Marylanders react with applause for goals, anxiety about achieving them CLINTON'S HEALTH PLAN

September 23, 1993|By Sandy Banisky | Sandy Banisky,Staff Writer Staff writers Jonathan Bor, Mark Guidera and Kim Clark contributed to this article.

The proposal is vast and complex, as befits a plan that's supposed to do no less than profoundly change America's health care system. The jargon is obscure: "universal access" and and "quality indicators" and "market forces." And the economic theories that underpin the whole package -- they're brilliant or baffling, depending on whom you ask.

The plan President Clinton sketched out last night has straightforward goals: security for everyone, high-quality care and savings. But, despite the president's energetic efforts to simplify, the details are so dense that the White House convened a two-day "health care university" to school members of Congress.

The complexity of the proposal is enough to produce anxiety, even for those who believe the health care system must be overhauled. Mr. Clinton called on Americans to change their ways and take more responsibility for their health care decisions and costs.

So, while some Marylanders applauded the goals Mr. Clinton outlined last night, they also have concerns about what the details will mean for them.

Ivy Ashie, a self-employed, uninsured mother of five from Columbia, says the health reform plan "sounds good. I like the stability and the security, the idea that it will always be there" for her and her children.

But Ms. Ashie is also trying to expand the cleaning service she has begun. And she's not sure she can afford to pay 80 percent of the health insurance of her future employees. "That's scary, especially for a small person like me," she said.

She'd like to believe the president's program can help her while her small company grows. But the president, she said, didn't tell her enough.

"If I was in Congress, I'd say, 'Go for it.' But once again, we have to wait for the details."

Those details will spell out the plan's impact on citizens such as Ms. Ashie and on industry and interest groups.

"Everyone is going to have to change," said Richard H. Wade, senior vice president at the American Hospital Association. "Consumers are going to have to change. Insurers are going to have to change. Doctors and hospitals are going to have to change. Government is going to have to change.

"Taking those lofty national policies and having them make sense, so people believe they're getting something out of it -- it's an enormous undertaking," Mr. Wade said. "We've never seen anything like it."

National surveys show Americans believe something has to be done about the health system. But a New York Times/CBS News Poll released yesterday indicated many Americans doubt that Mr. Clinton will be able to overhaul the system. Forty-five percent said the president "will be able to bring about significant health care reform." Forty-one percent said he will not.

Forty percent said the president's health care reforms "will be fair" to people like them, and 36 percent said they won't.

Despite their skepticism, most Americans said they support providing health coverage for everyone. And 61 percent, the poll found, would be willing to pay higher taxes to cover that cost.

For some older Marylanders with Medicare coverage, the proposal raises questions, though the president offered them reassurance last night.

Abe Bates, 77, and Irene Wolfe, "70 plus," were relieved to hear hTC the president's call for home health care and prescription coverage.

"The speech was wonderful, and his plan is really excellent," said Bates, a retired population consultant for the United Nations who lives in Woodbine. "My only hope is that he doesn't bargain it away as it moves through Congress."

"I'm convinced now this is the right way to go," said Mrs. Wolfe, a retired grants specialist with the National Institutes of Health who lives in a seniors-only apartment building in Columbia. "We have to make a change, and I'm willing to pay more for health care if it's needed to make that change happen."

Mr. Bates added, "I really hope he can achieve getting it passed. It's an ambitious, important plan. Americans deserve it."

In Silver Spring, Chuck and Donna Selden, who have extensive coverage from their employers, applauded at the end of the president's speech. But they said they had questions about how the plan would work and whether it would create a new government bureaucracy.

Ms. Selden, 35, a program manager at Westinghouse, said she felt a responsibility to make sure less fortunate people also get health coverage. "We do have a moral obligation to do this," she said.

The mother of a 14-month-old boy, she said she wouldn't mind if the health plan cost her a little more, though she doubted it would.

"Some people spend $30 to get their hair cut every three weeks," she said. "It is not asking too much to make a $10 co-payment" for doctor visits.

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