Prior to the construction of Howard County General, most emergency services were provided outside Howard County. In Baltimore and Montgomery General Hospital opened in 1920. With the rapid increase in population anticipated from the Rouse Company development he approved, County Commissioner Charles E. Miller, attempted to redevelop his families Historic Gray Rock farm in Ellicott City to build a 200 bed Lutheran Hospital and housing development. Despite multiple attempts,the zoning for the hospital was not approved as competition for the proposed Howard County General project. In addition, the State dropped another 1973 proposal to build a 200 bed unit in Ellicott City by Bon Secours for refusing to service abortions as a Catholic hospital.
Benjamin Bassler exchanged 92 acres (37 ha) of his fathers 400-acre (160 ha) family farm and airfield to The Rouse Company in exchange for a 504-acre (204 ha) farm to create Haysfield Airport. A hospital was proposed for the development as two others sought State and County approval. The 59 bed Columbia Hospital and Clinic was opened on July 9, 1973 serving members of the Columbia Medical Plan only. The Columbia Medical Plan was an early HMO created by the Rouse Corporation in conjunction with Columbia's chief backer and financier Connecticut General Life Insurance and Johns Hopkins, which initially discouraged private practices that would form competition. The hospital was an early adopter, integrating psychiatric admissions with regular admissions. After a year of operations, the facility was opened to residents outside the Columbia Medical Plan, with the new name Howard County General Hospital.  Within the first three years, the hospital was rated the second most expensive in the state and faced budget cuts after cost overuns and unpaid debt. It currently employs over 800 medical professionals and approximately 1,700 people total.