the outstanding quality of its medicine and its medical institutions. This
has come about, to a great degree, through a unique and enlightened
partnership between the State, the medical profession, voluntary hos-
pitals and community leadership. It is this partnership—its past, its
present and its future—which I should like to talk to you about today.
It is an old partnership, which I have indicated, and still it reaches
forward into new frontiers.

As recently as a year ago, Maryland took another significant step
forward in the health care of the indigent and the medically indigent.
We became the first State broadly to relate payments in the program to
the actual cost of service. And again Maryland placed itself in the
vanguard of medical progress. We are all aware that the voluntary
hospital system in this country is beleaguered by rising operating costs,
the obsolesence of facilities and the urgent need of expanded hospital
plants and equipment. One of the problems is: Where is the money
coming from to correct this situation? Voluntary hospitals are finding
it difficult to produce the funds needed by traditional fund-raising
devices. At the same time, private hospitals are wary of direct financial
intervention by federal and state governments. Somewhere, in my opin-
ion, there is a middle-of-the-road solution. And I suspect it will be
found in this unique partnership for health care in Maryland—physi-
cians, lawmakers, hospital trustees and administrators and community
leaders.

Over a great many years, your State government has been aware of its
responsibility for the medical and hospital care of its citizens who other-
wise could not afford such care. Maryland legislative history of the
nineteenth century is sprinkled liberally with appropriations of specific
amounts to individual hospitals for particular purposes. A singular
feature of this early history of medical care for low-income citizens was
the nature of the approach to the problem. It was never an undertaking
of the State alone. From the very beginning, it was a joint enterprise
of the State, the hospitals, the medical profession and the community.
This was not the case in most other states.

One of the early successes of this partnership was the institution of a
public health system. Maryland was the first State in the union to have
a health officer in every county. In time, there was developed within this
partnership an almost missionary zeal to bring good health care to every-
one in the State. Medical teams from the great hospitals in Baltimore
journeyed regularly by steamboat and even horseback to the outlying
hospitals of the State. Those pioneers of modern medical care in Mary-
land were many. On the honor roll we recall such names as Reilly,

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