Public to Get Campaign-Style Assault on Health Care Plan

Article excerpt

WASHINGTON _ President Bill and Hillary Rodham Clinton will embark in early fall on the sales job of the decade, a quest to sell Americans on a health care reform plan that is acknowledged even by its architects as a multibilliondollar social experiment.

Now that the national task force headed by Hillary Clinton has been disbanded, and much of its hammer-and-chisel work done, the Clintons and their political advisers are quietly hard at work planning a campaign-style assault on a skeptical public.

There will be catchy and (they hope) reassuring slogans, a massive fund-raising drive to subsidize the public relations blitz and perhaps another take-it-on-the-road trip across America for Clinton to explain his ideas to real people.

But what people will be most interested in, at least initially, is achieving a far better understanding of Clinton's proposal than they have now, if recent polls are a guide. The Clinton team so far has provided the public just a glimpse of the general mechanics of the plan, and a fragmented glimpse at that, delivered in sporadic news snippets over the past six months.

According to health care experts who worked on the task force, the bedeviling details are still being worked on. Those activities include all-important exercises in crunching the numbers, the ones that will be useful in answering the two questions everybody seems to have: "How much will reform cost me?" and "Will I get better, or worse, health care than I have now?"

Even members of Congress from the president's party, who would be on the front lines of drumming up support for the plan, say they are starved for specifics on a plan expected to cost the government anywhere from $30 billion to $90 billion.

U.S. Rep. Pete Geren, D-Texas, who has been listening for months to people's concerns about health care at town hall meetings, said that Clinton has been slow to bring Democrats in on the big picture.

Only in the last two weeks have administration officials begun to hold private briefings with members of Congress. When Geren asked task force member Judith Feeder, an official in the Department of Health and Human Services, for an outline of the plan on paper, he was told none was yet available.

"It's good that they're finally reaching out," he said. "It's unfortunate that it's taken this long."

The message from the White House for Geren and the rest of us is, "Stay tuned until mid-September," when the president is expected to unveil his health care reform package at a joint session of Congress.

Until then, here is what is known about the grand reform of the U.S. health care system as the Clintons see it:

It is based on an idea called "managed competition," which combines the American tradition of a market-driven health care industry with the power of government to manage some aspects of the market for the public good. It stands in contrast to the preferred model among congressional liberals, a government-run health care system such as Canada and Britain have.

The Clinton plan would impose not insignificant government controls on the marketplace to meet two social goals: guaranteeing health coverage for all citizens and keeping cost escalations in line with inflation. Necessarily, some of the power that the insurance and medical industries now exercise over access and prices would be curtailed, and government would have a far greater say in availability, cost and quality control.

The present, fragmented system of health insurers and providers would be replaced with a more governmentally "managed" one. Everyone would belong to new local "health alliances," quasi-public agencies that would be organized by state and by major metropolitan area. For instance, rural Texans might belong to a statewide alliance while urban dwellers in the Metroplex might belong to a Dallas-Fort Worth alliance. …