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    "ocrText": "FOIA Number: 2006-0810-F (2)\nFOIA\nMARKER\nThis is not a textual record. This is used as an\nadministrative marker by the William J. Clinton\nPresidential Library Staff.\nCollection/Record Group:\nClinton Presidential Records\nSubgroup/Office of Origin:\nFirst Lady's Office\nSeries/Staff Member:\nFirst Lady's Press Office\nSubseries:\nPress Office Clippings 1993 - 1994\nOA/ID Number:\n6128\nFolderID:\nFolder Title:\n[HEALTH CARE CLIPS: JUNE 1994-JULY 1994] [4]\nStack:\nRow:\nSection:\nShelf:\nPosition:\nS\n61\n3\n4\n3\nTHE PATIENT'S ADVOCATE\nBY MARILYN MOON\nHealth Reform and You\nQ.\nI'm very concerned about possible higher taxes as\nPRESERVATION\nPHOTOCOPY\na result of health plans being offered by President\nIt is difficult to know\nClinton and others. These plans are going to be\nfunded with a tobacco tax. At the same time, the\nfederal health officials are trying to cut the number\nwhether the proposed\nof Americans who smoke and some folks even talk\nabout having tobacco banned. It seems like a case of\nrevenue sources will be\nhaving your cake and eating it too. Are we going to\nget stuck with a lot of other heavier taxes when the\ntobacco tax doesn't provide the needed revenues?\nsufficient.\nA. One of the effects of a tobacco tax will likely\nbe to discourage smoking, but the estimates of\nMany states do not have the resources to cover\nhow much revenue would be raised take a\nall their citizens without federal government\nreduction in smoking into account. The 75-cent\nsupport. If such help is not part of this approach,\ntax on each pack proposed by Clinton would\nnot all states would participate. But if there is some\nraise about $10 billion to $11 billion each year.\nfederal support, would the federal government\nBy itself, this tax is certainly not enough to\nchoose just a few states for an experiment? In\npay for comprehensive health care reform. The\neither case, this would result in disparities in\nvarious plans also assume other ways to finance\ncoverage across the United States. Moreover,\nexpanded coverage, including savings from\nstates need to worry about companies' relocating if\ncutting Medicare and reducing or eliminating\nstate taxes were raised. That is less of a problem\nthe Medicaid program. Other ways that some\nfor the United States as a whole. But despite these\nplans finance reform include requiring that\nproblems, if national health care reform fails to\nemployers contribute to health insurance and\npass, a number of states are likely to move on their\nlimiting the extent to which insurance benefits\nown to change the health care system.\ncan be deducted from taxable income. Like you,\nmany people fear that additional revenue\nsources may also be needed, especially if costs\nUnder the proposed health plans pending in\nof health care continue to rise in the future.\nthe Congress, how will part-time and hourly\nComprehensive reform legislation would be\nemployees be covered?\ncomplicated, and it is difficult to know with\nA.\nThe Clinton proposal, with its employer\ncertainty whether the revenue sources that have\nmandate, would require employers to pay on a\nbeen proposed will be sufficient, especially after\nprorated basis for part-time and hourly workers as\nthe program has been in place for a few years.\nlong as they work more than 10 hours a week. The\nsingle-payer approach sponsored by Rep. Jim\nQ.\nHave policy makers considered evaluating\nMcDermott (D-Wash.) would cover everyone\nseveral of the plans by having different states try\nregardless of employment status and pay for the\npublic system through payroll and income taxes.\n6-28-94\nthem out? This way, they could give different\nplans a chance to see which one or ones could\nThe other major proposals would either require\nwork best, and implement the best plan for the\ncountry.\noptional, and these plans would make insurance the\nresponsibility of individuals. Employers under these\nA.\nOne of the suggestions for compromise on\nHEALTH MAGAZINE\nWASHINGTON POST\nindividuals to purchase insurance or leave coverage\nplans would be free to help pay the premiums, but\nhealth care reform is to give states a great deal\nthey would have no increased incentives to expand\nof latitude in designing reform. Many of the\ntheir current efforts. Low-income individuals under\nexisting proposals already allow some state\nall the plans would receive some type of subsidy to\nflexibility. There are, however, several\nhelp in the purchase of insurance, but the details\nproblems with allowing more flexibility, many of\nvary. The more generous these subsidies, the\nthem surrounding the issue of who would pay.\nmore expensive the proposal.\nWASHINGTON\no you have a question about President Clinton's health proposal or about\nD\nthe other bills in Congress? The Washington Post free telephone\ninformation service takes questions from readers about how the plan could\naffect them. Call POSTHASTE at 202-334-9000 on Я touch-tone phone and\nenter category code 8500 (in Prince William County, 703-690-4110). Health\neconomist Marilyn Moon of the Urban Institute provides answers in this column\nbased on information from the White House, Congress and other sources. While she\ncannot answer all questions or give personal advice, she will answer a range of\ninquiries.\nTHE PATIENT'\nBY MARILYN MOON\nHealth Reform and You\nQ.\nI'm very concerned about possible higher taxes as\na result of health plans being offered by President\nIt is difficult to know\nClinton and others. These plans are going to be\nfunded with a tobacco tax. At the same time, the\nfederal health officials are trying to cut the number\nwhether the proposed\nof Americans who smoke and some folks even talk\nabout having tobacco banned. It seems like a case of\nrevenue sources will be\nhaving your cake and eating it too. Are we going to\nget stuck with a lot of other heavier taxes when the\ntobacco tax doesn' it provide the needed revenues?\nsufficient.\nA. One of the effects of a tobacco tax will likely\nbe to discourage smoking, but the estimates of\nMany states do not have the resources to cover\nhow much revenue would be raised take a\nall their citizens without federal government\nreduction in smoking into account. The 75-cent\nsupport. If such help is not part of this approach,\ntax on each pack proposed by Clinton would\nnot all states would participate. But if there is some\nraise about $10 billion to $11 billion each year.\nfederal support, would the federal government\nPRESERVATION\nBy itself, this tax is certainly not enough to\nchoose just a few states for an experiment? In\nPHOTOCOPY\npay for comprehensive health care reform. The\neither case, this would result in disparities in\nvarious plans also assume other ways to finance\ncoverage across the United States. Moreover,\nexpanded coverage, including savings from\nstates need to worry about companies' relocating if\ncutting Medicare and reducing or eliminating\nstate taxes were raised. That is less of a problem\nthe Medicaid program. Other ways that some\nfor the United States as a whole. But despite these\nplans finance reform include requiring that\nproblems, if national health care reform fails to\nemployers contribute to health insurance and\npass, a number of states are likely to move on their\nlimiting the extent to which insurance benefits\nown to change the health care system.\ncan be deducted from taxable income. Like you,\nmany people fear that additional revenue\nsources may also be needed, especially if costs\nQ.\nUnder the proposed health plans pending in\nof health care continue to rise in the future.\nthe Congress, how will part-time and hourly\nComprehensive reform legislation would be\nemployees be covered?\ncomplicated, and it is difficult to know with\nA. The Clinton proposal, with its employer\ncertainty whether the revenue sources that have\nmandate, would require employers to pay on a\nbeen proposed will be sufficient, especially after\nprorated basis for part-time and hourly workers as\nthe program has been in place for a few years.\nlong as they work more than 10 hours a week. The\nsingle-payer approach sponsored by Rep. Jim\n&\nHave policy makers considered evaluating\nMcDermott (D-Wash.) would cover everyone\nseveral of the plans by having different states try\nregardless of employment status and pay for the\nthem out? This way, they could give different\npublic system through payroll and income taxes.\nplans a chance to see which one or ones could\nThe other major proposals would either require\nwork best, and implement the best plan for the\nindividuals to purchase insurance or leave coverage\ncountry.\noptional, and these plans would make insurance the\nresponsibility of individuals. Employers under these\nA. One of the suggestions for compromise on\nplans would be free to help pay the premiums, but\nhealth care reform is to give states a great deal\nthey would have no increased incentives to expand\nof latitude in designing reform. Many of the\ntheir current efforts. Low-income individuals under\nexisting proposals already allow some state\nall the plans would receive some type of subsidy to\nflexibility. There are, however, several\nhelp in the purchase of insurance, but the details\nproblems with allowing more flexibility, many of\nvary. The more generous these subsidies, the\nthem surrounding the issue of who would pay.\nmore expensive the proposal.\n0 you have a question about President Clinton's health proposal or about\nD\nthe other bills in Congress? The Washington Post free telephone\ninformation service takes questions from readers about how the plan could\naffect them. Call POSTHASTE at 202-334-9000 on a touch-tone phone and\nenter category code 8500 (in Prince William County, 703-690-4110). Health\neconomist Marilyn Moon of the Urban Institute provides answers in this column\nbased on information from the White House, Congress and other sources. While she\ncannot answer all questions or give personal advice, she will answer a range of\ninquiries.\nPM-Relying on Leon, Bjt, 720\nPanetta: A Persistent, Tough Insider Who Alienates Few\nWith PM-White House-Shakeup Bjt\nAP Photo WX103\nBy ALAN FRAM= Associated Press Writer=\nWASHINGTON (AP) When President Clinton needed a punchline last March\nduring a dinner thrown by the Washington press corps, he used Leon Panetta\nliterally.\nIt says right here that someday we'll all die, sighed Hillary Rodham\nClinton in a parody the first couple had taped of the insurance industry's\nHarry and Louise ads attacking the Clintons' health-care plan.\nHis jaw dropping, Clinton responded, Even Leon Panetta?'\nThe president picked the amiable congressional veteran for the punchline\nof the joke because of Panetta's refusal to wither under the intense political\nfire of the administration's first year, when he served as director of the\nOffice of Management and Budget. Now, for that attribute and others, Clinton\nhas chosen Panetta again, this time as his chief of staff.\nThe owlish, broad-shouldered Panetta, who turned 56 today, comes to his\nnew job after 16 years as a California congressman and nearly 18 months as\nClinton's budget director. He replaces Clinton's boyhood friend, Mack McLarty,\nwho was seen as too gentle for the election-year crunch that awaits health\ncare, the crime bill and some of the president's other top legislative\npriorities.\nAsked to list Panetta's qualities, lawmakers and others describe\na man who seems custom-made for the difficult job of Clinton's gatekeeper:\nOrganized. Experienced. Loves process. Knows how to say no. Understands\nissues and Congress. Popular with the press.\nIn the Capitol, Panetta's ascension Monday was greeted with uniform glee\nby fellow Democrats and with respect by Republicans.\nWhat Leon brings with him is a good knowledge of the workings of\nCongress, how to work with it and get around pitfalls, said Rep. Charles\nStenholm, D-Texas, a conservative who sometimes clashed with Panetta when\nboth were on the House Budget Committee. He's very fair. He listens. \"\nLeon knows Washington and knows Congress better than anybody in the\ncurrent White House team, said House Minority Whip Newt Gingrich, R-Ga. ``He\nbrings a level-headed, cheerful persistence that will be helpful to the\npresident.'\nBefore coming to Congress, Panetta was a Republican and director of the\nCivil Rights Office in President Nixon's Department of Health, Education and\nWelfare. Panetta was fired in 1970 after he complained that the agency was not\naggressive enough; he became a Democrat soon afterward.\nPanetta's ready, cackling laugh and the ubiquitous thick looseleaf books\ntucked under his arms were his trademarks in the halls of the House.\nThere, he persistently ranted about the need to attack burgeoning federal\ndeficits for years before Ross Perot dragged the issue into the spotlight of\nthe last presidential campaign. On a subject that can be eye-glazingly dull,\nhe was able to deliver passionate speeches on the need to cut red ink, his\nvoice loud and his face bulging with emotion.\nKnown as a master of the minutiae of the $1.5 trillion federal budget,\nPanetta was a major player in the 1990 budget summit with President Bush that\nyielded a $500 billion deficit-reduction package of taxes and spending cuts.\nAs White House budget chief, he helped guide Clinton's similar deficit-cutting\nplan to enactment last year.\nIn both those episodes, he was seen by some liberal Democrats as, if\nanything, too eager to reduce the deficit at the expense of cherished social\nprograms. During the marathon 1990 budget summit with Bush, he seemed more\nwilling than some other Democratic participants to strike a compromise with\nthe administration.\nIt is that willingness to reach out that persuaded many Republicans that\nPanetta was a fair, dedicated lawmaker.\nHe's never been one you leave negotiations with feeling angry and\nthinking he's less than a straight shooter, \" said Sen. Pete Domenici of New\nMexico, ranking Republican on the Senate Budget Committee. But that doesn't\nmean he's not tough.\nBut some Republicans haven't forgiven Panetta's departure from the GOP.\nOthers also recall the 1984 House commission Panetta headed that awarded a\ndisputed Indiana congressional race to the Democratic candidate.\nThis is the big leagues, and when hardball is called for, Leon will go\nmore than to the wall, \" said Rep. Jerry Lewis, R-Calif.\nAnd it is that quality that Clinton will be able to rely on during these\nnext, crucial months his presidency faces.\n****\nfiled by: APE- (--)\non 06/28/94 at 00:01EDT ****\n**** printed by: WHPR (JEL) on 06/28/94 at 08:17EDT ****\nPM-Digest Briefs, 1106\nEds: This package does not contain the following items from the News Digest:\nPM-Korea-Nuclear.\nWASHINGTON (AP) The daunting demands on President Clinton's new chief of\nstaff range from smoothing out ragged White House operations to advancing\nadministration priorities such as health care and welfare reform.\nBudget Director Leon Panetta says he'll be settling into a job he calls\nthe toughest in town by mid-July. At the same time current chief of staff Mack\nMcLarty, among the last of the Arkansans Clinton brought to his inner circle,\nwill take on his new role as counselor to his boyhood friend.\nWhat's happening is, we're now looking at a very large legislative\nagenda, Panetta, a former California congressman, said Monday night on\nCNN's Larry King Live. I have that kind of experience. I know the\nplayers. I know the arena\nWith McLarty sitting beside him, he added: The feeling was, this is the\nbest time that Mack become what he really is, which is\na close adviser of the president\n=\nWASHINGTON (AP) When President Clinton needed a punchline last March\nduring a dinner thrown by the Washington press corps, he used Leon Panetta\nliterally.\nIt says right here that someday we'll all die, sighed Hillary Rodham\nClinton in a parody the first couple had taped of the insurance industry's\nHarry and Louise ads attacking the Clintons' health-care plan.\nHis jaw dropping, Clinton responded, Even Leon Panetta?'\nThe president picked the amiable congressional veteran for the punchline\nof the joke because of Panetta's refusal to wither under the intense political\nfire of the administration's first year, when he served as director of the\nOffice of Management and Budget. Now, for that attribute and others, Clinton\nhas chosen Panetta again, this time as his chief of staff.\n=\nWASHINGTON (AP) With key committee votes approaching in both houses,\nSenate Republicans are circulating a scaled-down alternative to President\nClinton's health reform bill that relies on tax breaks for workers and federal\nsubsidies for the poor to expand coverage to the uninsured.\nIn contrast to Clinton's bill, the GOP draft contains no requirement for\nuniversal coverage and is stripped of the administration's proposal for\nemployers to finance insurance for their workers.\nIt also drops the tobacco tax hike the administration and many lawmakers\nfavor to pay for expanded health care. Financing would come from $100 billion\nin savings from Medicaid and Medicare over five years.\nLike virtually all proposals under discussion, the GOP draft calls for\nchanges to make it tougher for insurance companies to deny coverage to those\nseeking it.\n=\nUNDATED For all the shuddering on Wall Street, the plunging dollar isn't\nlikely to cause much pain on Main Street.\nAt the beginning of the year, one dollar was worth about 113 Japanese yen.\nBy Monday the dollar's worth had fallen roughly 12 percent to a postwar low of\n99.93 yen before rallying slightly to close at 100.35 yen on the Tokyo foreign\nexchange market today. The dollar is also down 10 percent from its high this\nyear vs. the German mark, Europe's strongest currency.\nIn theory, the dollar's decline weakens U.S. purchasing power because it\ntakes more dollars to buy the same amount of imported goods. It also can mean\nhigher prices and inflation.\nOne old economic formula says that a 10 percent decline in the dollar's\nvalue translates into a 1 percent rise in consumer prices over 1 to 1&1/2\nyears.\n=\nLOS ANGELES (AP) Defense attorneys and prosecutors are asking\na judge for access to evidence that could either link O.J. Simpson to a bloody\ncrime scene or help exonerate him.\nSimpson, 46, has pleaded innocent to murdering his ex-wife and her friend,\nRonald Goldman. Their stabbed and slashed bodies were found outside Nicole\nBrown Simpson's condominium on June 12. Simpson has been jailed without bail\nsince June 17.\nOn Monday, Ms. Simpson's father disputed a coroner's report that said she\nwas on the phone at 11 p.m. the night she was killed. A defense lawyer had\nsaid the timing of the call bolstered Simpson's alibi.\nA judge scheduled a hearing today to decide whether to give defense\nlawyers access to blood samples and other evidence, and whether prosecutors\ncan take a sample of Simpson's hair. Simpson was to attend the hearing.\n=\nWASHINGTON (AP) Pregnant women in Iowa, newborns in Tennessee,\na 67-year-old leukemia patient in Boston different people in different\ncircumstances, they and hundreds of others became Cold War guinea pigs.\nThey all were used in the government's search to learn more about how\nradiation affects the human body, according to new information made public by\nthe Energy Department.