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Package Draws Words of Praise, Warning : Reaction: Democrats, Republicans and special interests laud Clinton's overall goals. But the details of his reform plan raise some concerns.

September 23, 1993|MARLENE CIMONS and KAREN TUMULTY | TIMES STAFF WRITERS

WASHINGTON — For a diverse range of lawmakers and interest groups, all with a stake in the outcome of the health care reform effort, the Clinton Administration's proposal is the best of plans and the worst of plans.

Most expressed far-reaching support Wednesday for the major goals in Clinton's proposals: assuring universal health care coverage for all Americans, providing a comprehensive package of basic medical benefits with an emphasis on preventive services and making the overall system more efficient and cost-effective.

In a seemingly endless stream of telephone calls and faxes, many of them arriving hours before President Clinton actually delivered his address to Congress, organizations used words like "bold," "courageous" and "visionary" in response to Clinton's blueprint.

Although they did not yet know the exact words the President would use in his speech Wednesday night, the details of the plan have been available for weeks.

"Bill Clinton is the first President since Harry Truman to stand up and say: 'The time has come for comprehensive national health care reform and I have a plan,' " said John J. Sweeney, president of the Service Employees International Union of the AFL-CIO. "The Truman plan died under a partisan onslaught. . . . The Clinton plan will pass because it transcends ideological differences."

However, at the same time the broad principles of the plan were being lauded, many also quibbled with the fine points of how to accomplish such goals--especially regarding pieces of the plan that would affect them directly.

Republicans credited the President and First Lady Hillary Rodham Clinton, who headed the Administration's health care task force, for bringing the issue of health care reform to the forefront but reminded the public that there are several alternatives to the Clinton plan also pending in Congress.

"There's common ground among the Administration's plan, the bills introduced by Republicans in Congress and the principles endorsed by the nation's governors," said South Carolina Gov. Carroll A. Campbell Jr., one of three Republicans who gave the formal response to the President's plan.

Unlike most major legislative issues--in which most groups are either on one side or the other--Clinton's health care reform proposals offer almost everyone something to like--as well as something to hate.

Physicians, for example, applauded the concept of health care coverage for all with a guaranteed basic package of benefits, but they decried attempts to hold down health care expenditures and Medicare spending.

Mental health groups cheered the recognition that mental illnesses should be considered on a par with physical diseases but said they were unhappy that full coverage would not be provided until 2001.

The medical device industry praised numerous aspects of the plan, including universal coverage, the benefits package and the proposal to create health alliances, but predicted that it would be tough to blend government regulation with marketplace dynamics.

The drug industry said it was pleased that prescription drugs would be covered but said it opposes government attempts to restrain drug prices, saying that free-market forces, not government regulation, could best achieve this.

Nevertheless, there appeared to be near-universal agreement that the moment has arrived to do something about America's troubled health care system.

"Now it's time to roll up our sleeves and get down to work," the Health Industry Manufacturers Assn. said.

Campbell, who--with Sen. Connie Mack of Florida and Rep. Nancy L. Johnson of Connecticut--gave the GOP response Wednesday night, called Clinton's proposal "a one-size-fits-all" system that "will be bitter medicine for Americans to swallow."

"We need competition in the marketplace to bring quality and savings," Campbell said. "And we need some answers about where we'll get the money to pay for a new system."

He and others noted that Clinton's proposals are the starting point for a long, arduous process that now will shift to Capitol Hill, where final legislation will be drafted.

The final result is likely to be a compromise drawn among supporters of Clinton's ideas, those of liberal Democrats--who favor a Canadian-style single-payer system--and Republicans, who favor a free-market approach.

"I'm encouraged that the President and Mrs. Clinton have signaled their willingness to talk and compromise," Campbell said. "Republicans have promised the same."

Sen. Bob Kerrey (D-Neb.), who made health care reform the centerpiece of his failed presidential campaign last year, described the Clinton proposal as "a real good start. . . . I accept in total the underlying principles."

Nevertheless, Kerrey said he has some objections, including a concern--shared by many in Congress--that the underlying numbers are not realistic. The President's economic calculations may not fully anticipate the increase in medical costs that will occur as people use the health care system more, he said.

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