Clinton sees health reform financing coming primarily through savings

September 22, 1993|By Jack W. Germond | Jack W. Germond,Staff Writer

WASHINGTON -- President Clinton said yesterday that "we don't need a lot of money" from new taxes to finance his health care plan but refused to say just what financing formula, if any, he will spell out when he addresses a joint session of Congress and national television audience tonight.

Mr. Clinton confirmed that he will recommend a higher tax on cigarettes -- other administration sources said it would be 75 cents a pack -- and propose "other ways" to cover costs.

But he insisted that the new revenues will make up "a relatively small part of this whole package."

Most of the expense, he indicated, would be covered with the savings the new system would realize.

Over a White House lunch with a group of newspaper and magazine columnists, the president was alternately optimistic about his ability to convince the American people that the plan is worth enacting and defensive about criticism that the cost figures are not credible.

"I think profound changes happen in society when people understand that the cost of staying with the present system are actually greater than the changes, that the risks of staying with the present course of action are greater than the uncertainties of any change," he said.

The president was obviously nettled by suggestions that his plan may be based on projections that are too rosy, including a remark two days earlier by Sen. Daniel P. Moynihan of New York, supposedly a key Democratic ally, that the president's projections on cutting the growth of Medicare and Medicaid was a "fantasy."

Pointing out that the White House has made extensive use of outside as well as government analysts, Mr. Clinton said, "I'm doing the best I can to give good numbers."

Between bites of veal, asparagus and a poached apple, Mr. Clinton said his one non-negotiable goal was a system that provides universal health care coverage, but he also showed a willingness to bargain on the ways to get there.

"If somebody's got a better idea to achieve universal coverage, we'll be glad to hear it," the president said.

Hillary Rodham Clinton, the head of the task force that produced the health plan, said the White House might agree to phasing in the coverage over more than the three years between now and the target date of 1997 if the savings from other aspects of the program did not match projections.

Mr. Clinton quickly interjected, "That ought to be a two-way street" -- meaning that the program should take effect more quickly if the savings were realized at a more rapid pace.

Both the president and the first lady seemed optimistic about the prospect of some bipartisan cooperation on the issue.

Ms. Clinton said that she had detected "a convergence of ideas" on how to improve the system and that she now hoped for a bipartisan majority "within the next year at some point," although she conceded that the "exact contours" of the plan may have to change.

Mr. Clinton said he thought this was "a moment" in history when circumstances were particularly good for the country to accept such a far-reaching program.

His goal, he said, is to persuade Americans tonight and thereafter that his plan for health care security will "take advantage of the changes that are occurring and minimize the dangers."

By contrast, he said, the problem he is facing in the opposition to the North American Free Trade Agreement "is that the fear factor is so much more powerful than the hope factor" in the minds of U.S. workers.

Mrs. Clinton warned against allowing the negotiations over health reform to become "an actuarial debate" centered on cost estimates rather than broad social policy.

But she conceded that "moving from rhetoric in any of these plans to specifics is very difficult."

In his speech tonight, she said, the president will lay out "the general principles" as a precursor to months of debate ahead.

QUESTIONS?

If you have questions about President Clinton's complicated health care reform program and what impact it would have on you, we'd like to hear them. Call Sundial, the Baltimore Sun's telephone information service, at (410) 783-1800 (268-7736 in Anne Arundel County). After you hear the greeting, punch in the four-digit code 4425 on your touch-tone phone.

Responses may appear in future coverage of the president's program.

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