\nThe department disclosed on Monday that a review of more than 11,000\ndocuments unearthed at least 48 new experiments in which perhaps as many as\n1,200 people were subjected to radiation exposure, often with no evidence of\nconsent.\nThe additional human radiation tests were among stacks of documents made\npublic by the department on its nuclear program as evidence of what Energy\nSecretary Hazel O'Leary called a new era of openness in the once-secretive\nagency.\n=\nWASHINGTON (AP) Federal regulators are considering tougher requirements\non TV stations to boost the number of educational programs for young viewers.\nThey also want to make sure that shows such as `The Jetsons'' and Leave\nIt to Beaver'' don't show up again as ``educational'' programs.\nThe Federal Communications Commission is collecting recommendations today\nfrom broadcast networks, program producers and watchdog groups at its first\nhearing in 10 years on the state of children's television.\nThe commission is considering whether it should adopt a definition of what\nconstitutes an educational program and require stations to air a set amount of\neducational programs for children every week.\n=\nPORT-AU-PRINCE, Haiti (AP) The interception of 1,330 Haitians on the high\nseas has stunned U.S. officials and taxed America's ability to handle the\nrefugees.\nThe Haitians picked up Monday, combined with 786 Haitians apprehended over\nthe weekend, nearly equal the 2,239 intercepted in all of 1993.\nThe surge, which is expected to continue, could dramatically increase\npressure on the Clinton administration to quickly resolve Haiti's festering\npolitical crisis.\nU.S. Coast Guard officials, who stationed about 15 cutters and patrol\ncraft off Haiti after the new policy was announced, hinted the new Clinton\npolicy caused the refugee tide.\n**** filed by:APE-(--) on 06/28/94 at 05:33EDT ****\n**** printed by: WHPR (JEL) on 06/28/94 at 08:17EDT ****\nbc-sun-editorial a0843\n(bal) (ATTN: Editorial Page editors)\nHealth Reform: Who Pays?\n(c) 1994, The Baltimore Sun= The following editorial appeared in Monday's\nBaltimore Sun:\nSenate moderates pushing health care reform that puts the emphasis on\nindividuals, not employers, in purchasing insurance may be on to something.\nThe fact is that in the end it will always be individuals not employers, not\nthe government who have to pay the doctor (and the hospital and the\npharmacist and the insurance peddler).\nWhen you have an employer mandate, as Bill and Hillary Clinton\npropose, the cost is ostensibly covered by the boss. But employees inevitably\nfeel the impact in the form of smaller paychecks.\nWhat the debate on Capitol Hill is really all about is cost shifting of\nsomehow finding a way to force healthy, reasonably well-off people to help pay\nthe bills of the sick and the less fortunate.\nThe nation's poor already are covered by Medicaid, the elderly by\nMedicare. But the nation's jerry-built health care system too often fails to\ncover lower-income people who are self-employed or working for employers who\ndo not provide insurance. And why? Because insurance companies tend to deny\ncoverage to those with pre-existing conditions and refuse customers the right\nto carry their coverage from job to job. Because healthy citizens or the\nmillions of employees used to having their medical insurance extracted\ntax-free from their paychecks don't really want a change. Because there is so\nmuch red tape involved in medical billing that billions of dollars go to\nadministration rather than health care.\nA year ago remember? health care reform was widely regarded as a cause\nwhose time had come. But then came the details, and from them emanated so many\ndevils that today the whole reform movement could collapse. Republicans who\nonce were guarded or cautiously supportive of health reform now seem more\nemboldened to oppose the Clintons outright.\nPerhaps this can be blamed on the secretive way in which Clinton concocted\na vastly complicated 1, 300-page bill. Perhaps it can be attributed to a\nsmall-business lobby that cranked out the Harry and Louise'' commercials\nwithout ever quite informing the public that employers providing health care\nwere carrying the water of their deadbeat competitors.\nBe that as it may, the focus now is on proposals before the Senate Finance\nCommittee that would throw out employer mandates'' and substitute them with\ninsurance reforms, subsidies for the working poor'' paid for through tobacco\nand payroll taxes and vague prospects for taking further action perhaps even\nindividual mandates'' if more than 5 percent of the population remains\nuncovered at century's end.\nAs many holes can be picked in this approach as in the Clinton proposal or\nits variations. But if it is theoretically correct that the individual is the\nend source of health dollars, then bipartisan proposals in Senate Finance\ndeserve a fair hearing. The alternative, as even the Clintons are starting to\nsuspect, could be nothing at all.\nDistributed by the Los Angeles Times-Washington Post News Service=\n**** filed by:LAWP(-- on 06/28/94 at 02:43EDT ****\n**** printed by: WHPR (JEL) on 06/28/94 at 08:17EDT ****\nbc-MA-Beth-Israel-Pres\nTO STATE AND MEDICAL EDITORS:\nBETH ISRAEL HOSPITAL PRESIDENT DR. MITCHELL T. RABKIN PARTICIPATES IN\nWHITE HOUSE HEALTH CARE MEETING IN SUPPORT OF CLINTON HEALTH PLAN\nBOSTON, June 27 /PRNewswire/ -- Beth Israel Hospital President Dr.\nMitchell T. Rabkin today met with President Clinton, First Lady Hillary\nRodham Clinton, and Vice President Al Gore at the White House, and spoke on\nbehalf of medical academic leaders nationwide who support the Clinton/Kennedy\nhealth care bill.\nOver 70 chief executive officers of teaching hospitals and deans of\nmedical schools attended the meeting which was held in the East Room of the\nWhite House this morning at 11:30 a.m. followed by a press conference on the\nNorth Lawn of the White House.\nDr. Rabkin's remarks follow:\nRemarks by Mitchell T. Rabkin, MD\nPresident and Chief Executive Officer\nBoston's Beth Israel Hospital\nand\nProfessor of Medicine, Harvard Medical School, Boston\nat the White House, Washington, DC\nMonday, 27 June, 1994\n\"Thank you, Mrs. Clinton, and members of the White House staff, for making\nthis meeting possible on behalf of my colleagues. Those assembled here and\nothers unable to attend are leaders of America's top medical schools and\nteaching hospitals, concerned with the future of health care in America -- its\nquality, availability, financing, and its critical role in the health and\nfuture success of this nation.\n\"In some respects, today's gathering is an outgrowth of a productive\nmeeting in Boston a couple of months ago in which President Clinton, Senator\nTed Kennedy and others reaffirmed the critical importance of both universal\ncoverage and also support for the special functions of teaching and research\nin academic medical institutions. Their strong commitment has encouraged this\nlarger and nationally representative group to speak out today as individuals,\nfirmly and positively, on the primacy of these issues -- universal coverage;\nsupport for the teaching and training of tomorrow's doctors, nurses and other\nhealth care providers; and support for the research that uncovers new\nknowledge to understand and fight disease, disability, and poor health.\n\"As the debate heats up over health care reform, and as they wrongly imply\nin the TV commercial that there is some link between universal coverage and\nrationing, it becomes important for Harry and Louise to understand that\nrationing exists today, with 39 million of our citizens uninsured, many of\nthem working Americans and their dependents, and millions more in working\nfamilies this year who will lose their coverage through job loss, new illness,\nor other personal threats. True health care reform should eliminate that\nrationing, and that is precisely what universal coverage does. Without\nguaranteed health care coverage for everyone, each of us is insecure, each of\nus stands on the threshold of medical poverty. With universal coverage, no\none is rationed out of the system.\n\"As the debate mounts, our task is to share these insights with the people\nwe serve back at home -- all the people. They are the interests we represent;\ntheir health and welfare and their concerns must shape the outcome. Their\nvoices must be heard. We are pleased to join with President and Mrs. Clinton\nin standing up to be counted for the health of all America.\n\"Now, it is my pleasure to introduce the distinguished Dr. William Peck,\nDean of the Washington University School of Medicine, St. Louis, Missouri.'\n(Remarks by Dr. Peck)\nNOTE: More than 70 teaching hospital CEOs and medical school deans\nattended the White House meeting at the invitation of President Clinton and\nHillary Rodham Clinton.\nFor further information, contact:\nJ. Antony Lloyd, Vice President Corporate Communications\nBoston's Beth Israel Hospital,\n330 Brookline Avenue, Boston, MA 02215\nInternet Address: tlloydbih.harvard.edu\n-0-\n6/27/94\n/CONTACT: Chris Hickey of Beth Israel Hospital, 617-735-4431/ CO: Beth\nIsrael Hospital ST: Massachusetts IN: HEA SU:\nCM -- NE021 -- 2408\n06-27-94 18:08 EDT\n**** filed by:PR-F(--) on 06/27/94 at 18:14EDT ****\n**** printed by:WHPR(JEL) on 06/28/94 at 08:19EDT ****\nClintons push health reform plan\nWASHINGTON, June 27 (UPI) Battling moves on Capitol Hill to limit the\nscope of health care coverage, President Clinton asked medical school deans\nand heads of academic health centers Monday to personally call their\ncongressmen on behalf of universal access.\nAt a White House ceremony to trumpet support for his plan from the leaders\nof prestigious research centers nationwide, Clinton urged lawmakers now\ncrafting alternatives to put politics behind and put health care first.\nThis surely is not a political issue, Clinton said in launching a\nfervent appeal for help from the group. If we can get beyond the politics to\nthe reality, we can prevail here.\nAnd I want you to do that. You can do that.\nClinton spoke with an eye to efforts now underway in the key Senate\nFinance Committee and other panels to craft legislation that would limit\ncoverage to just 95 percent of Americans.\nHaving renewed his VOW to veto any bill that comes to him with less than\nuniversal coverage, Clinton returned to the White House bully pulpit to try to\nturn up the pressure on lawmakers.\nPointing to the influence of those gathered in the East Room, noting that\nnearly every congressman has a research institution or medical center in his\nhome state, Clinton said, I ask you to commit to make\na personal contact and a personal appeal to every member of the Congress from\nyour state to put politics aside and put the health care of the American\npeople first.\nIf we could have people of both parties bring to the deliberations of\nthe law in Congress less politics and more concern for health care\nwe would\npass a bill in this session of Congress, with bipartisan support, that\nguarantees health care to all Americans.\nFirst lady Hillary Rodham Clinton, who has visited many of the\ninstitutions represented in the room, said each was here today to uniformly\nsupport universal coverage because in the absence of universal coverage,\nevery other mission\nis at risk for the future.\nAnd Dr. Mitch Rabkin, president of the Beth Israel Hospital in Boston,\nrailed back at the health industry's widely aired Harry and Louise'' ads\nattacking the Clinton proposal for rationing health care.\nIt becomes important for Harry and Louise to understand that rationing\nexists today, Rabkin said. True health care reform should eliminate that\nrationing That is what universal coverage does.\nClinton added: The suggestion that somehow we don't have rationing today\nand we will have it if this passes is, to put it mildly, a stretch of\nreality.\n**** filed by: UPI- (us) on 06/27/94 at 13:24EDT ****\n**** printed by: WHPR (JEL) on 06/28/94 at 08:20EDT ****\nHE NEGOTIATIONS\nMoynihan Is Expected to Seek Employer Health Payments\nBy ADAM CLYMER\nSpecial 10 The York\nWASHINGTON, June 27 - Senator\nDaniel Patrick Moynihan will ask the\nenate Finance Committee on Tues-\niay to vote for a national health in-\nsurance proposal that would ulti-\nmately require employers to pay\nmost of the insurance costs for their\nworkers, a Senate aide said tonight.\nThe New York Democrat expects\nthe issue to come to a vote on Wednes-\nday and is not sure of the outcome,\nthe aide said. Republicans on the\ncommittee maintain that anything re-\nTHER\nRER\nDear\nquiring employers to pay will be de-\nCARE\nfeated.\nMr. Moynihan's proposal thrusts\nthe Finance Committee, whose ideo-\nSenate as a whole, back into the cen-\ner of the health care debate. A vic-\nHEALTH\nHIGH\nlogical balance reflects that of the\ntory in the Finance Committee would\nbe a dramatic message that victory\nin the Senate is likely, which in turn\nwould shore up the courage of ner-\nvous Democrats in the House.\nThe committee, which has always\nclaimed the central role on health\nissues, had looked increasingly mar-\nTHE\nginal until now, apparently waiting on\nthe sidelines until three other com-\nmittees took up their own legislation\nAs the Senate Finance Committee met privately on health care yesterday, Becky Ogle of the Consortium of\nbefore even scheduling its first vote.\nCitizens with Disabilities waited outside, her wheelchair displaying her support for the Clinton plan.\nConsistent With Clinton\nThe proposal backs away from\nwhere they will have to propose an\nployers to \"share responsibility,\" as\nPresident Clinton's call for immedi-\nplan, which has no requirements for\namendment to take it out.\nthe Administration puts it, for the\nate employer responsibility, a posi-\nemployers or individuals to buy in-\nWith 11 Democrats and 9 Republi-\ncosts of health insurance.\nsurance.\ntion Mr. Moynihan had supported -\ncans on the committee, Mr. Moynihan\nMr. Moynihan's proposal will re-\nalthough he acknowledged it would be\nUnder the original Breaux pro-\ncould lose one Democrat and still\nplace one which he announced earlier\nvery hard to pass. But the plan is\nposal, national health insurance ef-\nprevail on such an amendment with a\nthis month but never put before the\nformulated in a way that makes it\ntie vote. But he would still need 11\nforts would begin with steps, on which\ncommittee. That plan hewed more\nlikely all employers would be re-\nthere is little disagreement, that\nvotes to approve the bill, something\nclsoely to Mr. Clinton's proposal, but\nquired to pay for insurance within\nwould make insurance easier to buy\nhe hopes the committee can do by the\nhad no significant support in the com-\nfive years. It is therefore consistent\nand harder to cancel.\nend of the week.\nmittee.\nwith Mr. Clinton's demand that all\nBut these measures did not sub-\nEven if he loses, the aide explained,\nWhat he will announce tomorrow is\nAmericans be provided health insur-\nthe Republicans, and particularly\nstantially raise the percentage of\nclosely patterned on a proposal made\nance.\nAmericans with health insurance,\nSenator Bob Dole of Kansas, the Re-\nlast month by Senator John Breaux, a\nBy putting the requirement in his\npublican leader, will be forced to vote\nthere would be an automatic require-\nLouisiana Democrat who is frequent-\nnew proposal, Mr. Moynihan will also\nagainst what Democrats can charac-\nment for employers to start paying,\nly a swing vote on the committee. But\nput the Republicans in a position\nwhich is known as an \"employer\nterize as a proposal to require em-\nMr. Breaux has since come out for a\nmandate.\"\nFor example, if firms with 100,or\nmore employers, who now employ 6)\npercent of the nation's work force, did\nnot increase their percentage of CO\nerage from the current 89 percent\nworkers and their dependents to 96\npercent, then all employers in that\ncategory would have to insure their\nworkers.\nSlower, and slightly less universal\nrequirements would be imposed on\nsmaller companies.\nThe uncertain air that hung over\nthe Finance Committee's efforts was\nevident early this afternoon as Demo-\ncrats met at the Capitol to discuss\nwhat they thought Mr. Moynihar\nshould propose, reporters gathered\noutside and tourists waited nearby\nTHE NEW YORK TIMES, TUESDAY, JUNE 28. 1994\nfor admission to the Senate gallery.\nMr. Moynihan later emerged to say\nthat he hoped the committee could\nfinish work on a bill this week. When a\nreporter asked if it would work into\nnext week's scheduled Congressional\nvacation, he said, \"We're not that\nkind of a committee.\"\nWays and Means Tussle\nIn the House, the Ways and Means\nCommittee struggled over its version\nof the bill, putting off decisions\nhow to control costs but arguing for\nnearly 15 minutes over the design and\ninformation to be printed on the na-\ntional health card all Americans\nwould receive under the bill.\nAt one point, Representative Bill\nThomas, Republican of California,\nsuggested printing 202-456-1414 on-the\ncard. \"For anyone who doesn't know\nthe number, that's the White House,'\nhe explained. His proposal was re-\njected.\n9\nTHE DETAILS\nStudy Sees Problems in Subsidies to Help the Poor Buy Insurance\nBy ROBERT PEAR\nreduced at the very moment when the\nnumbers of people in middle-income\nChafee proposal and 95 cents under\nSpecial to The New York Times\nneed was greatest, in recessions, as\nfamilies. On the other hand, it says, if\nthe Cooper proposal.\nWASHINGTON, June 27 - A new\nthe numbers of poor and unemployed\nTaking issue with\nthe subsidies decline sharply as earn-\nstudy finds serious, unsuspected\npeople rose.\nings rise, they may discourage people\nPut another way, such a family\nproblems with many proposals for\nGovernment subsidies to help peo-\na crucial part of\nfrom trying to earn more, especially\nwould keep 24 cents of each additional\nthe Federal Government to help low-\nple buy insurance have been in health\npeople with incomes between the pov-\ndollar earned under the Clinton pro-\nincome people buy private health in-\nplans proposed by President Clinton;\nerty level and twice that amount\nposal, but only 5 cents of each addi-\nsurance by subsidizing their premi-\nRepresentative Jim Cooper, Demo-\nplans to overhaul\n($15,000 to $30,000 a year for a family\ntional dollar under the Cooper pro-\nums.\ncrat of Tennessee; Senator John H.\nof four). In other words they would\nposal.\nChafee, Republican of Rhode Island,\nhealth insurance.\nlose their benefits and be subjected to\nSuch subsidies are a feature of\nand Senator Edward M. Kennedy,\nmore taxes as well.\nThe Use of Overtime\nmost of the health insurance bills\nDemocrat of Massachusetts. Spend-\nbeing considered in Congress. Subsi-\ning on such subsidies would be sub-\nject to limits set by Congress. None of\nGradual Phasing Down Urged\nSuch high marginal tax rates could\ndies have been suggested as a way to\neasily discourage extra work effort\nmake sure that all Americans obtain\nthe proposals would increase the\nage without jeopardizing poor work-\ners. The workers would continue re-\nbecause people would keep relatively\nhealth insurance, with or without a\nspending limits in time of recession.\nPeople just above the poverty level\nrequirement that employers contrib-\nceiving similar coverage, with their\nlittle of their additional earnings, the\nalready pay a high \"tax\" on addition-\nreport says.\nute to the cost of workers' coverage.