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.
"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."
And many--both friend and foe--said after watching the President's address, punctuated as it was by unusually strong emotional references, that it had sent a powerful message to the American public.
"Tonight belongs to the President," said Dr. James Todd, executive vice president of the American Medical Assn., which represents about 300,000 physicians, roughly half of the nation's doctors. "He made the case for change in a very, very emotional, highly dedicated fashion and we compliment him for it."
Nevertheless, Todd said, "tomorrow, when the sun comes up, we're going to have to roll up our sleeves and see what it takes to get it done. We're going to have to address the reality of how we pay for it. . . . What the checks and balances are going to be. . . . One of the most significant things the President said tonight was that everyone was going to have to participate--and it's a wake-up call to every family and organization to bear their fair share."
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 into public focus, but they issued reminders that several alternatives to the Clinton plan are 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.
Senate Minority Leader Bob Dole of Kansas, issued a harsher assessment, proclaiming that "the national dialogue on health care has begun. America is ready for reform and so are we. . . . While everyone agrees on the diagnosis, we have some disagreements on the prescription. . . . Clearly those disagreements start with the Administration's insistence on job-killing employer mandates."
Dole insisted that the GOP is committed to working for "the right dose of reform, not an overdose of government control."
Even where the broad principles of the plan were generally being lauded, many quibbled with the fine points of how to accomplish its goals--especially when pieces of the plan would affect them directly.
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 the year 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 \o7 something\f7 about America's troubled health care system.
"The American people have made it clear that they want comprehensive reform. We in Congress will act," said Senate Majority Leader George J. Mitchell (D-Me.).
Sen. Edward M. Kennedy (D-Mass.), chairman of the Senate Labor and Human Resources Committee, called Clinton's speech "a powerful call to heal our health care system."