Governors hear health plan pitch Bipartisan support needed, Clinton says

August 17, 1993|By John Frece | John Frece,Staff Writer

TULSA, OKLA. -- President Clinton launched his campaign for a universal national health care plan yesterday by telling the nation's governors that reform cannot be accomplished without bipartisan support and everyone sharing in the cost.

In a 45-minute speech to the National Governors' Association, followed by a two-and-a-half hour private working session with the governors, the president tried to overcome concerns about how the program will work and how much it will cost by warning that the nation cannot afford to let the existing system continue.

"I don't think any of us will take America where we need to go unless we also reform the health care system, which is the biggest outstanding culprit in the federal deficit," he said.

In calling for support among Republicans and Democrats alike, Mr. Clinton said he never again wants to go through another six months of partisan battles like the ones waged over his recently enacted budget. "The whole issue," he said, "revolved around process instead of product, political rhetoric instead of personal concern for what is going to happen to this country."

To the loudest applause of the day, he said: "Surely, we can stop wringing our hands and roll up our sleeves and solve this problem. And surely we can do it without the kind of rhetoric, and air-filling 'bull' that we hear so often."

The president provided few new details of the plan, which is to be unveiled before Congress next month. But in his speech, and in remarks gleaned from interviews with governors who privately met with him, first lady Hillary Rodham Clinton and health care adviser Ira C. Magaziner, the general approach of the administration's plan is coming into focus.

Mr. Clinton said he wants to push for a program that offers a standard package of medical benefits for every American financed largely through their employers, building on a part of the current system that he says works. But to lessen the impact, the administration is talking about phasing in the "employer mandated" total coverage over at least five to seven years, and even longer for the smallest businesses or those that are barely making it.

Subsidies sought

The president said the plan should include subsidies -- estimated during the closed-door session at between $20 billion and $40 billion a year -- to help those businesses or individuals that cannot afford insurance on their own.

Where that money would come from is the key detail yet to be announced. Administration officials are talking about possibly raising "sin taxes" on items such as cigarettes, or by tapping into savings they predict will be generated by the plan itself -- a source of funding several governors said sounded iffy to them.

Even before the president interrupted his vacation to fly into the 102 degree heat of this northeastern Oklahoma city, Republicans here were saying they would oppose any program that includes an employer mandate, or higher payroll taxes, or cost shifts from the federal government to the states, or price controls on private industry.

"That doesn't mean we can't get together on a national health plan that would omit those four items," said Republican William F. Weld, the governor of Massachusetts. He and other Republicans said they view an employer mandate as the same as raising taxes, either of which, they said, could be devastating to small businesses.

'Frightening'

Minutes before Mr. Clinton's speech, John Motley of the National Federation of Independent Businesses told the governors the same thing, saying it was "frightening" to the 600,000 businesses his organization represents because no one knows what the new program will mean to them. He predicted companies could be forced out of business, and employees left jobless.

"What does a mandate solve? An employee not only doesn't have health insurance, he doesn't have a job, and is suddenly eligible for welfare and all sorts of programs," Mr. Motley said.

The White House immediately responded, issuing a statement-by-statement rebuttal to Mr. Motley's

comments, demonstrating the intensity with which the Clinton administration intends to wage this fight.

Health care costs now consume 14 percent of the nation's economy, compared with slightly more than 9 percent in Canada and about 8 percent in Japan and Germany, Mr. Clinton said in his speech. At the present rate, the U.S. figure is likely to grow to 19 percent by the end of the decade, but stay around 10 percent in other countries, he said.

"We'll be basically spotting our competitors 9 cents on the dollar in every avenue of economic endeavor," the president warned. "I don't think that is . . . right."

Even governors who were generally supportive of the president's effort expressed grave concerns about how Congress will ultimately transform the final product.

"Everybody has to be concerned with what Congress is going to do. The worst decisions in the world are made in the United States Congress," said Kentucky Gov. Brereton Jones, a Democrat.

Michigan Gov. John Engler, a Republican, seemed to agree: "Congress is so captive of interest groups that bartering on the health care bill could be very unpleasant."

Mr. Clinton tried his best to assure worried governors that state health care plans in place or in the works will not be pre-empted by the federal plan.

"It would be a health care plan for all 50 states, but each state could on their own institute basic improvements on the plan if they wanted to pay for them," said Tennessee Gov. Ned Ray McWherter, a Democrat. "It's flexible enough for what I call an umbrella concept that all of us would come under with our own programs."

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