\nOn Providing Subsidies\npremiums fully paid by the public\nal earnings because they may lose\nsubsidy system.\"\nBut the study, issued today by the\nfood stamps, tax credits and other\nMr. Greenstein- said that an em-\nMoreover, it says, \"Firms that em-\nbenefits as their incomes rise.\nployer mandate could also have some\nCenter on Budget and Policy Priori-\nRobert Greenstein, director of the\nties, a nonpartisan research institute,\nCenter on Budget and Policy Priori-\nploy large numbers of low-income\nunintended effects. For example, he\nsays that if subsidies are not careful-\nties, said the cost of subsidies would\nworkers would be able to make them-\nThus, the study concludes: \"Low-\nsaid, it would create incentives for\nly designed they will discourage peo-\nbe much higher if there was no re-\nselves and their employees better off\nincome subsidies should be phased\ncompanies to make greater use of\nquirement for employers to pay any\nby terminating health coverage and\ndown very gradually. Otherwise, in-\novertime by full-time workers, rather\nple from working and may encourage\ncompanies to drop health insurance\nof the premiums for their workers.\nconverting some or all of the savings\ncentives to work will be weakened toc\nthan hiring additional employees.\nthey now provide to employees.\nBut, he observed, in the absence of an\ninto higher wages or other employee\nmuch.\"\nUse of overtime does not increase\nemployer mandate, companies would\nbenefits.\"\nA family of four is classified as\nhealth care premium costs, while hir-\nMoreover, the study, which looked\nhave \"powerful incentives\" to drop\nMr. Cooper defended his proposal,\npoor by the Government if it had cash\ning new employees would do so,\" he\nsaid.\nat all proposals, says there are seri-\ncoverage for their employees and to\nsaying, \"It is essential that health\nincome less than $14,764 in 1993. For\nous problems in plans to limit the\nshift costs to the Government, which\ncare reform include subsidies to\neach additional dollar earned, the re-\nThe study by the Center on Budget\namount the Government could spend\nwould subsidize the premiums.\nmake coverage affordable for low-\nport says, a family of four that has\nand Policy Priorities examines the\non subsidies in any year: \"they make\nincome people.\"\nincome 25 percent above the poverty\neffects of subsidies on people at dif-\nno adjustment for recessions.'\nDescribing what would happen\nlevel and receives food stamps would\nferent income levels. The work of the\nwithout an employer mandate, Mr.\nThe study says that the proposed\nlose a total of 76 cents under the\ncenter was assisted by a grant of\nTo stay within the spending limits,\nGreenstein said the study found:\nsubsidies will become extremely ex-\nClinton proposal, 78 cents under the\n$20,000 from the Henry J. Kaiser\nthe study says, subsidies would be\n\"Employers could terminate cover-\npensive if they are available to large\nKennedy proposal, 90 cents under the\nFamily Foundation.\nTHE NEW YORK TIMES, TUESDAY, JUNE 28, 1994\nPoll Finds Public Losing Confidence\nin Clinton, Economy\nHealth Proposal Flags, but Key Points Have Strong Support\npresident's bottom-line issue-a\nBy David S. Broder\nguarantee of universal health insur-\nand Richard Morin\nWashington Post Staff Writers\nance coverage.\nSays nearly as clearly-72 per-\nOn the eve of President Clinton's\ncent to 27 percent-that employers\ndecision to shake up his staff,in-\nshould be required to provide that\ncreasing numbers of Americans said\ninsurance for their full-time work-\nClinton was a mistake-prone leader\ners, as in the Clinton plan.\nlacking in decisiveness and losing his\nSupports, 61 percent to 37 per-\nsense of the real problems facing\ncent, charging people more for plans\nfamilies, according to the latest\nthat provide a choice of doctors than\nWashington Post-ABC News poll.\nthose with assigned doctors. Clinton\nAlthough Clinton's overall approv-\nmaintains his plan would provide\nal rating held steady from a month\nfree choice for all.\nearlier at 50 percent, the new poll\nWere it left to the public, there\nconfirms that the president has lost\nwould also be federal price controls\nground with the public since the be-\non doctors, hospitals and drugs. Ful-\nginning of the year on a broad vari-\nly 75 percent of those polled support\nety of issues. The poll also found an\nthat, but none of the major plans in-\nupsurge in concern about the state\ncluding Clinton's is proposing direct\nof the economy.\ncontrols-which are fiercely op-\nOpinion on the overall Clinton\nPRESIDENT CLINTON\nposed by the health care providers.\nhealth care plan is increasingly nega-\nseen as lacking decisiveness\nOn the downside for Clinton,\ntive, but those polled say the presi-\nthose polled:\ndent is right in seeking a major over-\nnated by reports that the dollar was\nVoice increasing opposition when\nhaul of the system to require\ndropping against the Japanese yen\nasked about \"Clinton's health care\nemployers to pay most of the bills\nand the German mark.\nplan.\" Disapproval of the plan has\nfor everyone's health insurance. If\nAs a result, Clinton's approval\nmore than doubled since its intro-\nthose polled had their way, however,\nscores on handling the economy,\nduction last September, reaching a\nabortion would be dropped from the\nwhich had been in positive territory\nnew high of 53 percent in this poll.\nbasic benefits package in the plan.\nfrom December through May,\nOnly 42 percent approve of it,\nClinton's overall approval score is\ndipped to 46 percent approval and\nmatching the previous low.\n8 or 9 percentage points below\n48 percent disapproval in the latest\nwhere it had stabilized in the first\nDisplay a similar but slower ero-\npoll.\nsion of support when the Clinton\nthree months of 1994. His disap-\nEconomic anxiety was highest in\nproval is at 44 percent.\nplan is compared to the present sys-\nthe West and his economic perfor-\nBut 55 percent said Clinton is not\ntem. The percentage thinking the\nmance scores were notably low\na strong and decisive leader, up from\nplan better than what now exists has\nthere and in the South, and among\n44 percent in January. Now there\ndropped from 64 percent last Sep-\nwomen, working-class and poor peo-\nare three people who think he makes\ntember to 49 percent now; those\nple.\nmore mistakes than the average\nsaying it would be worse have in-\nAmong independents, approval of\npresident for every two who say he\ncreased from 17 percent to 41 per-\nClinton's economic performance\nmakes fewer.\ncent.\ndropped 10 points to 37 percent be-\nWhat has been a pillar of support\nThese negative trends clearly\ntween January and June.\nfor Clinton-his empathy for aver-\nthreaten Clinton's effort to put pub-\nCrime continues as the overriding\nage Americans-is suffering ero-\nlic pressure on Congress to enact his\nconcern with the economy edging\nsion. In January, 55 percent said he\nplan. Still, only 22 percent of those\nhealth care on the voters' priority\nunderstands problems of people like\nlist for Clinton and Congress. Nei-\npolled say Congress should reject it\nthemselves and 39 percent said he\nther Clinton nor Congress earns\nentirely. A stable 70 percent have\ndoes not. Now the numbers are 52\npublic approval for their current\nbeen saying for months they prefer\npercent yes and 46 percent no.\nhandling of health care, but the pub-\nto see something passed with minor\nThat may be related to increasing\nlic expresses slightly more confi-\nor major changes. Elsewhere, the\nworries about the economy. Despite\ndence in the lawmakers than in Clin-\npoll has little in the way of good\nseveral months of low inflation and\nton-44 percent to 36 percent-to\nnews for the president. The inter-\nincreasing employment, economic\ndo the job right.\nviewees are almost evenly split on\nconfidence is lower than it was last\nPublic attitudes toward health\nwhether he is an old-style, tax-and-\nwinter. In January and February, the\ncare remain a confusing and some-\nspend Democrat (44 percent) or a\nnumber of people who saw the econ-\ntimes contradictory mixture.\nnew-style Democrat careful with the\nomy improving exceeded, by 9 or 10\nOn the positive side for what Clin-\npublic money (49 percent).\npercentage points, the number who\nton is trying to persuade Congress\nAlmost three out of five of those\nsaw it declining. Now, 42 percent\nto do, the public:\npolied say the changes he is seeking\nsay it is getting worse and 39 per-\nSays, 58 percent to 38 percent,\nare mainly the right ones. But in a\ncent, better.\nthat the system needs a major over-\n1996 trial heat between Clinton and\nThe survey of 1,531 people was\nhaul, not just a good tuneup.\nan unnamed Republican challenger,\ntaken last Thursday through Sun-\nAgrees, by an overwhelming 78\nClinton can barely deadlock-36\nday, when economic news was domi-\npercent to 20 percent, with the\npercent to 39 percent.\nTUESDAY. JUNE 28. 1994 THE WASHINGTON POST\n35\nA12 TUESDAY, JUNE 28, 1994\nMoynihan\npackage of economic incentives,\nnew insurance regulation and gov-\nernment subsidies for the poor in\nA4 TUESDAY. JUNE 28. 1994\nHolds Back\nhopes of ensuring coverage of 95\npercent of Americans by the year\n2000. If the 95 percent target were\nTODAY IN CONGRESS\nHealth Plan\nnot reached, mandatory measures\nwould not be automatic, but would\nSENATE\nbe studied by a new, national com-\nMeets at 9 a.m.\nmission.\nCommittees:\nThe commission then would\nAppropriations-9 a.m. Interior subc\nBy Dana Priest\nmeets to mark up H.R. 4602, its FY95\nWashington Post Staff Writer\nmake recommendations to Con-\napprops. S-128, Capitol.\ngress to achieve the coverage goal.\nAppropriations-1 a.m. Meets to\nSenate Finance Committee Chair-\nmark up H.R. 4602. S-128, Cap.\nSpecial provisions in the bill would\nEnergy & Natural Resources-9:30\nman Daniel Patrick Moynihan (D-\nmake it difficult, but not impossible,\na.m. Energy research & development\nN.Y.) postponed release of his health\nfor Congress to reject the recom-\nsubc. hearing. 366 Dirksen Office Bldg.\ncare plan yesterday, indicating he\nEnergy & Natural Resources-2:30\nmendations.\np.m. Water & power subc. hearing. 366\nstill was making final decisions about\nThe Finance Committee is one of\nDOB.\nits shape and would release it today.\nEnvironment & Public Works-10\n28, 1994 THE POST\nfive congressional committees that\nAt a closed session of committee\na.m. Hearing on Superfund Reform Act\nare trying to pass health reform\nof 1994. Treasury Sec. Lloyd Bentsen;\nDemocrats this morning, members\nplans this session. Those plans\nEPA Administrator Carol Browner. 406\nagain discussed whether to fashion a\nDOB.\nwould be melded by the House and\nbill that finances universal coverage\nForeign Relations-10 a.m.\nby a certain date-President Clin-\nSenate leadership into bills for de-\nConvention on Regulating Fishing\nbate on the House and Senate\nVessels on High Seas hearing. 419 DOB.\nton's bottom line for health care re-\nForeign Relations-2 p.m. Western\nfloors.\nform-and how to pay for it.\nHemisphere & Peace Corps affairs subc.\nFinance is considered the most\nHearing on U.S. policy toward Haiti. 419\nMembers who attended the meet-\nDOB\ninfluential of the five committees\ning. said Moynihan appeared to be\nGovernmental Affairs-10 a.m.\nleaning toward allowing the commit-\nbecause it most closely reflects the\nHearing on delinquent criminal debt.\nmakeup of the Senate as a whole\n342 DOB.\ntee to vote on a measure, sponsored\nJudiciary-10 a.m. Constitution subc.\nby:Sen. John Breaux (D-La.), that\nand has a reputation for bipartisan\nhearing on implementation of Hate\ncompromise.\nCrime Statistics Act. 226 DOB.\nwould trigger a requirement that\nSelect Intelligence-4 p.m., closed.\nemployers pay for their workers'\nLate yesterday, Moynihan met\nHearing on intelligence matters. 219\nhealth insurance if voluntary meas-\nwith Treasury Secretary Lloyd\nHart Office Bldg.\nures failed to reduce the number of\nBentsen and Leon E. Panetta, the\nConferees-2 p.m. Legislative approps.\nfor FY95. H-301. Cap.\nuninsured. But there was a consen-\nhead of the White House Office of\nHOUSE\nsus in the meeting that any such\nManagement and Budget who yes-\nMeets at 10:30 a.m.\nterday was appointed White House\nCommittees:\nmeasure for mandatory employer\nAgriculture-10 a m. Considers\npayments would not pass the com-\nchief of staff, to discuss the com-\nlegislation to implement agricultural\nmittee, the members said.\nmittee's deliberations.\nprovisions of the Uruguay Round of\nGATT. 1300 Longworth House Office\nBreaux said yesterday that even\nMeanwhile, Sen. Robert F. Ben-\nBldg\nhe would vote against his original\nnett (R-Utah) became the first Sen-\nBanking, Finance, & Urban\ntrigger proposal. \"Foolish consis-\nate Republican to threaten a filibus-\nAffairs-10 a m. International\ndevelopment. finance, trade & monetary\ntency is the hobgoblin of little\nter on health care if the bill that\npolicy subc. hearing on international\nminds,\" Breaux said, quoting Ralph\ngets to the floor is anything like the\nlabor standards & use of trade\nWaldo Emerson. But such a com-\nClinton plan or a similar one passed\nagreements & development assistance.\n2128 Raybum House Office Bldg\nmittee vote might serve the pur-\nby the Labor and Human Resourc-\nGovernment Operations-9:30 a.m.\npose of convincing the White House\nes Committee, headed by Sen. Ed-\nCommerce, consumer & monetary\naffairs subc. hearing on Chief Financial\nthat its proposed \"employer man-\nward M. Kennedy (D-Mass.).\nOfficers Act compliance. 233 RHOB.\ndate\" is a non-starter, committee\n\"The Clinton plan, and its clone\nHouse Administration-10: m.\nDemocrats said.\nthe Kennedy plan, are in my view\nPersonnel & police subc. considers\nprinting resolutions & personnel items.\nAccording to an option discussed\npoison,\" said Bennett. \"They must\nH-328, Cap.\nyesterday, Moynihan then would\nbe defeated, even at the cost of\nMerchant Marine & Fisheries-10\noffer a proposal contained in his\ngridlock. Yes, filibuster, if that is\na.m. Coast Guard & navigation subc.\nhearing on new commandant of Coast\nown plan. a draft of which was ob-\nwhat it takes. This senator is pre-\nGuard. 1334 LHOB.\ntained by The Washington Post last\npared to engage in that to see to it\nMerchant Marine & Fisheries-2 p.m.\nweek.\nOceanography. Gulf of Mexico, & outer\nthat neither of these plans becomes\ncontinental shelf subc. & environment &\nMoynihan's draft proposes a\nlaw.\"\nnatural resources subc. hearing on\nCoastal Zone Management Act. 1334\nHouse Votes\nLHOB.\nNatural Resources-10 a.m. National\nparks. forests & public lands subc.\nTo Streamline\neliminate red tape by encour-\nhearing. 1324 LHOB.\naging agencies to buy com-\nRules-10:30 a.m. Hearing on H.R.\nmercial goods and services;\nDistrict of Columbia approps.: H.R.\n4600. expedited rescissions: & H.R.\nProcurement\nraise the acquisition threshold\n4299. intelligence programs auth.\nto $100,000; streamline con-\nH-313. Cap.\nThe House yesterday ap-\ntracts between the govern-\nScience, Space & Technology-10.30\nment and small businesses;\np.m. Energy subc. hearing on women &\nproved legislation designed to\nK-12 science & mathematics education.\nand establish pilot programs to\n2325 RHOB.\nstreamline the way the gov-\nexperiment with other innova-\nScience, Space & Technology-2 p.m.\nernment buys goods and ser-\ntive reforms.\nTechnology, environment & aviation\nvices.\nsubc. mark up. 2318 RHOB.\nHe described the bill as rev-\nRep. John Conyers Jr. (D-\nSmall Business-1:30 p.m.\nolutionary.\nProcurement, taxation & tourism subc.\nMich.). chairman of the House\nEarlier this month the Sen-\nhearing on unfair competition. 2359\nGovernment Operations Com-\nRHOB.\nate approved its version of\nmittee, and Rep. Ronald V.\nWays & Means- TBA. Mark up of\nprocurement legislation and\nhealth care reform legislation.\nDellums (D-Calif.), chairman\nthe two houses must hold a\nof the House Armed Services\nnegotiating session to recon-\nCommittee, played key roles\ncile differences.\nin steering through the legisla-\ntion, which passed on a voice\nvote.\nConvers said the bill would\n37\nWHERE HEALTH CARE REFORM STANDS\nCONGRESS\nL\negislation to reform health care must follow the path below before being enacted by Congress and\nsigned into law by President Clinton. Five committees with broad jurisdiction over health issues are\ndeveloping recommendations for health plans.\nOn March 23, a bill largely similar to Clinton's\nThe House Energy and Commerce health\nproposal-requiring employers to pay 80 percent of their\nsubcommittee abandoned efforts to produce a bill\nand the full committee appears gridlocked.\nworkers' insurance premiums-moved out of the House\nWays and Means health subcommittee on a 6 to 5 vote. A\nThe Senate Labor and Human Resources\nmodified version is now before the full committee.\nCommittee (which does not have a subcommittee\nthat votes directly on health issues) on June 9\nOn May 25, a similar bill was approved 17 to 10 by a\napproved a bill similar in most respects to\nHouse Education and Labor subcommittee. This legislation\nClinton's proposal that would require all employers\nwould allow discounts for very small firms and was\nexcept for very small businesses to pay about 80\napproved. 26-17, June 23 by the full Education and Labor\npercent of the health insurance premiums for their\nworkers.\nCommittee.\nA second bill, proposing Canadian-style, government-run\nA bill has been proposed by Senate Finance\nnational health insurance financed by taxes-was\nCommittee Chairman Daniel Patrick Moynihan\napproved June 9 by the subcommittee and June 23 by\n(D-N.Y.). The committee is discussing it and an\nalternative in closed session.\nthe full committee, 22-21.\nHOUSE\nSENATE\n1.\nSubcommittees did preliminary work.\nHealth\nHealth\nLabor-\nand the\nManagement\nTUESDAY, JUNE 28. 1994 THE WASHINGTON POST\nEnvironment\nRelations\nSenate bill markups don't occur\nat the subcommittee level.\nApproved\nUnable to\nApproved\na bill\nreach\ntwo bills\nagreement\n2.\nCommittees with broad jurisdiction now send recommendations to leaders.\nYOU ARE\nHERE: The\ndebate over\nnational\nhealth care\nWays and\nEnergy and\nEducation\nLabor and\nFinance\nlegislation\nMeans\nCommerce\nand Labor\nHuman\nSen. Daniel\nis at this\nRep. Sam\nRep. John D.\nRep. William\nResources\nPatrick\nstage in the\nGibbons\nDingell\nD. Ford\nSen. Edward\nMoynihan\n(D-Fla.).\n0\n(D-Mich.),\n(D-Mich.)\nM. Kennedy\n(D-N.Y.),\nlengthy\nchairman\nchairman\nchairman\n(D-Mass.),\nchairman\nprocess\nchairman\ndetailed\nhere.\nWorking on sub-\nNo action\nApproved two\nApproved\nDiscussing bill in\ncommittee bill\nso far\nbills\nbill\nclosed session\n3.\nLeaders\nmeld bills.\nHouse Speaker Thomas S. Foley (D-Wash:).\nSenate Majority Leader George J.\nleft. and Majority Leader Richard A.\nMitchell (D-Maine) may blend bills\nGephardt (D-Mo.), right. meld bills into\ninto one before sending to floor.\none and send to Rules Committee\nHouse debates bill.\n4.\nMembers\nSenate debates bill.\nSubstitutes may be offered.\ndebate bills.\nSubstitutes may be offered.\n5.\nBill goes to conference.\nHouse Senate conference committee reconciles differences\nand sends final version back to each chamber.\n6.\nEach chamber votes.\nHouse votes on a\nSenate votes on a\nfinal \"conference\nfinal \"conference\nCongress hopes to pass\nreport\" version.\nreport\" version.