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O.C. Lawmakers Assail Health-Care Plan : Congress: The county's six GOP House representatives say the nation can't afford the Clinton prescription.

September 26, 1993|ROBERT W. STEWART | TIMES STAFF WRITER

WASHINGTON — It may be the only public policy issue on which President Clinton and Orange County's six conservative congressmen agree: The nation's health care system is seriously ailing.

But the Republican lawmakers say the revolutionary cure outlined by the President is medicine that the nation can ill afford, and a prescription that will only make the patient worse.

"Most people in this country are happy with the health care they're receiving, and anything that threatens that is not going to win support," said Rep. Dana Rohrabacher (R-Huntington Beach). "It should be a matter of reforming the system we have, rather than totally remaking it."

In interviews after Clinton's Wednesday night address to Congress and the nation, members of the Orange County congressional delegation offered their supply-side critique of the President's health plan. They also described the efforts that they and other conservatives will undertake to win passage of a program more to their liking.

Instead of the sweeping reformation outlined by the President, the congressmen called for incremental steps, such as rewriting malpractice laws, ensuring the "portability" of insurance from job to job, or creating tax-free, health care IRAs. That approach would reduce costs and improve coverage while keeping the framework of the existing health care system, they argued.

The Orange County representatives acknowledged, however, that the package that emerges from Congress sometime before the 1994 elections more likely will resemble Clinton's wish list than theirs. And, they said, it will be the product of a long and perhaps bitter debate.

"I have no doubt we will pass something," said Rep. Christopher Cox (R-Newport Beach). "What it will look like is very difficult to say."

Members of the Orange County delegation expressed the most skepticism about the elements of the Clinton plan that are philosophically at odds with their conservative credo of less government, less spending and less intervention in the marketplace.

While the President rejected calls for a Canadian-style, single-payer health plan, his proposal would create a powerful new National Health Board and a system of regional alliances through which all workers would have to purchase health insurance.

The plan would require businesses to pay 80% of the cost of workers' insurance premiums and limit the cost of medical services.

"The Clinton plan really turns health care into a government-run social program, and I think there is going to be a considerable cost involved in setting up that government structure," said Rep. Ed Royce (R-Fullerton), a freshman who represents northeastern Orange County.

"He's setting up a new entitlement, the biggest one we've ever had," added Rep. Robert K. Dornan (R-Garden Grove), one of Clinton's most virulent critics. "This thing is going to go wild. If you think health care is expensive now, wait till you see how much it's going to cost when it's free."

Referring to the prototype for a national health care card brandished by the President during his speech, Rohrabacher said: "Didn't you get a little queasy when you saw him holding up that credit card? I looked at him, and I said to myself, 'This guy looks like W.C. Fields trying to sell a bottle of elixir.' "

Cox said, "Obviously, the centerpiece of (the Clinton plan) is collectivization," borrowing a phrase from the old Communist lexicon. "By that I mean the elimination of existing private health care arrangements and the substitution of the mandatory regional health care alliance. I think it is a monumentally bad idea."

Clinton vowed that the new system will allow consumers to continue to choose their own physicians. But several congressmen argued that in practice, things may not work out that way.

Under the Clinton model, each regional alliance would be required to offer at least one program that works like traditional health insurance coverage. Known as "fee for service," the plan would allow a worker to select his own doctor, and pay a fixed percentage of the doctor's fee. The alliance, or the insurance company with which it contracts, would pay the rest.

Other choices would resemble "managed care" programs, in which patients select from a limited network of doctors, or health maintenance organizations, in which patients visit a large health care group.

If the lone "fee for service" program offered by a regional alliance becomes oversubscribed, said Royce, "individuals literally would have to enter a lottery to be able to continue to choose their own doctor."

Rep. Ron Packard (R-Oceanside), who represents South County, said he is equally concerned about that issue.

"Health care is fundamentally a personal relationship between a patient and a doctor," said Packard, a former dentist. "When you create federal and state bureaucracies to administer, regulate and deliver health care, you undermine that basic relationship.

"I cannot support placing the federal government in between an individual and their doctor."

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