LAWYER-LOBBYIST Vinnie DeMarco ran into Gov. Robert L. Ehrlich Jr. on the street one day near the end of the recent General Assembly session.
Hey, governor, thanks for signing that prescription bill, Mr. DeMarco said. The legislation in question will allow poor families to buy drugs at the state's much-lower bulk purchase rates.
You're welcome, said the governor (or words to that effect). It's a good idea.
One of many advocated by Vincent DeMarco, lobbyist extraordinaire. This year, as many as four major health initiatives moved toward enactment with the force of Mr. DeMarco's energy - and the push of electoral politics. They included higher reimbursement rates for doctors, community health clinics, the prescription drug bill and a bill that forces a big employer to pay more of its employees' health insurance costs.
Many others were involved in these initiatives. But Mr. DeMarco and his Fair Share Health Care team were a constant.
Who could be surprised?
Over the last 20 years, Mr. DeMarco has moved Maryland and the legislature toward new heights of problem-solving. First it was the partial handgun ban of 1988. Then an increase in the cigarette tax and a reduction in teen smoking during the 1990s. And this year, a step toward health care for all - the so-called Wal-Mart bill, which imposes a fine on companies with more than 10,000 employees if they don't spend at least 8 percent of payroll on health care.
The concept was as important as the pressure on a single company. If a company doesn't provide a certain standard of insurance coverage, companies that do are operating at a competitive disadvantage - a disadvantage subsidized by taxpayers. When hospitals treat patients who don't have insurance, Marylanders cover the costs. So taxpayers are, in effect, subsidizing businesses that don't offer sufficient insurance coverage.
One of Wal-Mart's competitors, Giant Food Inc., was a major supporter of the DeMarco initiative precisely for that reason. Giant offers insurance coverage that exceeds the 8 percent floor. In the General Assembly, Giant vs. Goliath (Wal-Mart) seems to have worked to the advantage of Fair Share Health Care.
In addition to political and economic leverage, Mr. DeMarco builds coalitions. He generates letters to senators and delegates. He commissions polls supporting his ideas. He rallies political supporters, trotting them out to endorse his plans.
It's a measure of his acumen - or good luck - that a substantial boost for his small-d democratic ideas came this year from the Republican governor. Mr. Ehrlich supports the prescription bill but rejects the Wal-Mart premise, calling it anti-business and promising a veto.
Democrats rushed to pass the bill because they believe a veto would spotlight the governor as a friend of big corporate interests and an enemy of the little guy.
Democrats challenged business interests to offer an alternative solution for a problem many of them acknowledge: Too many Marylanders end up in hospital emergency rooms when earlier care covered by insurance might have shielded them from serious and costly illnesses.
The question now is, what's next? The DeMarco team will almost certainly try to expand the Wal-Mart idea to smaller Maryland companies. The same principle will apply.
Fair Share also wants to see Maryland increase eligibility for coverage under Medicaid. Right now, a family of four is eligible for Medicaid in Maryland if its income falls below 47 percent of the federal poverty line, which is $19,350 for this year. Fair Share will try to move that figure eventually to 100 percent. Then families living on $19,350 or less will be covered.
These successes, again, don't spring full-blown from Mr. DeMarco's brow. He could hardly be unaware of the current political dynamic.
So he stages press events with star Democratic advocates: Baltimore Mayor Martin O'Malley and Montgomery County Executive Douglas M. Duncan, who seem ready to appear whenever Fair Share calls. They show up to offer themselves as friends of the poor and the working man or woman - in contrast, they hope, with Mr. Ehrlich.
It adds up to a lobbyist's dream: The General Assembly's Democratic majority is often on Mr. DeMarco's side, and the Republican governor is on Mr. DeMarco's side - whether he signs the bills or not.
C. Fraser Smith is news director for WYPR-FM. His column appears Sundays.