\na bill by the end of this\nsession in October.\n7.\n-Compiled by Spencer Rich\nBill goes to President Clinton.\n38\nBY ABIGAIL TRAFFORD\nLacking a Sense of Urgency,\nCongress Dawdles on Reform\nhen Hillary Rodham Clinton\nhealth status or whether a family member has a\nW\nchallenged members of Congress to\npre-existing medical condition.\ngive Americans the kind of health\nThis idea doesn't originate with the First Lady.\ncoverage they themselves enjoy, she\nIn fact, some members of Congress have been\nwas roundly criticized for not playing by\nadvocating it. Senator Ted Kennedy (D-Mass.) has\nWashington rules. Key Republicans thought it was\nproposed that the Federal Employees Health\na cheap shot against Congress. No\nBenefit Program, which covers Congress and the\ninside-the-Beltway savvy, the insiders sniffed. The\nfederal government, serve as a model for extending\nArkansas Outsiders just don't get it on how to play\ncoverage to all Americans. As he has said: \"If that\nwith Congress in the big political leagues.\nkind of coverage is good enough for members of\nBut that is a typical\nCongress, it is good enough for\nBeltway conceit to cast the\nCOMMENTARY\nevery man, woman and child in\noutsiders as bumbling\nAmerica.\"\nbarbarians on Capitol Hill. Granted, there's a\nAnd this is not a Democrats-only point of\ncertain schoolyard common sense that says don't\nview. The concept has bipartisan support, or at\nslam the people from whom you want to get\nleast lip service. Two weeks ago, according to\nsomething. In that sense, the First Lady's timing\nnews reports, Senate Minority Leader Bob Dole\nwas not the best since at that moment the critical\n(R-Kan.) said in a taped interview for NBC that\nSenate Finance Committee was trying to fashion a\nhe thought all Americans ought to be able to\nbill to present to the whole Senate.\nparticipate in the federal health care program.\nIt was also a little disingenuous to single out\nSo why all the fuss about Hillary Clinton putting\nCongress, since the federal government,\nher foot in her mouth? Entre nous, as over-civilized\nincluding the Clintons themselves, have the\ninsiders would say, it was just bad political manners.\nsame health care coverage as the lawmakers on\nBut the concept makes good political sense.\nCapitol Hill.\nIt also stirs the populist pot. Challenging\nBut beyond Washington, her words struck a\nmembers of Congress to give as good as they get\nchord. The bigger mistake was to limit her\nhighlights the underlying issue of timing: What's\nremarks to Congress. After all, why shouldn't\ntaking so long?\nevery American have the same health care\nPerhaps the critical difference between Congress\ncoverage as not only members of Congress but\nand the 38 million uninsured Americans is that\nalso federal bureaucrats?\nmany of those without coverage personally feel the\nThe suspicion in the heartland is that if\nurgency of enacting a national health care\nCongress had the same imperfect health care\nplan-now. Not in five years or 10 years. After all,\ncoverage as many Americans, a national health\nmost other industrialized countries have long had\ncare plan would have been passed years ago.\nnational health programs for their citizens.\nThat's the point: The policy architects inside\nOf the 38 million Americans who are without\nthe government who design health plans and the\nmembers of Congress who legislate them do not\nhealth coverage at any given time, about 24\npersonally feel the desperate urgency of the\nmillion are chronically uninsured, according to\nneed for health reform. They don't know what\nEBRI. A recent study suggests that the\nit's like to fall through the cracks in the current\nlong-term uninsured may number 28 million\nnonsystem of health care and face financial ruin\npeople in the U.S. Over the past decade, the\nbecause of uncovered medical costs.\nranks of those without coverage has steadily\nCelebrity-status politicians along with their\nincreased.\nentourage of policy analysts belong to an elite\n\"What's the message here-that the richest\nsegment of society: the mostly healthy,\ncountry on earth with the greatest legislative body\nemployed or employable, and covered.\ncannot give to its people what other countries\nThey are quite different from the profile of\ngive?\" asks HHS Secretary Donna Shalala.\nthe uninsured. According to the Employee\nAs the trend for people to be without\nBenefit Research Institute (EBRI), adults\ninsurance goes up, the goals of a national plan\nwithout coverage are usually working in firms\ncome down. The latest gimmick to break the\nwith fewer than 100 employees. They also tend\npolitical gridlock is to fashion a bill that\nto be poor; about half are in families earning less\nredefines the concept of universal coverage. In\nthan $20,000. For many people with little or no\nthis doublespeak, 91 percent or 95 percent of\nhealth insurance. a medical problem has the\nthe population suddenly equals \"universal.\"\npotential of quickly bankrupting a family.\nAnother Capitol Hill strategy gaining favor is\nIf they had the same options for health\nproclaiming that the subject is so complex. it best\ncoverage as federal workers, they would find\nto take another year to design a national plan.\nthemselves enjoying a choice of affordable plans\nOnly people with good health care coverage\nwith fairly comprehensive benefits, regardless of\ncould find these steps acceptable.\nTUESDAY. JUNE 28, 1994 THE WASHINGTON POST\nBY MARILYN MOON\nHealth Reform and You\nQ. I'm very concerned about possible higher taxes as\na result of health plans being offered by President\nIt is difficult to know\nClinton and others. These plans are going to be\nfunded with a tobacco tax. At the same time, the\nfederal health officials are trying to cut the number\nwhether the proposed\nof Americans who smoke and some folks even talk\nabout having tobacco banned. It seems like a case of\nrevenue sources will be\nhaving your cake and eating it too. Are we going to\nget stuck with a lot of other heavier taxes when the\ntobacco tax doesn't provide the needed revenues?\nsufficient.\nA. One of the effects of a tobacco tax will likely\nbe to discourage smoking, but the estimates of\nMany states do not have the resources to cover\nhow much revenue would be raised take a\nall their citizens without federal government\nreduction in smoking into account. The 75-cent\nsupport. If such help is not part of this approach,\ntax on each pack proposed by Clinton would\nnot all states would participate. But if there is some\nraise about $10 billion to $11 billion each year.\nfederal support, would the federal government\nBy itself, this tax is certainly not enough to\nchoose just a few states for an experiment? In\npay for comprehensive health care reform. The\neither case, this would result in disparities in\nvarious plans also assume other ways to finance\ncoverage across the United States. Moreover,\nexpanded coverage, including savings from\nstates need to worry about companies' relocating if\ncutting Medicare and reducing or eliminating\nstate taxes were raised. That is less of a problem\nthe Medicaid program. Other ways that some\nfor the United States as a whole. But despite these\nplans finance reform include requiring that\nproblems, if national health care reform fails to\nemployers contribute to health insurance and\npass, a number of states are likely to move on their\nlimiting the extent to which insurance benefits\nown to change the health care system.\ncan be deducted from taxable income. Like you,\nmany people fear that additional revenue\nsources may also be needed, especially if costs\n&\nUnder the proposed health plans pending in\nof health care continue to rise in the future.\nthe Congress, how will part-time and hourly\nComprehensive reform legislation would be\nemployees be covered?\ncomplicated, and it is difficult to know with\nA. The Clinton proposal, with its employer\ncertainty whether the revenue sources that have\nmandate, would require employers to pay on a\nbeen proposed will be sufficient, especially after\nprorated basis for part-time and hourly workers as\nthe program has been in place for a few years.\nlong as they work more than 10 hours a week. The\nsingle-payer approach sponsored by Rep. Jim\nQ. Have policy makers considered evaluating\nMcDermott (D-Wash.) would cover everyone\nseveral of the plans by having different states try\nregardless of employment status and pay for the\nthem out? This way, they could give different\npublic system through payroll and income taxes.\nplans a chance to see which one or ones could\nThe other major proposals would either require\nwork best, and implement the best plan for the\nindividuals to purchase insurance or leave coverage\ncountry.\noptional, and these plans would make insurance the\nresponsibility of individuals. Employers under these\nA. One of the suggestions for compromise on\nplans would be free to help pay the premiums, but\nhealth care reform is to give states a great deal\nthey would have no increased incentives to expand\nof latitude in designing reform. Many of the\ntheir current efforts. Low-income individuals under\nexisting proposals already allow some state\nall the plans would receive some type of subsidy to\nflexibility. There are, however, several\nhelp in the purchase of insurance, but the details\nproblems with allowing more flexibility, many of\nvary. The more generous these subsidies, the\nthem surrounding the issue of who would pay.\nmore expensive the proposal.\n0 you have a question about President Clinton's health proposal or about\nD\nthe other bills in Congress? The Washington Post free telephone\ninformation service takes questions from readers about how the plan could\naffect them. Call POSTHASTE at 202-334-9000 on a touch-tone phone and\nenter category code 8500 (in Prince William County, 703-690-4110). Health\neconomist Marilyn Moon of the Urban Institute provides answers in this column\nbased on information from the White House, Congress and other sources. While she\ncannot answer all questions or give personal advice, she will answer a range of\ninquiries.\nTUESDAY. JUNE 28. 1994 THE WASHINGTON POST\n58\nGo Figure\nOne Company's Data\nIt already has; last year, industry\nanalysts say, revenue of the suburban-Vir-\nginia research and consulting company\nFuel Diverse Views\njumped about 30% to around $20 million,\nreflecting a surge in health-care reform\nIn Health-Care Debate\nbusiness. Value Health doesn't break out\nfigures for Lewin. whose business also\nincludes analyses for federal and state\ngovernments as well as studies for hospi-\nLobbyists Clamor for Studies\ntals and other health-care providers.\n\"I think a lot of people who have rather\nBy Lewin-VHI; Clients\nscruffy reputations think that Lewin gives\nthem a little bit of credibility,\" says Rep.\nExpect Certain Results\nPete Stark, a California Democrat who\nheads the House Ways and Means Commit-\ntee's health subcommittee. He adds, \"You\n'Take It With a Grain of Salt'\ntake It with a grain of salt.'\nBy HILARY STOUT\nA1\nSpecial Computer Model\nMost agree on why Lewin is in such big\nStaff Reporter of THE WALL STREET JOURNAL\ndemand: It is both good and fast. For many\nWASHINGTON - Every member of\nyears virtually the only firm doing this\nCongress this year received a health-re-\nkind of health-economics analysis, the\nform report from a group called Families\n24-year-old company was in an ideal mar-\nUSA with a glossy orange cover and the\nket position to cash in on the health-care\nheadline: \"Better Benefits. Millions\nreform movement. But its best weapon is a\nHelped by Clinton Réform.\"\nhighly sophisticated computer model, the\nEach lawmaker also got a report from\nHealth Benefits Simulation Model, devel-\nthe Heritage Foundation warning that the\noped over the past decade. It can do things\nother companies' computers can't. Deter-\nEconomic Analyses Faulted\nmined to perform its own, independent\nanalysis of the 1,342-page Clinton health-\nAs drug makers try to win business from\nfrugal health plans and physicians, eco-\ncare bill, Lewin completed the task in just\nnomic analyses of drug treatments have\nover a month, more than three times faster\nproliferated. But concerns are growing\nthan the Congressional Budget Office.\nabout wide variations in the reliability of\nRobert Rubin, a 48-year-old internist\nthe studies. Article on page B1.\nand nephrologist and the company's presi-\ndent, says Lewin decided to undertake the\nClinton bill \"has huge hidden costs, in the\nproject at its own expense because \"we\nform of wage reductions and job losses.\nactually thought we could do a service to\nThe two studies have one thing in\nthe country. While this sounds corny, we\ncommon: Both were based on analyses by\nreally did believe that.\"\nthe same company, Lewin-VHI Inc., a\nHe estimates the company lost between\ndivision of Valúe Health Inc.\n$80,000 and $200,000 in business it had to\nThese days, no self-respecting interest\nturn down in order to finish the study by a\ngroup comes to the table without a study to\nDecember deadline. Lewin's final report\nback up its view, and Lewin is one of the\nconcluded that the White House had un-\nhottest health-care research outfits in\nderestimated premiums for the federally\nWashington. When it comes to lobbying\nguaranteed benefits package by 17%, but\nCongress, \"the days of wine, women and\nthat its basic scheme for financing univer-\nsong are over,\" says Fred Graefe, a vet-\nsal coverage was sound. When the report\neran health-care lobbyist. \"I don't go any-\ncame out, according to one person on the\nwhere in this town without being armed\nscene, White House officials were so re-\nwith a Lewin-VHI study. You can't win\nlieved that some jumped up and down in\nwithout it.\"\nglee.\nConflicting Results\nStudies With Viewpoint\nThe company's success and influence\nThe paying customers don't care what\npoint up both the power and shortcomings\nLewin determined on its own. Various\nof research data in today's Washington:\ngroups - often bitter opponents - set their\nThe nature of the questions guides the\nown parameters for studies they can use to\nnature of the answers. When you are a\npromote their positions on health care.\npaying client, you usually get to ask the\nFor example, another study Lewin did\nquestions. Consequently, studies often re-\nfor Families USA, which backs the Clinton\nport conflicting results, adding to a com-\nplan, concludes that the president's plan\nplex issue's uncertainties rather than help-\nwould save the average American $695 a\ning cut through the fog.\nyear in health-care expenses. But the\nThe debate over health care is no\nstudy Lewin prepared for the Heritage\nexception. Indeed, so many interest groups\nFoundation, a foe of the Clinton proposal,\nbrandish Lewin data to bolster their view-\nsays the bill would save families on\npoints that Senate Finance Committee\naverage only $31 - and 53% of Americans\nChairman Daniel Patrick Moynihan says\nwould see health costs go up.\nabout the only sure thing regarding health-\nAre the studies contradictory? Net at\ncare legislation is this: \"Whatever else\nPlease Turn to Page A10, Column 1\n1/2\ncomes out of this year. Lewin-VHI will do\nvery well.\"\nTHE WALL STREET JOURNAL TUESDAY, JUNE 28, 1994\nA10 THE WALL STREET JOURNAL TUESDAY, JUNE 28, 1994\nGo Figure: Data From a Single Firm, Lewin-VHh\nAre Used to Support Differing Views of Health Care\nBut the Lewin study didn't address the\nAll this research ping-pong dismays\nContinued From First Page\nportion of the same bill that would help\nsome people active in the struggle over\nall, say Lewin's top executives. \"I think\nsubsidize health-care coverage for individ-\nhealth care. An aide to one prominent\nthat if you took all our reports and put them\nuals whose incomes are up to 200% of the\nlawmaker on health-care issues says\non a table, you would be hard-pressed to\npoverty level. Lewin's union client didn't\nLewin studies are overused and end up\nfind a contradiction.\" says Larry Lewin,\nwant that part assessed: \"The next step of\n\"looking like they can come to whatever\nthe company's 56-year-old chairman. who\nthat model would have been to look at the\nconclusion their clients want.\"\ncame to Washington to work in the John-\nsubsidies in the Cooper bill, and we\nBut Carmela Dyer, an official of the\nson administration. \"It has to do with how\ndidn't.\" Ms. Connerton says. The study\nAmerican Hospital Association. contends\nthe question is asked.\" Often, adds Dr.\nwould have cost more, and \"the subsidies\nthe volume and diversity of Lewin's clients\nRubin, a former Reagan administration\nwould have only gone up to a certain point,\nunderscores its objectivity. She was the\nhealth official, \"There are subtle differ-\nand most of the people affected by the tax\nproject officer on a study Lewin did for the\nences in the assumptions used, or the\ncap are middle-income.' she says.\nAHA concluding that the Clinton plan's\nmethodology.'\nThe same month the union released its\nMedicare savings would mean hospitals\nFor Heritage, Lewin factored in the\nstudy. the Heritage Foundation released\nmight get only 71 cents for each dollar of\nwages that might be lost because of the\nits own Lewin analysis of a health-care\ncare provided to elderly patients.\nplan's requirement that all firms pay part\nproposal with an even stricter tax cap.\nof the cost of their workers' health bene-\nDivergent Interests\nThat bill. which was sponsored by Republi-\nfits. In the Families USA study, it did not.\ncan Sen. Don Nickles of Oklahoma and\nThe company itself is an alliance of\nMoreover. the studies make projections\nwhich Heritage helped write, would wipe\ndivergent political interests. Mr. Lewin. a\nover different time frames. and each group\nout all tax breaks for employer-provided\nHarvard Business School graduate and\nhas chosen to highlight results from differ-\nhealth benefits. replacing them with tax\nformer Marine, decided he wanted to come\nent years. There is something else at work\ncredits for the purchase of health insur-\nto Washington after John Kennedy was\nin the conclusions. too, says Dr. Rubin:\nance. Looking at the trade-off, Lewin found\nslain and became involved in Lyndon\n\"It's the spin the client puts on it.\"\nthat families' annual health costs would\nJohnson's war on poverty. He also was a\nFor example, in April, Lewin did a\ndecline by an average of about $643-\nmember of Bill Clinton's transition team.\nstudy for the Service Employees Interna-\ncounter to the conclusions in the union's\nDr. Rubin, who still teaches a medical-\ntional Union, which vehemently opposes\n\"Hammering the Middle Class\" study of\nschool course every Friday, was an assis-\nthe idea of limiting the tax breaks for\nthe Cooper bill.\ntant secretary in the Health and Human\nemployer-provided health benefits. The\nstudy concluded that workers would lose\nAn Armory of Reports\nServices Department during the Reagan\nadministration.\nbetween $195 and $476 a year if a cap were\nBut it doesn't stop there. The Cooper\nFounded as Lewin & Associates in 1970,\nplaced on those tax breaks. The union\nbill's supporters have another Lewin report\nthe company in the mid-1980s merged with\nincorporated the most onerous of the\nin their arsenal, a more recent study\nan archrival called ICF, then headed by\nLewin findings into its own report, titled it\nprepared for the Healthcare Leadership\nDr. Rubin. It was like \"the Dallas Cowboys\n\"Hammering the Middle Class\" and called\nCouncil, a group of insurers and other\nand the Washington Redskins merging,\"\na press conference.