Doctor faces tight congressional race in attempt to keep Maryland's Eastern Shore red

Washington -- Andy P. Harris, MD, is trying to keep Maryland's congressional 1st District in Republican hands. But this year's political climate and a few fellow Republicans aren't making it easy.

The conservative three-term state senator and obstetric anesthesiologist surprised some observers by defeating incumbent Republican Wayne T. Gilchrest, a moderate, in the party's primary in February. Gilchrest angered many Republicans by splitting with the party on several occasions, such as when he opposed the troop surge in Iraq.

Now Dr. Harris is facing moderate Democrat Frank Kratovil, state's attorney for Queen Anne's County. The contest has appeared tight at times, but it "should not be a close race," said former Maryland Gov. Bob Ehrlich, speaking at an Oct. 11 GOP fundraiser for Dr. Harris at the Maryland State Fairgrounds in Timonium. Dr. Harris was minority whip during Ehrlich's administration, which ran from 2003 to 2007.

Ehrlich said Republican voters need to send a message to Democrats on Capitol Hill and in Annapolis: "Hands off our district. This is our district." In 2004 President Bush won the 1st District, centered on the state's eastern shore, 62% to 36%. Maryland Democrats redrew the district in 2002 to include more Republican voters and therefore increase the chances that Democrats would win other Maryland congressional races.

A Democratic Congressional Campaign Committee poll of 400 likely voters conducted Sept. 9-12 showed the candidates in a statistical dead heat. But Dr. Harris said his campaign had not really begun advertising heavily at that point.

The physician candidate has hit a few political speed bumps in the race. President Bush endorsed Gilchrest in the Republican primary. Then in early September, Gilchrest bucked the party by endorsing Kratovil, Dr. Harris' Democratic opponent. Kratovil "will be a smart, tough legislator who will always put his friends and neighbors ahead of party," Gilchrest said in a statement. Two Republican county commissioners also have endorsed Kratovil.

Democrats are trying to make the race competitive. The party is spending hundreds of thousands of dollars to support Kratovil's campaign in an attempt to gain an additional House seat.

Dr. Harris has the support of MedChi, Maryland's state medical society, and AMPAC, the American Medical Association Political Action Committee. AMPAC has donated $5,000 to Dr. Harris' campaign -- the maximum allowed -- in both the 2008 primary and general elections.

Dr. Harris has helped in trying to secure better state payment for doctors in Maryland and in explaining medical issues to other state senators, said Neilson Andrews, executive director of the Baltimore County Medical Assn. "From that point of view, he's been a wonderful senator," she said. Twelve physicians serve in Congress, two in the Senate and 10 in the House.

A consumer-driven platform

Dr. Harris and Kratovil appear to offer very different paths for health system reform.

Kratovil has embraced the concept of requiring people to have health insurance and has called for more spending to reach universal coverage. His campaign declined several interview requests to speak about his health care positions.

Dr. Harris instead favors proposals that reduce government influence in health care and place the consumer in charge of his or her own health care. Although economic troubles have taken center stage this year, health care will remain an important issue for the country, he said. "No matter who wins the next presidential election, I think there's going to be something done about health care," he said. "It's going to be defining which direction we take in our effort to reduce the number of uninsured."

Dr. Harris said Congress can embrace one of two visions for health care. Lawmakers either can expand government health programs or make individual health insurance plans more affordable, perhaps in part by eliminating state benefit mandates. He prefers the latter vision. Government-organized -- but not funded -- health plan pools also may have a role in making insurance less expensive.

Instead of expanding Medicaid, Congress could offer vouchers or tax credits that allow people to buy private health insurance. "Physicians and patients have been shortchanged by traditional Medicaid," Dr. Harris said, in part because average payment is lower than Medicare or private insurance. Making insurance more affordable will reduce the number of uninsured, he said.

The physician candidate would consider preserving Medicare by requiring some beneficiaries to contribute more. The Medicare Part A trust fund, which helps cover inpatient care, is on track to be exhausted by 2019. That could be slowed if Congress imposed higher premiums on beneficiaries with higher incomes. Such income-relating of premiums is already in effect for Medicare outpatient care. Dr. Harris said he would prefer not to cut Medicare benefits.

President Bush's ban on human embryonic stem cell research funding does not need revision, Dr. Harris said. "We're going to figure out that there's no need for the federal government to get involved in research that destroys living human embryos because we're going to be able to innovate our way around that question."