governor in my 28 years here that would even come close to Anthony Brown’s involvement,” says Maryland House Speaker Michael Busch.
Brown, who is one of the highest-ranking state or local public officials to have served in the Iraq War, is now running to fill O’Malley’s seat when the governor is term-limited out in 2014. Brown says he plans to focus on infrastructure investments to boost the economy, career-readiness for the state’s youth and continued health reform. “But what really underlies the work I do,” he says, “is eliminating the gaps and inequities that exist in our economies and our communities.”