\nfirms in the medical industry pushing for a\nMr. Lewin says. As Lewin-ICF, the firm\n\"We were extremely unhappy about the\nmarket-based reform scheme. The study\ngrew rapidly but narrowed its focus to\ntitle,\" says Dr. Rubin, though Lewin didn't\nsays that while the Cooper bill would cover\nhealth and environmental work. In late\nchallenge the union over it. Lewin's agree-\nonly 91% of the U.S. population, it would\n1992, it was sold to Value Health, based in\ntake care of 97% of the cost of medical care\nment with clients gives it the right to\nAvon, Conn., for $11 million.\nreview press releases issued on Lewin\nin this country.\nTo avoid conflicts, Dr. Rubin says that\nresearch and to put out its own release if it\nA phony 91% solution, contended Fami-\non all \"politically sensitive\" material. both\nfeels study results have been distorted.\nlies USA in a mid-June report based on-\nhe and Mr. Lewin review the final product.\nyou guessed it - still another Lewin study.\nThe company's executives also say they\nLewin's services cost about $25,000 for a\nThe Cooper bill \"would result in 1.3 million\nwill turn down clients who clearly want to\nsimple run of numbers to as much as\nAmericans losing health insurance each\nskew the results.\n$125,000 for a more complex analysis, and\nmonth,\" said Ron Pollack, Families USA's\n\"We're at the point now where people\nclients seem to expect to get the kind of\nexecutive director.\nsay our reputation for being fair is such\nresearch they pay for. Peggy Connerton,\nthat we're just not going to do something in\ndirector of public policy for the service-\na half-baked way,\" says Dr. Rubin.\nemployees union, says the group gave\nLewin \"the scenarios and the parameters\"\n2/2\nfor the study it commissioned. The union\nasked Lewin to analyze effects of the\nManaged Competition Act, a proposal writ-\nten chiefly by Democratic Rep. Jim Cooper\nof Tennessee. The bill would limit the tax\ndeduction businesses can take for provid-\ning health benefits to workers. The result,\nthe study concluded, would be either lower\nwages or higher out-of-pocket expenses for\nworkers.\nTHE WALL STREET JOURNAL TUESDAY, JUNE 28, 1994\n70\nMoynihan Remains Skeptical of Parts\nMoynihan Is Skeptical\nOf Health Plan Drafted by Moderates\nOf Part of Health Plan\nDrafted by Moderates\nBy DAVID ROGERS\ncan. \"Seventy-three percent of our people\nAnd HILARY STOUT\nare employed by small business. 1 just\nStaff Reporters of THE WALL STREET JOURNAL\nthink putting it in would doom the bill.\nContinued From Page A3\nWASHINGTON-Daniel Patrick Moyni-\nAs a practical matter, any such trigger\ncare plan. Rep. Sam Gibbons, the acting\nhan, chairman of the Senate Finance Com-\nwould be designed foremost to give the\nchairman, said he \"imagined\" he would\nmittee, is expected to embrace portions of\nadministration some political cover by\nhave to give ground still on the question of\na health-reform plan drafted by panel mod-\npreserving the hope of universal coverage.\na standby cost-control provision for private\nerates. But he remains skeptical of the\nNo one is discussing an effective date\ninsurance. But the Florida Democrat again\nunderlying financing and the plan's ability\nbefore the year 2000, when President Clin-\ndelayed taking up the divisive issue in an\nto achieve its stated goal of covering 95% of\nton would be either at the end of his second\neffort to complete other sections of the bill\nAmericans.\nterm or out of office. And the interim goal\nfirst.\nThis skepticism is reinforced by early.\nof 95% coverage is meaningless unless\nIf Mr. Gibbons is to meet his deadlines\ncost estimates indicating the plan won't\nthere is a commitment of resources to\nthis week, the issue is likely to come up\nhave sufficient funds to fully phase in pro-\nsubsidize poor and working-class families\ntoday, and insurance interests claim they\nposed subsidies by the target year 2002.\nwho won't buy insurance otherwise be-\nhave the votes to strike the provision\nAnd Mr. Moynihan, who is now drafting\ncause of the high cost.\nentirely. Democrats prefer to find some\nhis own alternative, may force a debate in\nFive-Year Budget\ncompromise, however, to preserve party\nthe committee on a standby mechanism to\nrequire businesses to provide health insur-\nAs drafted, the centrist proposal sets\nunity, and there have been preliminary\nout a five-year budget of $246 billion to\ndiscussions about delaying implementa-\nance for their employees if the 95% goal\nfinance both the initial subsidies and new\ntion of the cost controls or requiring a\nisn't met on time.\nThe New York Democrat will present\ntax deductions to help individuals buy\nvote by Congress before they are put in\nhis proposals to the full committee tomor-\nhealth insurance. The plan calls for an\nplace.\nambitious $1-a-pack increase, in cigarette\nThe opposition among Democrats re-\nrow, with the process being closely\ntaxes that would yield a windfall in the\nflects misgivings among not only moder-\nwatched by the White House because of the\ncommittee's pivotal role as a forum for\nearly years. But once the phase in of\nates on the panel but also an influential\ncompromise on health care. Treasury Sec-\nsubsidies begins in 1997. budget analysts\nbloc of often more-liberal members who\nretary Lloyd Bentsen and Leon Panetta,\npredict the available funds could start\nhave ties to the insurance industry. These\nnamed yesterday by President Clinton to\nrunning short as early as 1998.\ninclude Reps. Barbara Kennelly of Con-\nbe his new chief of staff, met with Mr.\nTo avoid widening the deficit, the gov-\nnecticut and Richard Neal of Massachu-\nernment must slow the rate of increase for\nsetts, who both have large home-state\nMoynihan last night. When asked whether\nSen. Moynihan's draft would meet the\nsubsidies. But this means that fewer peo-\ninsurance constituencies, and Rep. Mi-\nple would receive the assistance needed to\nchael McNulty of New York, a former\npresident's standard of universal cover-\nage, Mr. Bentsen said: \"My understand-\nmake insurance affordable, and some\ninsurance executive.\ning is it does.\"\nestimates indicate the subsides may be\nadequate to reach only 92% coverage. Over\nModerate Alternative\na longer period, by 2003 and 2004, cost\nThe moderate alternative, which was\nestimates suggest that the full subsidies\nthe subject of a closed-door committee\ncould eventually be implemented, but\nmeeting yesterday, stops short of this\nthe cost of the program could range near\npromise and wouldn't require employers to\n$100 billion a year.\nhelp pay for their workers' insurance.\nThe finance panel faces significant\nInstead, it relies on a mix of market\nprocedural hurdles if it tries to complete its\nreforms and subsidies to try to achieve 95%\nwork before the July Fourth recess, which\ncoverage by the year 2002.\nbegins at the end of this week. But a\n1994\nGiven the power of this bloc, many of\ncertain surreal quality has settled over the\nthese ideas could be incorporated in the\nproceedings as both sides have an invest-\nchairman's proposal, and it's uncertain\nment in not seeming to obstruct progress.\nhow much further he can take the debate.\nSen. Dole Plans Alternative\nThough weekend news reports suggested\nSenate Republican Leader Robert Dole\nthat Mr. Moynihan may try to move\nof Kansas is attempting to draft his own\nup the deadline, this is at odds with\nalternative for the GOP members. but\nadministration estimates now indicating\ndoesn't want to give the administration\nthe proposal won't generate sufficient\nany chance to blame him for its failure to\nfunds to finance the required subsidies\nget more from the finance panel.\nuntil 2003 or 2004.\nThough decisions haven't been made\nTo achieve coverage of 95% of all\nyet. staff drafts of the GOP plan focus\nAmericans by an earlier date. the plan\nlargely on insurance-market reforms with\nwould require even more taxes and spend-\nmore-modest subsidies than those pro-\ning reductions to pay for more-generous\nposed by Mr. Chafee and other moderates.\nsubsidies to encourage low-income people\nA cigarette-tax increase is among the\nto buy insurance. This could prove an\noptions, but much greater weight is put on\nimpossible hurdle and increase the likeli-\nsavings. including a proposed per-capita\nWALL STREET JOURNAL TUESDAY, JUNE 28,\nhood that any standby provisions would\ncap on federal expenditures for Medicaid\nbe triggered into action.\nand a more symbolic elimination of gov-\nIn shaping their proposal. moderates on\nernment contributions for health insur-\nthe panel had considered a variety of\nance for high-level federal employees, in-\nstandby devices. But a leader of the cen-\ncluding members of Congress and the\ntrist group. Sen. John Chafee, warned\npresident.\nTHE\nyesterday that even a standby mandate on\nWhile attention focused on the Senate\nemployers to pay for health care could kill\nyesterday. the House Ways and Means\nhopes of compromise.\nCommittee pushed stubbornly ahead in\n\"Look kiddo. I come from a small-busi-\ntrying to complete work on its own health-\nness state,\" said the Rhode Island Republi-\nPlease Turn to Page A4. Column 2\n74\nExtra Baggage Distorts\nUse Medicare Rates,\nOriginal Intent of A to Z\nDestroy Health Care\nIn response to your May 24 editorial\nIn his \"Hospitals' Overcapacity is Fi-\n\"Look Who's Blocking A to Z\": The dis-\nnanced by Insurers\" (Letters, June 15),\ncharge petition for the A to Z plan is com-\nProf. Uwe Reinhart questioned why health\npletely different from the legislation I co-\ninsurers, businesses and individual payers\nsponsored. and your readers need to know\ndo not reimburse health care providers at\nthe truth.\nMedicare rates rather than suffer the ef-\nThe A to Z bill provides a process for\nfect of government cost shifting. He and\namendments to be offered to lower discre-\nyour readers deserve an answer.\ntionary spending for fiscal 1994. This is a\nFirst, nongovernment payers of health\ngood and necessary proposal. On that. I\ncare bills do not have the police powers to\nfully agree. The rule. however, is different\nenforce a policy of paying suppliers as low\nand actually changes the substance of the\nas 40% of costs and 17% of charges. Second,\nbill. While it establishes the length of de-\nnone of us would want the Third World\nbate and the nature of the amendments to\nlevel of hospital care that would result if all\nbe offered, it also broadens the scope of the\nof us paid hospitals at Medicare reim-\nbill to include cuts in mandatory spending\nbursement rates. I have an office full of ex-\nprograms. such as Social Security. a pro-\namples where Medicare payments to hos-\nvision that was never included in the orig-\npitals are only 17% to 18% of charges.\ninal bill. This is a highly unusual tactic-\nWhile some hospitals carry excess fat,\nparticularly since the two sponsors of the\nhealth care as we know it would cease to\nlegislation never informed the co-sponsors\nexist in the U.S. if all payers used\nof this unprecedented approach.\nMedicare rates.\nThe purpose of a rule is to set the para-\nHere is a simple Hospital Finance 101\nmeters within which a bill is to be consid-\nquestion: If 45% of your customers pay\nered. It should not change the substance of\nyou 40% of your costs, how much do you\nthe bill. In the case of the original legisla-\nhave to charge the remaining 55% in order\ntion, it would permit specific cuts in waste-\nto break even? The universally held truth\nful discretionary spending, but does not\namong U.S. hospital finance professionals\nendanger a vital program like Social Secu-\nis that Medicare/Medicaid payment rates\nrity.\nhave inflated U.S. hospital prices by 50%\nThe previous two rules mirrored legis-\nto 75% in the private sector. In the world\nlation we co-sponsored. It was, in fact, the\nof classroom theories there may have\nthird rule that completely altered the orig-\nbeen a cost shift, but not in the real\ninal intent of the bill.\nworlds of hospital finance and health in-\nAs a fiscally responsible member of\nsurance.\nCongress with a proven record of fiscal re-\nThe massive \"hidden tax\" on U.S.\nstraint and trimming of government waste\nhealth care commonly referred to as gov-\nthrough my work on the House Budget\nernment cost shifting is nothing more than\nCommittee, I remain committed to reduc-\nlast ditch liberal efforts to foster unsound\ning our national budget deficit and cutting\nentitlement programs by government\nspending. These are genuine goals that\nmandates rather than leveling with a tax-\nmerit consideration through an equally\nweary public on the real costs of such pro-\ngenuine process. I am one of two members\ngrams. Let us have faith that the truth will\nof Congress who received the second high-\neventually prevail over deception.\nest rating-99%-from the bipartisan Con-\nRON JONES\ncord Coalition out of the 435 lawmakers in\nPresident\nthe House.\nMutual Medical\nREP. OLYMPIA J. SNOWE (R., Maine)\nPeoria, III.\nWashington\nTHE WALL STREET JOURNAL TUESDAY, JUNE 28, 1994\n85\nTUESDAY, JUNE 28, 1994\nUSA TODAY\nSHAKE-UP\nWASHINGTON\nPanetta, McLarty,\nGergen and Rivlin\nPanel today awaits\nLEON PANETTA, new chief of staff; was budget director:\nRecord: Barely 100 days into Clinton's administration.\nthe Moynihan plan\nwith a revolutionary economic plan designed to rein in the\ndeficit, trade pact and Russian aid package in limbo on Cap-\nitol Hill, Panetta told reporters Clinton needed to \"define\nThe Finance Committee, the key Senate panel on health\nreform, learns today how Chairman Daniel Patrick Moyni-\nhis priorities\" and take the battle to the public. The com-\nments were viewed by some as insubordinate, by others as\nhan, D-N.Y., intends to finance his plan.\nHe distributes a detailed proposal that calls for 95% of\nintentional message-sending In reality, it was just Panetta\nAmericans to have health insurance by 2000. He's expected\nbeing candid as always.\nto use a watered-down form of President Clinton's contro-\nReputation: Panetta, a former House Budget Com-\nversial employer mandate - forcing firms to pay for their\nmittee chairman, is a hard-working pragmatist, affable\nworkers' coverage. \"There will probably be some votes on\neven while making the tough choices that come daily for a\nmandates,\" says Sen. John Breaux, D-La. But he doubts\nman charged with balancing a $1.5 trillion budget while\nthere is sufficient support for requiring the payments.\nparing the mighty deficit he hates.\nMoynihan's backup: If the 95% goal wasn't met, a new\nWhy he got top spot: Panetta combines McLarty's\ncommission would recommend specific steps - possibly in-\ncharm with some of the rougher traits associated with for-\ncluding the mandate - to reach it. Such recommendations\nmer White House bosses. He also knows Congress, a plus in\nwould take effect unless Congress voted them down.\nthe final crucial battles over health-care and crime legisla-\nPresident Clinton says employers should share the cost of\ntion this summer and fall.\ninsuring all Americans. Monday. right after naming budget\ndirector Leon Panetta his new White House chief of staff.\nTHOMAS 'MACK' McLARTY,\nnew\ncounselor\nto\nClinton;\nhe sent Panetta and Treasury Secretary Lloyd Bentsen to\nwas chief of staff:\npress that point with Moynihan.\n- Jessica Lee\nRecord: Fairly or not, he caught the blame for: the\ntravel office staff firings that were\nSENATE RACE: Sen. Jim Sas-\nlater rescinded; Clinton's $200 hair-\nser, D-Tenn., is gaining support for\ncut, which was widely reported -\nthe post of majority leader. Mon-\ninaccurately - as tying up Los An-\nday he got the endorsement of four\ngeles Airport; the handling of the\nmore senators. Patty Murray of\ninvestigation into the suicide of top\nWashington and Max Baucus of\naide and fellow Arkansan Vince\nMontana ended speculation that\nFoster; the spiraling Whitewater\nthe race between Sasser and Sen.\ninvestigation; Paula Jones' sexual\nTom Daschle, D-S.D., would be a\nharassment suit; the staff's tell-all\nregional contest when they\nramblings to Washington Post\npledged their support. Earlier this\nwriter Bob Woodward for the book\nGannett News Service\nmonth, Sen. Russell Feingoid, D-\nThe Agenda; the misuse of a White\nSASSER: Gains four\nUSA TODAY\nWis., who had been considered a\nHouse helicopter for a staffer's golf\nPRESERVATION\nMcLARTY\nPHOTOCOPY\nmore endorsements\nDaschle supporter, and Sen. Barba-\nouting.\nΓa Boxer, D-Calif., said they would\nBehind the latest move: A Clin-\nvote for Sasser, who has more than 20 senators' support.\nton friend since childhood, and later a political supporter\nwhile heading a utility in Arkansas, his arrival at the White\nSPACE STATION:\nThe House is ready to resume its\nHouse was met with skepticism that he was tough or politi-\nannual debate on funding for the planned space station. A\ncal enough to handle the job. The White House says he was\nsubcommittee approved the Clinton administration's $2.1\nbehind the reshuffling, but first lady Hillary Rodham Clin-\nbillion request for the orbiting space laboratory as part of a\nton also was disappointed with McLarty's handling of\nVeterans Affairs and Housing and Urban Development\nhealth-care reform.\nspending bill earlier this month. To date, the federal gov-\nernment has spent $11.2 billion on the space station.\nDAVID GERGEN, new special adviser to president and\nsecretary of State; was counselor to Clinton:\nWHITEWATER HEARINGS SET: The House Bank-\nRecord: Gergen's darts at the\ning Committee scheduled Whitewater hearings for July 26.\nnew administration in U.S. News\nCommittee Chairman Henry Gonzalez, D-Texas, invited 22\n& World Report brought a call\nwitnesses to appear, including special counsel Robert Fiske\nfrom McLarty. He wanted the\nand former White House counsel Bernard Nussbaum.\nmagazine editor - and aide to\nThe hearing will cover the death of White House lawyer\nthree Republican presidents - to\nVince Foster and whether Clinton aides tried to cover up\njoin Clinton's staff as senior adviser\nthe Whitewater affair.\nto stabilize relations with Congress\nRepublicans had wanted a broader hearing to probe\nand the media. McLarty sold the\nwhether a failed savings and loan, owned by Clinton's\ndeal to Clinton. At first, Gergen was\nWhitewater partner James McDougal, improperly fun-\ncredited with steadying the staff\nneled money into the real estate development.\nand with improving the White\nBut Fiske asked that the hearing only cover issues he has\nHouse's workings with the media.\nUSA TODAY\nfinished investigating He'll release his report on Foster and\nPerception: Hillary Clinton\nGERGEN\nthe possible coverup this week.\nnever warmed to him, and many\nstaffers resented his Republican credentials. This chance to\nPRIMARIES AND RUNOFFS:\nUtah\nvoters\nare\nexpect-\nimprove foreign policy spin could round out his public ser-\ned to largely ignore today's first-ever June primaries. A Sen-\nvice portfolio.