Clinton health program gets a cautious diagnosis



COMMERCE, Calif. -- The Easter recess is a traditional time for members of Congress to come home and find out what's on the minds of their constituents. In Rep. Lucille Roybal-Allard's 33rd Congressional District, a near-in suburb of Los Angeles, what induced more than 100 constituents to turn out at 7:30 the other morning was something more real and immediate to them than Whitewater: how the Clinton health care plan would affect them and their community.

Roybal-Allard is a first-term Democrat representing a district in which Hispanic-Americans make up 83 percent of the population. She is generally supportive of the Clinton plan but is aware of concerns among small-business owners and their employees in the district.

She had in tow Small Business Administrator Erskine Bowles, a former small businessman in North Carolina, to explain the plan and answer questions. His presentation was concise and upbeat.

No health insurance plan could be more anti-small business than the one now in existence, he said. "The profit sector has failed us," he said, because there is "not any solution without universal coverage."

The Clinton plan, he said, not only would cover everybody, but would provide comprehensive coverage, "not some kind of bare-bones insurance" that the poor often have to settle for now. The plan would be affordable, thanks to provisions for discounts for small businesses, and premiums would be capped so that employers would not have to worry about higher costs in the future.

Bowles assured his audience that no pre-existing condition or occupational exception would bar employees from coverage and, finally, that the planned "health alliances" would give small businesses the collective purchasing power with insurance companies that would keep rates down. ("I wish we had enough ZTC sense to call them 'buying groups,' " he said in an aside, aware of critics' cries of "socialized medicine.")

It all sounded fine, especially from a man who assured listeners that he considered them his "customers" and who said he answered his own phone calls and wrote his own replies to complaints -- in longhand. Here was a bureaucrat of a small businessman's dreams.

But as the questions came, it was clear that his listeners wanted more than courtesy. The matter of covering everybody is of particular concern in this community, where small businesses struggling to make a profit employ many part-timers and undocumented workers without providing health insurance. What about them, Bowles was asked.

The administrator said undocumented (immigrant) workers were not covered under the plan, nor were certain workers under age 18 or working students under 24. But one listener wondered later whether a small businessman might be required to pay into the system based on his total payroll -- meaning that he might be paying for employees excluded from coverage.

Another listener questioned the exclusion of students. In this low-income community, he said, "our kids need to work." Anthony Thorpe, a sculptor and painter who, among other things, puts the names of movie stars on the sidewalks in downtown Hollywood, says if students don't work, they often are "prone to gang activity." Still, he said, if he has to pay insurance to helpers, he'll just have to try to work alone.

Another questioner wondered about the prospect of small businessmen resorting to the hiring of "independent contractors" to avoid paying insurance premiums, just as many businesses, large and small, do now to avoid paying vacation, retirement and other benefits.

Bowles' straightforward approach, and his willingness to answer individual questions afterward, were well-received by the audience. But a lot of doubts remained, not simply about costs but about the ability of government to run the plan, even using the existing private insurance structure.

"They've got to be able to do a better job than they do on defense spending and other parts of the budget," said John J. Smith, who employs 50 people to do maintenance repair work for refineries.

Congresswoman Roybal-Allard herself came away from the meeting with new concerns about the impact on the many undocumented workers in her district. Her constituents' questions, she says, will set her about getting more answers, which is what such meetings during the Easter recess, here and around the country, are all about.

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