When the wave of public interest in health care reform began to build last year, the Carroll countian at the helm of the Maryland Health Resources Planning Commission was ready.
Or, as James R. "Smokey" Stanton, a Westminster resident and executive director of MHRPC, puts it: "Last summer, when it became clear that there was at last a national debate on health care, and in Maryland many divergent opinions, the commissioners decided that we had a role."
The 14-member commission appointed a health policy committee drawn from its membership to take a comprehensive look at health care issues that will involve providers, such as hospitals and nursing homes; private insurance companies; organized groups, such as the American Association of Retired Persons; and the public.
The General Assembly has more than 20 health care reform bills in the legislative hopper this session, but Mr. Stanton says the MHRPC study won't be left behind by legislative changes or by the national health care reform proposals under study by a task force led by Hillary Rodham Clinton.
Health care can be reformed incrementally or all at once, he says. The General Assembly is taking the incremental approach, but it appears likely that the legislature will come up with significant reform of the insurance aspect of health care this year.
"When this session started, I had the opinion that there would not be anything significant [in health care reform] coming out of this session of the General Assembly," Mr. Stanton says. "I've had to revise that opinion."
A bill sponsored by Del. Casper R. Taylor Jr., D-Allegany, is headed for floor debate after clearing the House Economic Matters Committee. It is designed to make health insurance more available to all Marylanders, particularly those employed by businesses with two to 50 workers; to stabilize costs by spreading risk among a larger number of people; and to set up a commission to gather data and draw up a standard benefits plan.
The MHRPC committee plans to come up with a set of broad recommendations during the summer that Mr. Stanton says will outline "what's broken and what's not broken and what needs to be fixed."
The recommendations are to go to Gov. William Donald Schaefer and the General Assembly. They will also be submitted for public debate at a series of town meetings around the state next fall.
Mr. Stanton says the committee has tried to include all the various groups involved in health care issues but, "I am not naive about this. This is a political process. There are going to be some oxen that get gored."
The committee's work should position Maryland officials to respond to the national health care reform proposals that will come from a task force chaired by first lady Clinton, the executive director says.
Mr. Stanton says health care changes should assure equity and participation by those involved. His "horrible example" is the state proposal in October 1992 to eliminate Medicaid subsidies for nursing home care to anyone earning more than $12,660 a year, a plan that was quietly shelved after affected Marylanders raised an outcry.
"That should not be happening in 1993 America. That is not what our state and our country stand for," Mr. Stanton says. "But we can't afford to keep on doing what we're doing."
As executive director of MHRPC, Mr. Stanton heads a 45-member professional staff that works with hospitals and nursing homes seeking certificates of need that will allow them to build new facilities or expand existing facilities.
He also spends a lot of time in Annapolis during legislative sessions, testifying before committees and lobbying on administration-backed health bills.
Mr. Stanton, his wife, Sandra, and son, Mike, a sixth-grader at East Middle School, are Carroll countians by choice.
A native of Garrett County, Mr. Stanton came to his present job in 1985 from the Health Systems Agency of Western Maryland (now the Western Maryland Health Planning Agency), where he was executive director.
When the family was looking for a new home, he recalls, the three of them drove out Route 140 from Baltimore to Emmitsburg, then came back for a second look at Westminster.
"We realized that if we were to move to the city, we'd be fish out of water," he says.