\nate race pits Craig Oliver against Bill Rigley for the Inde-\npendent Party nomination. The winner will face incumbent\nALICE\nRIVLIN,\nnew budget director; was deputy:\nRepublican Sen. Orrin Hatch and Democratic challenger\nRecord: She surprised Washington when she be-\nPatrick Shea. In the House. Dixie Thompson and Torn Dras-\ncame Panetta's deputy. She was\nchil are battling for the GOP nomination. The winner goes\nwidely regarded as overqualified\nagainst Democratic incumbent Rep. Bill Orton.\nfor the job after eight years as\nIn other states' runoffs today:\nhead of the Congressional Budget\nAlabama - Republican governor. Former governor\nOffice. the non-partisan arm of\nFob James faces Ann Bedsole. House 5th District Republi-\nCongress that analyzes the budget\ncan: Wayne Park faces Hugh McInnish; one of them will\nand the fiscal impact of legislation.\nmeet Democratic Rep. Bud Cramer.\nShe sounded alarms about the ris-\nMississippi - Democrat U.S. Senate: Ken Harper\ning deficits during the Reagan ad-\ngoes against Hiram Eastland for the right to face GOP in-\nministration.\ncumbent Sen. Trent Lott. House 1st District: Each party\nChallenge: Rivlin, a hard-liner\nhas a runoff for election to replace retiring Rep. Jamie\non the budget deficit, lacks experi-\nWhitten. On the Democratic side, Bill Wheeler faces Tim\nence in working with Congress to\nFord; on the GOP side, Roger Wicker battles Grant Fox.\nUSA,TODAY\nput together the budget - one of\nRIVLIN\nthe qualities that made Panetta\nWritten by Charmagne Helton\npopular on Capitol Hill.\nMoynihan health plan\nmelds with moderates'\nBy J. Jennings Moss\nTHE WASHINGTON TIMES\nTo Clinton, \"every\nSen. Daniel Patrick Moynihan's health\nneed not mean 'all'\nplan, to be presented to the Finance Com-\nmittee today, will be a merger of his ideas\nand a proposal by a bipartisan group of\nBy Frank J. Murray\nmoderates. according to senators.\nTHE WASHINGTON TIMES\nWhen Mr. Moynihan, New York Demo-\nHow could \"every American\" not be\ncrat and chairman of the committee,\ndefined as 100 percent of Americans?\npresents the final product to the panel. it\nIf the Clinton White House knows,\nwill shift the debate from closed rooms to\nit's not telling, but the administration\npublic hearing rooms.\nhas begun making such a distinction on\nSpeaking to reporters after meeting with\n\"universal\" health care coverage.\nthe panel's Democrats yesterday morning,\nFrom President Clinton to Press Sec-\nMr. Moynihan said he had not decided\nretary Dee Dee\nwhether mandates on employers or indi-\nNEWS\nMyers, the rhetoric's\nviduals would be in the package. The mod-\nlogic sounds like res-\nerates' plan called for no mandates.\nANALYSIS\nervations a men-\n\"That is basically a question of what will\ntal asterisk to the\nmove a bill. I'll have a final judgment on\npresident's read-my-lips promise of\nthat in the morning,\" Mr. Moynihan said.\nprivate insurance for every American.\nIf that is the intent. it could allow Mr.\nA Polish diplomat speculated\nSen. John H. Chafee. Rhode Island Re-\nClinton to back away from his promise\npublican and a pivotal player in the seven-\nto veto any health bill providing less-\nEmbassy\nthat Mr. Kozminski's quick recep-\ntion at the White House was con-\nmember bipartisan \"rump group,\" later\nthan-universal coverage in the foresee-\nnected to Mr. Clinton's upcoming\nsaid he expects employer mandates to be\nable future.\nRow\ntrip to Eastern Europe. He is due\nincluded in Mr. Moynihan's bill. The reason\n\"You all can define that however you\nin Warsaw July 6 for a visit to co-\nfor the inclusion is so the committee can\nwant,\" Miss Myers said yesterday.\nincide with a meeting of foreign\ntake a vote on the contentious issue, which\nThe quest for a definition permeated\nministers of nine countries that\nlikely would fail.\nher press briefing, and she was told the\nhave received U.S. aid through\n\"The proposal that the moderates have\nwords seemed simple enough they\nthe Support for Eastern European\nput together will be merged with the\nshould mean the same thing to public,\nDemocracy Act, the diplomat\nchairman's bill. We don't know what it will\npresident and news media.\nFrom envoy to critic\nsaid.\nactually entail - if it has mandates until\nThroughout the long briefing Miss\nSecretary of State Warren\nwe see it tomorrow,\" Sen. Tom Daschle,\nMyers eluded every request that she\nHungarian Ambassador Pal\nChristopher, who will accompany\nSouth Dakota Democrat, said yesterday.\ndefine universal or at least agree that\nTar will go from an envoy for his\nMr. Clinton, is due to meet the\nMr. Daschle is part of the minority on the\n\"every American\" means 100 percent.\ncountry to a critic of the new\nforeign ministers of Albania, Bul-\nAmong the definitions Webster's\ngovernment, dominated by for-\ngaria, the Czech Republic, the\ncommittee - those who back President\nClinton's proposal to require businesses to\nNew World Dictionary lists for \"uni-\nmer Communists, when he re-\nFormer Yugoslav Republic of\nversal\" as an adjective, the most rel-\nturns home next week.\nMacedonia, Hungary, Poland, Slo-\npay 80 percent of the cost of their workers'\nevant seem to be \"present or occurring\nMr. Tar, in his last public\nvakia, Slovenia and Romania.\nth insurance 80 that every American\neverywhere or in all things\nused,\nspeech as ambassador yesterday,\nMr. Kozminski, who replaced\nhas health coverage.\nintended to be used, or understood by\ntold the American Jewish Com-\nAmbassador Kazimierz\n\"I'm skeptical that it [universal cover-\nall.\"\nmittee (AJC) to watch the new\nDziewanowski, is one of the sec-\nage] can be obtained if this is all we do,\" Mr.\nWith many legislators mentioning\ngovernment for any cracks in a\nond wave of diplomats from East-\nDaschle said of the idea of eliminating\nalternatives that would result in 91 per-\ncoalition between the Socialists,\nern European countries, follow-\nmandates. \"But I'm optimistic that this will\ncent or 95 percent coverage, an inter-\nwhose supporters are anti-\ning those who arrived here after\nallow us to continue the process and we'll\nviewer on KMOX radio in St. Louis\nWestern and anti-capitalist, and\nthe collapse of communism.\nhave opportunities on the floor and in con-\nasked Mr. Clinton on Friday if he was\nthe Free Democrats, who support\nBefore he left Poland, Mr. Koz-\nference to try and build upon what we do\nwilling to compromise on that.\na market economy.\nminski told reporters that I\nhere in the committee.\"\n\"You said you'd veto any bill that did\n\"The old Communists are back\nwho went before him represented\nnot insure every single living Amer-\nin power.\nThey profess to be\nthe \"poetry of breakthrough\"\nTwo congressional panels already have\napproved health plans similar to Mr. Clin-\nican,\" the reporter recalled accurately.\nSocial Democrats,\" he said. But\nand that his job is more\n\"Universal,\" Mr. Clinton responded.\nthe \"contradictions in the coali-\nmundane, calling his m\non\nthe\nton's and a third - the House Ways and\n\"We need to have universal coverage.\ntion\" are many.\n\"prose of normality.\"\nMeans Committee - is trying to finish its\nThat's what I said.\"\nThe supporters of the Social-\nThe other ambassadors who\nwork this week. Clinton backers hope these\nAsked yesterday how the president\nists expect \"some redistribution\npresented their credentials, in or\nmeasures will prevail.\ndifferentiated \"universal\" coverage or\nof wealth, increase in pensions. a\nder of their precedence in the\nIf these Democrats win. at least one Re-\ninsurance for \"every American\" from\ndecrease in prices\nbut I don't\ndiplomatic corps, are Fatikh Tes-\npublican has vowed to filibuster a health\n100 percent, Miss Myers got into a long\nsee that.\nhabaev of Uzbekistan, Branislav\nbill.\nand somewhat caustic debate with re-\n\"From everything I hear, they\nLichardus of Slovakia, Jerome\n\"The Clinton plan and its clone - the\nporters. She accused them of being\nwant to speed up privitization, for\nMendouga of Cameroon, F\n[Senate Labor and Human Resources Com-\nready to define the president's words.\nexample,\" he said.\nTabbarah of Lebanon, Khalii\nmittee] plan are in my view poison,\" said\n\"I think the president and others of\n\"For the time being, I don't see\nUgur of Turkmenistan, Kepas is\nSen. Robert F. Bennett, Utah Republican.\nus here at the White House have\nany slowing down\" in the eco-\nmael Watangia of Papua New\nworked hard to stay out of a debate\nnomic policies promoted by his\nGuinea, Lionel J. Wood of New\n\"They are based on the assumption that the\nabout numbers,\" she said.\nconservative party.\nZealand, Moise Koffi Kournoue o\nonly way reform can work is through\n\"His definition of universal care is\n\"I think the pendulum will\nthe Ivory Coast, Benjamin Kip-\ngovernment-imposed price controls. They\nguaranteed private insurance for ev-\nswing back to the center-right,\"\nkorir of Kenya, Sven Alkalaj of\nmust be defeated even at the cost of grid-\nery American,\" Miss Myers explained.\nhe said of the next elections\nBosnia and Manaspas Xuto of\nlock. Yes, filibuster, if that is what it take.\"\n\"But isn't that 100 percent?\" re-\nscheduled in four years.\nThailand.\nOn Sunday. The Washington Post re-\nporter after reporter inquired, asking\nMr. Tar, an international banker\nThe Uzbek ambassador had\nported that Mr. Moynihan had prepared a\nwhether 95 percent or some other\nbefore becoming a diplomat, in-\nwaited the longest to present his\ndraft bill that ditched all mandates in favor\nnumber could be deemed \"universal.\"\ntends to head a conservative\ncredentials. He arrived\nin\nof relying on incentives to businesses to\n\"We're just not getting drawn into a\nthink tank and prepare to run for\nNovember\nprovide health insurance, insurance re-\ndebate about numbers,\" she said over\nparliament.\nforms and government aid to the poor. The\nand over.\nHerman Obermayer, an AJC\nDIPLOMATIC\ngoal would be to have 95 percent of the\nFinally, a reporter said what was\nboard member, introduced Mr.\nDIARY\npublic covered by 2000.\nwanted was definition, not numbers.\nTar as a \"unique ambassador\n\"We think it was clear, we think we\nfrom a unique country for Jews.\"\nToday\nA Finance Committee staffer said yester-\nunderstood it, and we think when the\nHe said Hungary, with 80,000\n10 a.m. - News conference\nday, \"substantial things have changed\"\ntime comes - when he puts his signa-\nJewish residents, had the second-\nSalim A. Salim, secretary-general\nsince the article was published. although\nture or veto on it - it will be because\nhighest number of Jews in Eu-\nthe Organization of African Unity,\nthe aide would not discuss those changes.\nthis is or isn't what we think we under-\nrope after France.\nmeets the press at the residence O\nDuring the past two months, as Finance\nstood.\" she was told.\n\"The ambassador is a man of\nSouth African Ambassador Harry\nCommittee members have met behind\nMiss Myers laughed and said, \"I\npolitical conscience but not a\nSchwarz. 3101 Massachusetts Ave\nclosed doors. the number of people - re-\ndon't have any idea what you just\npolitician,\" Mr. Obermayer said.\nNW. Contact: 202/232-4400.\nmeant by what you said.\"\n8 p.m. - Lecture - James\nporters, lobbyists and activists - loitering\nIt got so tiresome that she finally\nHutson of the Library of Cong\noutside its Dirksen Senate Office Building\nannounced herself open to any other\nCheaper by the dozen?\nreviews Swiss-U.S. relations during\nsuite of offices has swelled.\ntopic.\nMany new ambassadors here\nWorld War II. Swiss Embassy. 290\nYesterday. government watchdog Ralph\nCathedral Ave. NW. Contact:\nYou guys are cranky. It's Monday.\nmight want to drop a thank-you\nNader paced the corridor while a group of\n202/745-7900.\nYou don't want to be here,\" she ob-\nnote to the new Polish envoy,\npeople in wheelchairs and others who sup-\nserved.\nwhose arrival in Washington\nIf you have a tip, suggestion or\nport the Clinton plan lingered near the\nIn his January State of the Union\nended what for some was a long\nquestion, call Embassy Row at\nmeeting room door.\naddress, Mr. Clinton waved a pen and\nwait to see President Clinton.\n202/636-3297.\n\"What they doing in there is ludicrous,\nwarned he would use his first veto if he\nOnly 16 days after landing\nabsolutely ludicrous and we expect those\ndid not get what he asked for.\nhere, Ambassador Jerzy Kozmin-\nguys to come up with a health plan for ev-\n\"If the legislation you send me does\nski presented his diplomatic cre-\neryone in this country - not 95 percent, not\nnot guarantee every American private\ndentials last week in a White\n91 percent but 100 percent.\" said Becky\nhealth insurance that can never be\nHouse ceremony.\nOgle, 38. of the Real Health Care for All\ntaken away, I will take this pen, veto\nBut because he was the latest\ncampaign.\nthat legislation, and we'll come right\narrival, protocol demanded that\nback here and start over again,\" Mr.\nMs. Ogle, who has spina bifida, sat in a\nthe ceremony also include 11\nClinton said.\nother ambassadors who were\nwheelchair plastered with bumper stickers\nwaiting to present their creden-\npromoting universal coverage.\n123\nTUESDAY.\nJUNE\n28.\n1994\nThe\nWashington\nTimes\nThird party, anyone?\nTwo years after the strongest\nshowing by an independent pres-\nidential candidate in 80 years,\nClinton likes camp\npollsters say President Clinton\nand top Republicans have failed\nPresident Clinton has finally\nto win the election-crucial block\nInside Politics\nadopted Camp David.\nof independent voters.\nHe plans to spend the long In-\nThe Christian Science Monitor\ndependence Day weekend in the\nreports Ross Perot is running at\nMaryland retreat he had largely\n20 percent in recent polls, a\nr\nshunned since taking office, his\nhigher than the 19 percent of the\nthird consecutive weekend in the\nnational vote he received in 1992.\nCatoctin Mountains.\nAnger toward Washington is also\n\"He certainly enjoyed his\nup since the last election.\nweekends there, the last two\n\"The American people are will-\nweekends there.\" White House\ning to break from the two-party\nPress Secretary Dee Dee Myers\nsystem,\" says pollster Gordon\nsaid. She insisted he wasn't\nBlack of the New York Indepen-\nsneaking away to fish, as Jimmy\ndent Party. \"The problem is you\nCarter says he did.\nhave to have the resources to pre-\nAnd Mr. Clinton hasn't yet\nsent them with an alternative.\"\ndropped in on nearby Holly Hills\nBut some political observers\nCompiled by Alan McConagha\nCountry Club that former admin-\nwarn that American voters have\nistrative director David Watkins\nhistorically not been kind to\nThe Richards lectures\nclaimed to be checking out on his\nthird-party candidates and that\nbehalf when he took his famous\nthis is not a firm block of voters\nCongress' coverage\nIn what the Houston Chronicle\nhelicopter golfing trip.\nwaiting to be seduced by a\nThe Wall Street Journal re-\ndescribed as another of her lec-\n\"He's spending time with his\nthird party.\nported that the congressional\ntures to teen-agers, Texas Gov.\nfamily, mostly, I think. Reading,\"\nhealth plan is not likely to be a\nMiss Myers said.\ncrowd pleaser despite the politi-\nAnn Richards proposed statewid\nRed Meat II\ncal fuss being made by Hillary\ncurfews for young people to help\nRodham Clinton over getting one\nreduce juvenile crime.\nGOP vs. Rosty\nDemocratic National Chair\nas good as the members enjoy.\nThe Democrat said she hoped\nTwo House Republicans are\nDavid Wilhelm at a party strat-\nThe federal employees' pack-\nthreatening to file a complaint\negy meeting: \"The Republican\nTexas communities would impose\nage isn't \"as generous as most\ntheir own but added that she\nagainst Rep. Dan Rostenkowski if\nParty has a problem. Its state,\nunion health plans, or the pro-\nwould consider legislation at the\nthe chamber's ethics committee\nparties are rapidly being taken\ngrams of many Fortune 500 com-\ndoes not launch a probe of the\nover by the forces of the radical\nstate level. Her GOP opponent,\npanies.\" For example, there are\nHouse post office episode, Roll\nright, the very same people who\nGeorge W. Bush, supports local\nno preventive dental care or sub-\noption only on curfews.\nCall reports.\nbrought us the 1992 Republican\nstance abuse benefits.\nChris Shays of Connecticut and\nconvention in Houston.\"\nMrs. Richards said, \"My\nScott Klug of Wisconsin are pre-\nmamma always said that there's\nChristian Republicans\npared to force a floor vote on a\nnot anything going on at 2 o'clock\nOutbursts redux\nresolution that would require an\nLeading Republicans say the\nin the morning that should be of\nethics panel probe of the post of\n\"Actually, his outbursts are\ninfluence of religious conserva-\nany concern to me.\"\nfice if the committee does not\nnothing new,\" wrote Carl M. Can-\ntives depends on whether they\ntake it up on its own.\nnon in the Baltimore Sun.\nlimit themselves to messages on\nRed meat\nHouse Democratic leaders\n\"In the past year, President\nabortion and homosexuals or if\nhave supported the federal at-\nClinton has publicly displayed hi.\nthey broaden appeals to issues\nDick Cheney in Iowa: \"When\ntorney in resisting GOP calls for\ntemper with increasing fre-\nsuch as the economy and health,\nwe left office, America's strength\nan immediate ethics probe, say-\nquency, causing some promism\nthe New York Times reports.\nand resolve could not be ques-\ning such action could impede the\nDemocrats to wonder why such\nAs evidence that the religious\ntioned. In the 17 months he's\nJustice Department's criminal\nconsummate political cam-\nconservatives are not dividing\nbeen in office, Bill Clinton has\ncase against Mr. Rostenkowski.\npaigner is unnerved by the kind\nthe party, some Republicans\nsquandered that legacy.\"\nof criticism that is standard in\npoint to their support for two pro-\nFutures\nmodern politics.\"\nchoice Republicans - Sens. Paul\nSocial Security cuts\nMr. Cannon said that a Demo-\nCoverdell of Georgia in 1992 and\nColumnist Michael Barone in\nIn Washington state's 2nd Con-\ncrat who knew Mr. Clinton w\nKay Bailey Hutchison of Texas in\nU.S. News & World Report says\ngressional District, Democratic\nhe was governor of Arkansas\n1993.\ncurrent political signs suggest\nstate Rep. Rob Johnson and Re-\ncontends that his political skills\nSenate Minority Leader Bob\nthat Social Security payments\npublican businessman Jim An-\nseem to fail when he is criticized\nDole told the Times' Richard L.\nmay be cut sharply for future\ndrews became the latest to\n\"He's a good man, but he was\nBerke: \"The plus side of it is\nbeneficiaries.\nthrong the field in what is rated a\ngovernor and then president for\nwe're bringing people into the\nMr. Barone says the fiscal, de-\npartisan toss-up to succeed retir-\nall but, like, two years since he\nparty, and they are middle class\nmographic and political vectors\ning Democratic Rep. Al Swift.\nwas in his 20s.\nwith strong family values. If I\npoint in that direction because of\nNot Rollins\n\"He's never had to bite his\nthought they were all directed at\nthe public's general inclination to\ntongue, never had to pick up 1.\none or two issues, I'd be worried.\"\ncurb government spending and\nFormer GOP Chairman Rich\ndinner check, always had a DC\nthe fact that Social Security\nBond insisted to the New York\nliceman there when a bully\nA miracle?\n\"is where the money is.\"\nPost's Fredric Dicker that he was\ncomes by. He's been spoiled\n\"Jimmy Carter, truster of Leo-\nHe speculates that cuts would\nnot the one who recommended\nand it shows.