Health care issue gives Clinton chance to recover ON THE POLITICAL SCENE



WASHINGTON -- President Clinton is facing another of those critical moments next week when he makes his case to the nation for health care reform. But this time the political context is somewhat less forbidding than was the case with his economic package.

Several new opinion polls have shown the president's approval rating creeping up close to 50 percent and, for the first time since last spring, higher than his disapproval rating. The figures are not gee-whiz impressive enough to intimidate Congress into supporting the North American Free Trade Agreement or buying his plan for health care. But neither does Mr. Clinton find himself necessarily on the defensive.

There is no mystery about the improvement in the presidential image. For one thing, the August recess of Congress gave him more than three weeks in which he was not being rhetorically beaten about the head and shoulders by someone like Senate Minority Leader Bob Dole, or such noisy conservatives as Sen. Phil Gramm of Texas and House Minority Whip Newt Gingrich of Georgia.

Moreover, Mr. Clinton has used the respite to good advantage. Since his vacation on Martha's Vineyard, the president has been constantly on the offensive defining the national agenda in attention-getting circumstances -- first on reinventing government, then on NAFTA and, most intensively, on the health care reform plan he will outline for a joint session of Congress and a national television audience next week.

All these issues are substantial enough to fill the screen and provide new grist for the political mill. The early White House clumsiness in finding an attorney general, for example, seems light-years ago. The controversy over Mr. Clinton's plan to revoke the prohibition against homosexuals in the armed forces has faded off the front pages. Nobody is rehashing the ineptitude that led to the collapse of his economic stimulus plan.

Thus, although it may be fair to say that Mr. Clinton has acquired considerable political baggage in his first eight months in office, it may be equally accurate to say that he now has a chance for a fresh start of sorts -- and on an issue of genuine concern to many Americans.

The operative question now is whether Mr. Clinton has the political skills to use that opportunity in the same way he used the fresh start he enjoyed when he was running for the office and Ross Perot pulled out of the campaign in July of 1992. The answer to the question may speak volumes about his prospects for the rest of his term and perhaps even for winning a second term.

In one sense, the health care issue is an ideal vehicle for a president who is trying to demonstrate that he can be an effective national leader. The evidence is abundant that there is enough genuine concern about health care to assure that both the president and his critics will have an attentive audience for their debate and negotiations over the next several months.

And the concern is pervasive enough so that many Republicans in Congress recognize this is not an occasion for unblinking partisanship.

There are, however, two underlying elements of the equation that make it plain some strong political leadership -- or perhaps salesmanship -- is going to be required.

First, although everyone seems to have a horror story about his own experiences with the health care system, most Americans profess to believe they receive good care and feel secure about continuing to do so. What this means is that inevitably there will be the resistance of inertia to radical change such as that the president is proposing.

Second, although the White House wouldn't define it in these terms, there is a substantial and essentially permanent underclass of people who are among the 37 million uninsured who will be provided care only at some considerable public cost.

The issue here is whether those in the majority that feels protected will be willing to spend something more for universal coverage and the hope that their own care will be improved in the long run. Or, alternatively, will they see the plan as just another "welfare program" cooked up by another liberal Democratic administration?

These are the questions that President Clinton must answer beginning with his speech next week and in the months of bargaining that lie ahead. But this time, for a change, he has a few cards in his hand.

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