Public deserves the truth on Clinton health plan ON POLITICS



WASHINGTON -- As the battle lines form for the debate over President Clinton's health-care reform package, one problem looms larger than most for the administration: public confusion.

The details of the package, as presented by White House spin doctors and critics leaking selectively, are so complex that they invite not only misunderstanding but also distortion, as opponents pull out all the stops to defeat the president's plan.

In advance of Clinton's speech to the nation on his package this week, prominent members of his own party are busy taking shots at it. Sen. Pat Moynihan of New York, chairman of the Senate Finance Committee, on NBC's "Meet the Press" Sunday labeled as "fantasy" the White House's initial cost projections to finance the reform, which would bring coverage to an estimated 37 million uninsured Americans.

Moynihan, regarding the administration's claim that it will save $238 billion in Medicare and Medicaid cuts and reforms by the year 2000 and provide $91 billion in deficit reduction, cited the doubling of Medicaid costs in the eight years of Ronald Reagan and redoubling in the four years of George Bush. "To say that you're going to reverse that rate down to zero growth in the same period," he said, "is to have lost touch with reality."

These remarks commanded the headlines the next day, doubtless leaving the impression to some that Moynihan is against the Clinton plan. And that impression was reinforced by a further Moynihan remark lauding Senate Republicans for coming up with their own proposal, which is much less ambitious and less costly but for the first time at least allows for the concept of universal coverage.

Asked whether he was talking about a plan "a little bit closer to the Republican plan than to what the president is talking about," Moynihan replied: "That might be. There wouldn't be anything so awful about that." But it was clear from further Moynihan observations that what he was hailing was a bipartisan approach and what he was criticizing in the Clinton proposal was the implication that it could be brought off without sacrifice, not the package itself.

"We mustn't pretend that this is going to be free," he said at one point. He noted that Congress in the Clinton deficit-reduction package narrowly passed this summer "just went through hell" squeezing $57 billion out of Medicare costs, and he suggested that the eventual package is "going to have some measure of cost controls in the form of rationing." That remark seemed to imply reduced benefits in some areas -- certain to be seized on by opponents.

The administration says it will not provide complete specifics on how the reforms will be financed for a few weeks -- a delay that will provide a window of opportunity for critics of the Clinton health-care reforms.

Any absence of specifics -- and dependable specifics -- opens the door to more speculation and exaggeration about the perils involved to those who have health insurance now and will be asked to support the extending of coverage to the uninsured.

Sen. Bob Kerrey of Nebraska, who made health-care reform the centerpiece of his failed 1992 bid for the Democratic presidential nomination, had it exactly right in an interview with David Broder of the Washington Post when he said: "We cannot describe the health plan as something it isn't. The people will find out the truth and they will never forgive us if we have misled them."

As Kerrey also noted, one of Clinton's problems with his budget proposals was that he didn't level with the voters on the compromises with earlier promises that it contained.

Into the ninth month of his presidency, the "Slick Willie" label lingers, and he simply can't afford to overstate what the health-care package will do, or understate its costs.

In the existing climate, with an army of hostile lobbyists and special interests mobilizing to strip it down, the desire to make the package sound better than it is, and painless at that, is understandable.

But on this vital issue that can be make-or-break for his presidency, the best politics will be telling, without blue smoke and mirrors, what is achievable, and at what price.

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