\"\nnid Brezhnev until Afghanistan,\nnot be vigorously postested be-\nconsultant Ed Rollins to Berna-\ntruster and promoter of the BCCI\ncause the people now turning 65\ndette Castro, New York's Repub-\nbanker until thousands of deposi-\ndo not have the sense of moral\nlican Senate candidate.\ntors were bilked of their savings,\nentitlement \"a stronger emo-\n\"I would have strongly argued\nmakes his pilgrimage to the last\ntion than greed\" that moti-\nagainst him in the belief that the\nStalinist - and again bets on the\nvated the World War II genera-\nrace is already a long shot and\ncontagion of his own indisputable\ntion.\nthe candidate doesn't need the\ngoodness.\" wrote columnist Wil-\nAmericans of the silent gen-\nproblem of a hired gun,\" Mr.\nliam Safire in the New York\neration don't feel as entitled to\nBond said.\nTimes.\nbenefits far greater than the\nmonetary worth of their contri-\nbutions, and baby boomers and\nFear and loathing\ngeneration X don't expect to get\nThe blasted dream\nHunter S. Thompson in an ex-\nmuch from Social Security any-\n\"Once Clintonites dreamed of\ncerpt from his new book, \"Better\nway, Mr. Barone observed.\nrealignment. Now they are\nthan Sex: Confessions of a Politi-\nNow that Demcorats control\nscrambling for survival,\" says\ncal Junkie Nixon was a mon-\nthe government and the push for\nRonald Brownstein in the Los An-\nster with insanely wrong convic-\nthe cuts is likely to be led by\ngeles Times.\ntions. Clinton is a humorless punk\nDemocratic Sen. Bob Kerrey,\n\"Under siege from Whitewater,\nwith bad habits. Nixon was so\nhead of the entitlements commis-\nCattlegate and Paula Jones, his\nbad he could get innocent people\nsion, the objections of older\npoll numbers sagging, his health\ninto politics, but Clinton is bad in\nDemocrats may be overcome.\ncare plan struggling for air, it is\na way that will get-all but the\nThe reason for President Clin-\ndifficult to remember that Clin-\nworst ones out.\"\nton to go along despite campaign\npledges to the contrary? It would\nton once seemed to many Demo-\nmake more money available for\ncrats their best hope for realign-\ninnovative government programs.\ning national politics.\n\"Bill Clinton's promise was\nthat he could inspire a lasting\nnew Democratic majority in na-\ntional politics.\n\"Does anybody think of Bill\nClinton that way today?\"\n130\nThe ripple of the unintended consequences of health care reform\\\nBy Peter J. Levin\nthe mandate to pay for an ever\nlic has exhibited an aggressive\nprogram EHSDS, or the Experi-\nchanges were occurring in the mar-\nislative solutions to bureaucrati-\nincreasing number of aged nursing\ndesire to benefit from their physi-\nmental Health Services Delivery\nketplace: (1) there was a new focus\ncally revamp the health care sys-\nF\nFormer Health, Education and\nhome residents whose care has\ncians' use of the latest techniques.\nsystems, was created to foster the\non cost consciousness by employ-\ntem. A number of attempts at\nWelfare Secretary Joseph Cal-\nbecome the liability of the state.\nComprehensive Health Planning\ndevelopment of rational delivery\ners; and (2) care was being moved\nhealth planning have taken place in\nifano in an April 1, 1993 arti-\nThere may be more responsive,\nwas enacted to help rationalize\nsystems in a number of selected\nout of the hospital into a variety of\nthe past that were not as overarch-\ncle in the Washington Post wrote of\neffective, and less costly ways to\nhealth care delivery locally by lim-\nareas. The idea was to put togeth-\nambulatory settings by providers.\ning as what President Clinton has\nthe ripple of unexpected conse-\ncare for these people but the legis-\niting the diffusion of technology\ner the 4P's (payers, political, pub-\nThese were to have a much more\nproposed. Health planning has\nquences when government tries to\nlation prevents flexibility in choice\nthat was deemed to be duplicative\nlic, providers) in a voluntary coali-\nlasting effect than all of the\nfailed in our country because it did\nre-invent the way we deliver and\nof facilities, services, or methods of\nand unnecessary by putting the\ntion that together with dialogue\nattempts in the past at legislating\nnot take into account the realities of\npay for health care. there is a long\npayment.\nbrakes on hospital capital expendi-\nand data would lead, in a locality,\nhealth planning.\npolitics, interest groups, and the\nhistory of federal attempts at trying\nMedicaid stands out today as a\ntures. Local CHP agencies made\nto a more rational and equitable\nProbably the most acute legisla-\nevolving marketplace. Rarely have\nto improve the structure of the\nprime example of a federal attempt\nup of community representatives,\nhealth care delivery system.\ntive failure was the passage of cat-\nwe been able to replace the market\nhealth care system in this country\nto affect the availability of, pay-\nproviders and others were to over-\nEHSDS had no legal clout,\nastrophic coverage as a part of\nthrough policy innovation.\nand the unintended, frequently neg-\nment for and cost of health services\nsee and guide the evolution of the\napproval authority or money to\nMedicare. this well intentioned\nGovernment has repeatedly\native consequences. With all the\nto Americans. While many in need\nhealth care delivery system in a\ninfluence behavior. In a way, these\neffort to cover the very sick and\nshown that it can create programs\nbest intentions, it is naive to try to\nhave benefitted from Medicaid, a\nlocale largely by conducting a\nserved as prototypes for the struc-\nreduce bad debts by health care\nto increase the level of services,\nredo the American Health care sys-\nvery unfortunate consequence has\nmulti-step public review process.\nture of the HSA's, or Health Sys-\nproviders backfired when the elec-\nbut that it has an extremely difficult\ntem in one piece of legislation.\nbeen the cost shift to individuals\nthe infamous CON, or certificate of\ntems Agencies, which were given\ntorate, in the form of Medicare eli-\ntime slowing down the proliferation\nMedicaid was passed in 1965 as\nand insurers, and ultimately to\nneed, process was created as the\nformal approval authority over the\ngible, rose up and demanded its\nof regulations, services, and expen-\na means of sharing with the states\nemployers and employees, because\nmeans of doing this within a state\nCON process in their locals as suc-\nrepeal. They refused to pay more\nditures. Our system of government\nTUESDAY. JUNE 28. 1994 The Washington\nthe cost burden of caring for per-\nof the governments' failure to pay\napproved local health plan. It\ncessors to the CHPs.\nto benefit the few who needed addi-\nmakes it almost impossible to have\nsons with poverty level incomes or\nthe real cost for the provision of ser-\nrequired hospitals, nursing homes\nThe public interest was expected\ntional coverage with almost no vis-\nunbiased evaluation followed by\nthose whom had become impover-\nvices.\nand others to apply to obtain\nto be dominant on each HSA board,\nible improvement in the benefits to\nrational dialogue that then leads to\nished by the cost of medical care.\nThere have been several other\napproval prior to making capital\nfree from control by providers, the\nthe vast majority. For the first time\nthe curtailment of government\nMedicaid may be the government\nwell-intentioned efforts at planning\ninvestments. Physicians in private\ngroup with the greatest economic\nwe saw consumers rebel against a\nsponsored programs and expendi-\ncost increase \"sleeper\" of all time.\nby the Congress. Regional Medical\noffices were exempt from oversight\ninterest and the ability to organize\nfederal program that promised pay-\ntures. It would be useful for the\nIt has eaten up state budgets at a\nPrograms were initiated to serve as\nand the approval process and they\nsustained monitoring of and a ready\nment for the very seriously ill, a\nelectorate to acknowledge that our\nmore rapid rate than any other fed-\na framework for dissemination of\nwere able to invest in new technol-\ninterface with the planning and\nsmall but costly minority in the pro-\ncountry does not have a successful\neral-state cost sharing program\nthe most advanced medical knowl-\nogy and the creation of services as\napproval process. In fact, politi-\ngram. They did this because there\nhistory of merging public policy\nand paralyzed the ability of states to\nedge throughout the country to\nthey wished. the CON process was\ncal and bureaucratic interests grew\nwas an immediate increase in the\nand private delivery to create new\nexpand care for children and oth-\npracticing physicians and their par-\nin itself a bureaucratic hurdle\nin proportionate power and the\nmonthly premium and no visible\ngovernment sponsored programs\ners. this has occurred because of\nents who were suffering from heart\nwhich led to the creation of an\nHSAs soon became politically and\nexpansion of benefits to the major-\nthat are supposed to decrease the\ndisease, cancer and stroke. The\nindustry of consultants, lawyers,\nprocedurally gridlocked from deal-\nity. We might conclude from this\ncost, increase the availability and\nidea was a noble one, to make spe-\nand lobbyists who were necessary\ning with the major issues of health\nthat with the creation of a national\nreduce the use of inappropriate ser-\nPeter J. Levin is a fellow in\ncialty care available in rural and\nto obtain local Comprehensive\ncare reform.\nhealth plan the public will not hes-\nvices. this certainly will not hap-\nHealth Care in the office of Sen.\nsuburban areas that previously was\nHealth Planning and state agency\nWhile all these programs were\nitate to hold their elected repre-\npen through the passage and imple-\nConnie Mack, Republicant of Flori-\nfound only in major urban medical\napproval. In almost all states, this\nwell intentioned, they were chewed\nsentatives accountable for the ben-\nmentation of a single bill by\nda. Mr. Levin is former dean in the\ncenters. It appeared desirable to\ncumbersome and intrusive process\nup in the reality of changes occur-\nefits package. this will result in\nCongress. A carefully phased in\nCollege of Public Health of the Uni-\ndisperse specialists and this has\nhas been overturned because of its\nring in the marketplace. Provider\nconstant pressure to increase the\nprogram aimed at realistic targets\nversity of South Florida, Tampa\noccurred. Now, specialists are\ndismal record at controlling costs or\nsurvival once again was primary\ncoverage.\nproposing limited immediate solu-\nand former chairman of the Flori-\nfound everywhere their diffusion\nrationalizing the diffusion of tech-\nover a generalized desire to\nWe should be aware of \"the rip-\ntions with financial safeguards has\nda Hospital Cost Containment\nlimited only by constraints of the\nnology.\nimprove community well-being.\nple of unexpected consequences\na much greater chance of passage\nBoard.\nmarketplace. In addition, the pub-\nAnother federally sponsored\nAnd, more important, two major\nwhenever we begin to expect leg-\nand ultimate success.\n6/28/94\nFROM\nUSDAY\n1994,06-27\n23:25\n#660 P. 03/05\nHarry and Louise Turning Tail\nWashington - Harry and Leuise\nsmall health insurance companies as\ntes. bottom-line Jemands entil now\nChickenlittie, the housey fearmongers\ntually had only nerrow objections 10\nIt's too late.\" said 1 Senate starTer, watching\nfeatured in those health insurance in-\nCEnter's approach. but they attacked it\nClinton's propotals disabline in the Senate Finance\nduatry TV commercials, appear to he\nwith a bludgeon. As u terror campaign.\nCommittee \"They\" turred and feathered the\nsuffering d sudden done of fright them.\n3\nit has bown M brilliant sucress. Although\nClinton plan for su lung - and new they want to\nselves Serves hum -ight, LOO.\nmast Americans still want national in.\nput a nice Pat on it?\"\nAfter ontha of sprcading terror\nsurance they have become you WHIN of\nLike Harry and Louse loctors, too, have\nabout President Hill Christin's health\nanything Clinton proposes that they are\nbeen having second dhoughts about their long.\nF1 sposals. Hurry and Louise unexpect\nletting health reform slip away\nstanding opposition to government-funded \"so-\nediy showed -P in a newspaper ad here\nSpecifically, ae R result of the general.\ncraimed medicine. What scares them is that\nyeste. day. supporting supporting\nHIA A-aided onelaught against the Clin-\nthey are rapidly losing their independence to\nCititon's two basic demands: univer-\nLars-Erik\nten reforms, the Senate Finance Com-\nfor profit insurance companies, which are far\n3a. erage and an employer-breed fi-\nNelson\nmitter LM walking away from both the\nstricter about holding down costs than the gov-\nnameing avecem\nemployer-paid premiums and from\nemailment than ever been. \"Many doctors notieve\nIf health care reforms and insurance reforms\nguaranteed or versal coverage. And the is what\nthat maybe living under the government is net-\nare gring to work Bb well - we want. they must\nscares Harry and Louise\nter than living under these compunies,\" D-. Rot.\nwork together. Hand in Hand. Everyone cooperar-\nThe thin, minimalist compromises being offered\nland Lowe of the California Medical Association\ning. That means universal coverage. says the 40\non Capital Hill could soddle the health insurers\nCold the Washington Post and month These\nsponsored by the Health Insurance Association of\nwith the worst of all worlde: The obligation to at\nfor-profit entities are really making pronte an\nAmerica. Through universal coverage and our\nSept all applicants for insurance without requiring\nthe backs of doctors\npresent employer-based system. we can huld down\nall American:, or their employers, to pay into the\nFor doctors the choice is not returning the\nCOSTS and ensure coverage for everyone.\"\nsystem. Without universal coverage, Americans\nNorman Rockwell dave or independent medical\nExectly what Clinton has been goying all along.\ncould wall until they were sick before buying th-\nproctices: those times are gone. New they maki\nThis IN \" amazing turnsbout Up to now, Harry\nsurence. and the insurers would not be nhic to\ndecide which prospect given them more freedom LI,\nat 1 Louise have apread fear that Clinton's plans\nturn them away. HIAA has lung recognized this\npractice medicine: A Canadian-style government\nto national insurance will mean rationing of\ndunger, but it has not advertised in support of who\nfinanced * store with free choice of doctors Class\nhealth care They have washed that it could run\nversal coverage. It her only attacked\nton's mixed government-private atem; or being\nout of money. presumably leaving people to die in\nSimilarly, HIAA favors employer-based financ-\nforced by market preasure into an insurance come\nshe streets They have shares their worry that\ning as the securest income source for insurance\npany's hrath-maintenance organization\nAmericans would be fr reed into health plans de.\ncompanies. If employers are required to pay o0\nAs health reform about to fall victim to\nsigned he government bureaucrats who would not\npercent of insurance premiums. as Clinron wants.\ninertia. to partisan pelitics and to\ncover important illnesses.\nthe insurance companies will be rolling in money.\ninhhying, even its opponects realize the current\nMore important. their incessant drumbest of\nWhen asked. HIAA officials have always NO d they\nhealth system has to change and toot the Clin-\nnegativism has helped to poison the debate about\nfavor universal coverage and employer-paid premi-\nton plan, with all to un doubted faults. may be bec-\nnational health care. Harry and Louise - i.e.. the\nums. But they DRIVE not advortised in favo: of Clin-\nter than the likely alternativea.\nWORLD BRIEFS\nNATION BRIEFS\nSurge in Haitians\nKravchuk, a former Communist\nClinton to Move\ndetect condition\nSeized on Boats\nlender who carried the become of\nindependence throughout the car.\nTo Dismiss Suit\nIn an article in the Journal of\nClinical Medicine. an immunoi-\nThe U.S. Coust Guard picked up\npaign. was the clear favorite in\nPresident Bill Clinton will nak\nagist at the University of Medi-\nwestern the strongh old of\nabout 1.300 boat people fleeing\nthat a sexual Increasment lawsuit\ncine and Dentistry of New Jersey\nUkrainian nationalism But for\nHeith yesterday, more these half the\nmer Prime Minister I. onid\nbe dismissed until he leaves the\nreports his team cas: can detect\ntotal number picked up in Caribbe-\nKushma. who seeks closer time\npresidency, according to papers his\nLyme disease RE soon as a few\non waters in all of last year.\nThe surge ccincides with Presi-\nwith Moscow, commanded strong\nlawyer filed yesterday in U.S. Dis-\ndays or weeks after infection\ntrict Court in Little R.s.k. Ark.\nCurrent tests are sometimes in-\nsupport in the industrialized dest\ndent Clinton's new policy. which\nThe motion ASKS the court to al-\nconclusive and can fail to detect\nand south, regions with large eth-\nrook effect June 16. to grant refu-\nnic Russian populations\nlow Clinton is delay the normally\nthe discuss for as long as a LOU-\ngees picked-up at vest # chance for 8\nrequired response to the allega-\nple of years after infection.\nhearing to determine whether rhev\nLinns until courts have decided\nare eligible for political asytom.\nMissing Freighter\nwhether = president can be: such\nHouse Unit to Hear\nA US embasay spokesman suic\nabout 900 were picked DD yeaterday\nPollution 'Suspect'\nAttorney Robert Bennett of\nWashington said in the court pe-\nWhitewater Case\nin 25 toat. Later, the Coast Guard\nAn ore-camying ship that disup.\npera that Clinton will file a inot.\nin Mian.. said the figure was closer\npeared after leaving port last week\nby Aug. 5 arguing that presidents\nThe House Banking Committee\nto 300. but that :: would not have\nmay have caused the oil stick coat-\nare Time while in office from\nwill begin Whitewater acorings\nan accurate count until today in\ning penguins and spoiling priatine\nhaving to deal with private law-\nJuly 26 and has asked special\naddition 25 heats carrying 786 Hai-\nSouth African beaches, officials\nsuits.\ncounsel Robert B. Fiske Jr. and\ntiana had been intercepted by U.S.\nand yesterday\ntop White. House officials to Lear\nships over the weekend. in all of\nThe Apells Sea. \" Penamenian-\nFDA OKs Drug\ntify.\n1993 Coust Guard Petty Officer\nregistered are carrier based in\nCommittee Chairman Henry B.\nToni Long-Gay said, 2,239 Haitiana\nHong Kong. left Saldanha Bay\nTo Combat AIDS\nGonzelez eaid yesterday that he in-\nwere apprehended\nnorth of Cape Town on June 20\nvited Fiske to the initial hearing to\nwith & crew of 36 and has not been\nA fourth drug that attacks the\nreport or. the \"Washington prese\nheard from since. It was carrying\nvirus that AIDS was ap-\nof his investigation into the Arkan\nVoting Shows Split\nabout 800,000 gallons of fuel 0.1.\nproved yesterday by the Fond and\nBAS land deal in which President\nAmong Ukrainians\nDrug Administration and is EX-\nhill Clintor and first lady Hillary\nVow on Arafat\npected to be on the market within\nRadham Clinton were partners.\nUkraine A nationalist weat and\ntwo weeks.\npro-Russian east lurched toward a\nThe chemical name is stavudine,\nThe mayor of Jerusalem an-\nor d4'1' It will be sold by Bristol-\nStorm Systems\ncuilision yesterday when early elee.