Rising Cost of Health Care Could Hurt Bush Impact on Family Budgets Concerns Voters, Pollsters Say. QUESTION OF ACCESS

Article excerpt

EVERY time a Chrysler rolls off an assembly line in the United States, the cost includes at least $700 in health-care expenses for the company's employees.

Health-care costs at Chrysler Corporation, like thousands of other American businesses, are becoming an overwhelming burden that is driving up product prices, cutting profits, and threatening the prosperity of American firms and families.

Democrats say health care will be the most critical and controversial domestic issue of the 1990s. They say it could bring about a political showdown with George Bush that could put a Democrat back into the White House.

"Americans see major problems in the health-care system and want strong public solutions," says Celinda Lake, a Democratic pollster.

Republicans admit there is cause for concern. "The political future of the country is up for grabs here," says Doug Bailey, a Republican consultant. The domestic agenda, "led by health care," is what the battle will be about, he predicts.

Thirty-five million people in the US have no health insurance, but Ms. Lake says the problem goes far beyond "compassion" for those uninsured Americans. Even people with good jobs and insurance sense that they are increasingly at risk, she says. Costs are escalating so fast that millions feel in danger.

Pollster Humphrey Taylor, president of Louis Harris and Associates Inc., agrees. "Fear of losing one's health insurance is now a major concern," he says.

"This is a pocketbook issue, not a compassion issue, for most voters," Lake says. As one voter recently told her in a focus group:

"Affordability is the biggest problem. If you speak of access, you should be able to afford it. Something could be there, available. But if you can't afford it, what good is it?"

The crisis that Lake and Mr. Taylor see in health care has sprung from several causes.

1. The middle class "squeeze." Ever since the 1970s, middle- class incomes have leveled off. Wives often must enter the workplace just to keep their families on the same economic level that a single breadwinner could attain in the 1950s and 1960s.

2. Job insecurity. Many sources of steady jobs - banks, auto companies, and steel mills, to name a few - have hit hard times. That has forced millions of people to take lower-paying jobs, often without fringe benefits like health insurance.

3. Soaring costs. Americans spent $604.1 billion on health care in 1989, or about $2,400 per person. That is double the per capita spending in many European countries where health-care access is guaranteed. …