\nnounced plans yesterday to Cy in\nMyers Souibb Co. under the brand\nLion returns signated a July runuff\nJews from abroad to stand in the\nSock It to South\nname Zerit.\nbetween President Leonid Krav-\nway of any future visit to the city\nchuk end his main challenger\nby PLO Chairman Yasser Arafat\nStorms rumoled across the\nUnitficial results from Sunday's\n\"I was not elected 5 deal only\nNew Way to Detect\nSouth. spinning off tornadoes,\npresidential butloting showed a\nwith sanitation,' said right-wing\nLyme Symptoms\nanapping trees nn1 flooding\nstark regional division in the vast\nMayor Ehud Olmert durying Prime\nstreams\nformer Soviet republic the world's\nMinister Yitzhak Rabin's inais-\nResearchers say they have de\nAt lenst five people were killed,\nHurd-largest nuclear power. The\ntonce lest week that Arefat had 0\nveloped a new Lyme disease test\ndozens were injured and 36.eral\nfirst official returns were not ex-\nright LO pruy nt Mustim holy aites.\nthat could lead to earlier diagno-\ntowns had heavy dainege.\nJUNF\nnectod until today.\nCOMPLED KICIM NEWS SPATCHES\n818 and treatment of the hard-co-\nCOMPLETED FROM NEW DISPATURES\n6/28/94\nSenate Girds for Partisan Clash on Health Care Reform\nexpects to get few if any Republicans. Relying entirely on\n(Washn) By Karen Hosler and John Fairhall= (c) 1994,\nDemocrats is risky because there are only 56 Democrats,\nThe Baltimore Sun=\nand 51 votes are required to pass a bill.\nWASHINGTON Despite centrist efforts to compromise on\nThe White House is trying to remain above the\nhealth care reform, Republican and Democratic Senate\nlegislative hard ball at least until the end of this week,\nleaders are preparing for a partisan clash that could\nwhen Congress adjourns for a weeklong Independence Day\nprevent any sweeping legislation from passing this year.\nrecess. But Clinton, Hillary Rodham Clinton and various\nSenate Republican leader Bob Dole of Kansas and Senate\ninterest groups backing health care reform are working to\nMajority Leader George J. Mitchell of Maine have both\nbuild enthusiasm for the central elements of their\napparently concluded that it serves their political and\nproposal.\npersonal interests to fight rather than bargain.\nDole is resisting the compromise plan drafted last week\n(Optional add end)\nby a bipartisan group of moderates from the Senate Finance\nCommittee. Even though that proposal is less ambitious\nWhite House press secretary Dee Dee Myers noted that\nthan a bill Dole co-sponsored last year, the Republican\nthe president is flexible about the financing of\nleader is crafting an even more modest plan and imploring\nlegislation. Although he supports a requirement that\nhis troops to line up behind him.\nemployers pay the bulk of insurance costs, \"he would look\n'I've got 40 Republicans, and they've only got\nat other ways,\" she told reporters.\nthree,\" Dole said of the three Republican moderates who\nAdministration officials argue that without all\nhelped shape the compromise. \"Two of them aren't going to\nAmericans participating in the insurance system, it will\nbe around here next year like the rest of us,\" he added,\nbe impossible to control the skyrocketing cost of health\nreferring to two members who are retiring.\ncare and protect unhealthy people against exorbitant\nThe political calculation of Dole, a prospective\ninsurance rates.\nchallenger to President Clinton in 1996, is easy to\n\"Universal coverage is really critical to health care\nunderstand. There is little incentive for him to cast\nreform,\" said Dr. Michael E. Johns, dean of medical\ntough votes in order to give Clinton a victory on health\nfaculty at the Johns Hopkins School of Medicine in\ncare legislation that would be the centerpiece of the\nBaltimore. \"To go through this incredible effort and\npresident's re-election effort.\nthen come out with something that leaves a large segment\nBut there are a lot of reasons for Dole to wait until\nof the population uncovered, really is just not facing up\nafter this year's congressional elections, when, both\nto the reality of the situation.\"\ntradition and polls suggest, the Republicans will pick up\nDistributed by the Los Angeles Times-Washington Post\nmore seats and be in stronger position to write the health\nNews Service=\ncare legislation as they want it.\nThe Republican leader fears, however, that he will look\nlike an obstructionist if he is forced to stop a\nClinton-like bill with a filibuster near the end of the\nprocess. So he is trying his best now, confidants say, to\nJapan Faces Currency Crisis as Yen Outweighs Dollar\nprevent the Finance Committee from breaking its deadlock.\n(Tokyo) By Thomas Easton= (c) 1994, The Baltimore\nThat wouldn't stop the legislative process, but it would\nSun=\nmake it so difficult that the effort might collapse on its\nTOKYO Japan, already gripped by political turmoil, now\nown.\nfaces a full blown currency crisis.\nMitchell, who serves as the president's chief agent in\nThe yen became more valuable than the penny Monday for\nthe Senate, is devising a risky strategy aimed at calling\nthe first time since World War II, as financial markets\nDole's bluff. He and other Democratic liberals, who are\nshrugged off strong central bank intervention. The losing\ntrue believers in the health care overhaul Clinton\nstruggle between the Bank of Japan and the market became\nproposes, don't want to yield as much ground as it would\nevident early in the day, with the yen steadily rising\ntake to win Republican votes.\ndespite the bank's purchase of billions of U.S. dollars.\nEven the bipartisan compromise itself a breakthrough\n\"The fear,\" said David Snoddy, a financial analyst at\nin many respects falls far short of meeting Clinton's\nJardine Fleming, an investment bank, ``is that nobody\ngoal of guaranteed health insurance for every American\nknows why this happening.\"\nthat can never be taken away.\nAt the end of trading, the yen was quoted at 99.93 to\nSome Democrats, like Sen. Thomas A. Daschle of South\nthe U.S. dollar, down just a fraction from an intraday\nDakota, a Mitchell protege who hopes to replace him next\nhigh of 99.5 and, importantly, cracking the psychological\nyear as majority leader, are willing to back the\nbarrier of yen-penny parity. The previous low was 100.40,\nbipartisan bill, even though they feel it isn't generous\nset Friday.\nenough, just to break the committee deadlock.\n(The dollar also closed under 100 yen in London,\nLet's get it through committee and see what we can do\nfinishing the day at 99.96 yen, but stabilized slightly in\non the floor,\" Daschle said.\nNew York, where it closed at 100.45 yen, down from\nA much-postponed committee drafting session on health\nFriday's close of 100.60.)\ncare legislation was put off again Monday until Wednesday.\nThe committee is expected to consider proposals to require\n(Begin optional trim)\nemployers to buy health insurance for employees after a\ncertain date. Supporters of a Clinton-style plan say such\nNews shows are filled with the predictable kaleidoscope\nan employer ``mandate\" is crucial to ensuring universal\nof reactions: Manufacturers of cars and electronics\ncoverage.\nexpress anguish and mutter about having to raise the price\nMitchell's plan is to combine whatever comes out of the\nof their exported goods; importers of cars and food can\nSenate Finance Committee with a much more generous version\nbarely contain their joy; foreign tourists groan at the\nof the Clinton plan approved by the Labor and Human\ncost of even the briefest stay in Japan; and Japanese\nResources Committee, chaired by Sen. Edward M. Kennedy,\nleaving to go abroad talk about the delights of riding on\nD-Mass.\nhappily on a strong currency.\nMitchell's strategy is to tailor the combined bill\nThe most recent rise in the value of Japan's money\nlargely to meet the concerns of Democrats because he\nmerely continues a trend evident since the early 1970s,\n159\n6/28/94\nwhen it was delinked from its post-war rate of 360 yen to\nthe dollar. In the past, however, the yen's increase in\nHealth Reform: Who Pays?\nvalue has occurred when the country's economic growth was\nfar stronger and the attractiveness of domestic production\n(c) 1994, The Baltimore Sun= The following editorial\nmore evident.\nappeared in Monday's Baltimore Sun:\nThe latest surge has caused great alarm in Japan as one\nSenate moderates pushing health care reform that puts\nindustrial company after another has shifted manufacturing\nthe emphasis on individuals, not employers, in purchasing\nto less costly sites outside the country. Companies\ninsurance may be on to something. The fact is that in the\ncontinuing to produce in Japan are beginning to consider\nend it will always be individuals not employers, not the\nincreased purchases of crucial materials like steel and\ngovernment who have to pay the doctor (and the hospital\nparts from abroad, breaking the domestic suppliers' hold.\nand the pharmacist and the insurance peddler).\nWhen you have an ``employer mandate,\" as Bill\nThe new high for the yen comes just as Japan seems to\nand Hillary Clinton propose, the cost is ostensibly\nbe pulling out of its worst recession in almost half a\ncovered by the boss. But employees inevitably feel the\ncentury. Similar rebounds during the past 30 months have\nimpact in the form of smaller paychecks.\nfaded following new highs in the yen and in almost every\nWhat the debate on Capitol Hill is really all about is\nforecast now being issued in Tokyo there is an ominous\ncost shifting of somehow finding a way to force healthy,\ncaveat that this could occur once again.\nreasonably well-off people to help pay the bills of the\nsick and the less fortunate.\n(End optional trim)\nThe nation's poor already are covered by Medicaid, the\nelderly by Medicare. But the nation's jerry-built health\nExplaining the strength of the Japanese currency,\ncare system too often fails to cover lower-income people\neconomists point to numerous factors ranging from monetary\nwho are self-employed or working for employers who do not\npolicy throughout the world, to inflationary expectations\nprovide insurance. And why? Because insurance companies\nin the United States. But the single factor that appears\ntend to deny coverage to those with pre-existing\nto cut across all analysis is the persistently strong\nconditions and refuse customers the right to carry their\ntrade surplus posted by Japan.\ncoverage from job to job. Because healthy citizens or the\nNext to the surplus exists a painful paradox. That is\nmillions of employees used to having their medical\nthe bewildering fact that Japanese consumers cannot afford\ninsurance extracted tax-free from their paychecks don't\nproducts sold here even those made in Japan for anything\nreally want a change. Because there is so much red tape\nlike the prices charged abroad. This has been a strong\ninvolved in medical billing that billions of dollars go to\nimpetus here for political reform that could crack the\nadministration rather than health care.\ngovernment-fostered a web of regulations blocking imports.\nA year ago remember? health care reform was widely\nregarded as a cause whose time had come. But then came the\nYet the initial triumph of political reform last summer\ndetails, and from them emanated so many devils that today\nhas stalled. The latest government resigned Saturday and\nthe whole reform movement could collapse. Republicans who\nin a general chaotic scramble for power, it is possible\nonce were guarded or cautiously supportive of health\nthat a ruling coalition will emerge that has little\nreform now seem more emboldened to oppose the Clintons\ncommitment to change or any consistent policy.\noutright.\nSince last July the United States has been involved in\nPerhaps this can be blamed on the secretive way in\noften testy negotiations with Japanese officials to widen\nwhich Clinton concocted a vastly complicated 1,300-page\nmarket access and thus diminish the country's persistent\nbill. Perhaps it can be attributed to a small-business\ntrade surpluses. Those discussions appear to have been put\nlobby that cranked out the ``Harry and Louise\"\non hold with the demise of Japan's government.\ncommercials without ever quite informing the public that\nemployers providing health care were carrying the water of\n(Optional add end)\ntheir deadbeat competitors.\nBe that as it may, the focus now is on proposals before\nEven in the midst the current pessimism, however, there\nthe Senate Finance Committee that would throw out\nis some thought that what is occurring now may be merely\n``employer mandates\" and substitute them with insurance\nthe markets over-reacting.\nreforms, subsidies for the ``working poor\" paid for\nIt's a classic overshoot,\" said Robert Feldman of\nthrough tobacco and payroll taxes and vague prospects for\nSalomon Brothers, a U.S. investment firm.\ntaking further action perhaps even ``individual\nConcern about inflation in the United States and other\nmandates\" if more than 5 percent of the population\neconomic factors in each country has been overblown,\nremains uncovered at century's end.\nFeldman said. Both countries have already taken, or are\nAs many holes can be picked in this approach as in the\nsoon to take, steps that will redress any reservations.\nClinton proposal or its variations. But if it is\nDistributed by the Los Angeles Times-Washington Post\ntheoretically correct that the individual is the end\nNews Service\nsource of health dollars, then bipartisan proposals in\nSenate Finance deserve a fair hearing. The alternative, as\neven the Clintons are starting to suspect, could be\nnothing at all.\nDistributed by the Los Angeles Times-Washington Post\nNews Service=\nPolitics & Policy: A Look at Lawmakers' Medical Plans Suggests Congress's\nHealth Coverage Isn't So Generous --- By Hilary Stout Staff Reporter of\nThe Wall Street Journal\nWASHINGTON -- For President Clinton and his allies on health care, it has\nbecome the one sure-fire applause line: Give every American what Congress\ngets.\n\"You say it and the audience goes crazy,\" says Families USA foundation's\nArnold Bennett, a member of the team helping the administration craft its\nhealth-care message.\nHillary Rodham Clinton uses it in virtually every speech she gives. Just\nthis week a group of Democratic senators, including Labor and Human Resources\nCommittee Chairman Edward Kennedy of Massachusetts, called a news conference\nto demand that the general public get the coverage that \"members of Congress\nhave arranged for themselves.\" Sen. Harris Wofford, the Pennsylvania Democrat\nwho won his seat in 1992 by stressing health care and faces a stiff\nre-election fight this year, is circulating a petition demanding a bill that\noffers \"every Pennsylvanian and every American the same kind of guaranteed\ncoverage and choice of private health plans that members of Congress get.'\nBut while focusing on Congress's benefits may be a stroke of political\nbrilliance, the prospect of actually getting what Congress gets might not\nplease large numbers of Americans, including some of the most vigorous\nsupporters of the president's health-care bill.\nThe federal employees package isn't as generous as most union health plans,\nor the programs of many Fortune 500 companies. For example, many of the\npolicies available to federal employees don't include substance-abuse benefits\nor preventive dental care.\nHowever, Congress's benefits package would be an improvement for a vast\nnumber of Americans, particularly many employees of small and midsize\nbusinesses and, of course, the estimated 39 million people with no health\ninsurance. Still, the federal government's share of the premium isn't as\ngenerous as most unions and many big employers -- or, for that matter, the\n80% share the White House would like employers to bear. And as far as the\nscope of the benefits and the patient cost-sharing requirements, Congress's\nplan isn't nearly as comprehensive as Medicaid, the federal-state health\nprogram for low-income people.\nWhat lawmakers -- and indeed all federal employees, including the president\n-- get is the opportunity to enroll in one of an array of health-care plans,\neach offering a comprehensive package of medical benefits, with the premium\npaid in part by their employer: the taxpayers.\nIn the Washington area, members of Congress can choose from among nearly 30\nhealth plans, including 14 health-maintenance organizations and seven\n\"fee-forservice\" plans, which pay at least part of the bill for visits to the\ndoctor or hospital of the patient's choice. The benefits in each plan vary,\nbut generally include hospital and emergency services, doctor visits, lab\ntests, prescription drugs and some dental care. Depending on the policy,\ncoverage may include children's immunizations and some nursing-home benefits.\nUnlike much of the general public, Congress is also free of some of the\nonerous insurance-industry practices that shut some people out of the market.\nUnder the Federal Employee Health Benefits Program, no health plan can drop C\nrefuse to enroll a government employee or dependent because of a medical\ncondition.\nBut as far as cost-sharing goes, Congress isn't getting quite the ride that\nmany working Americans do. According to the Office of Personnel Management,\nwhich runs the federal benefits program, the government pays on average 72% (\nemployee health premiums, and no more than 75%. But for some policies the\nshare is far less.\nFor example, the government's share of a family policy for a Blue\nCross/Blue Shield \"high option\" fee-for-service plan is $306.41 a month, or\nless than half; the employee pays $343.24. For a Blue Cross standard option\nplan -- which has higher deductibles and generally pays 75% of most doctor\nbills instead of 80% -- the government pays $303.77 for a family plan and the\nemployee pays $101.25.\nThe political thrust and parry over the \"what Congress gets\" argument\nflusters some Republicans. For instance, House Minority Whip Newt Gingrich, a\nstaunch foe of the president's health-care proposals, was taken aback on NBC's\n\"Meet the Press\" Sunday when a reporter asked him, \"Why can't the average\ncitizen have the same health-care plan that Congressman Gingrich has?\" The\nGeorgia Republican replied, \"I have a Blue Cross plan that I pay for every\nmonth.\nI think it's about $400.\"\nNot exactly. The total monthly premium for the standard-option Blue Cross\nplan Mr. Gingrich and his family are enrolled in is just over $400. But on\nMonday a spokesman for Mr. Gingrich said the congressman only pays about $100\na month. The government picks up the remaining $300.\nAmong other things, Republicans are especially irked that Democrats seldom\nmention that the president gets the same benefits as lawmakers. (The Clintons\nhave the same plan Rep. Gingrich has.) Senate Minority Leader Robert Dole of\nKansas this week denounced the argument as a \"cheap shot,\" and said he plans\nto propose that the president and members of Congress pay their entire premium\ncosts themselves. Democratic Sen. Wofford, though, has already gone him\none-up: He says he'll pay the full cost of his health insurance until Congress\npasses coverage for all, and is challenging his GOP opponent, Pennsylvania\nRep. Rick Santorum, to do the same.\nIn addition, the president's allies are already planning a sequel to the\n\"what Congress gets\" line, says Mr. Bennett of Families USA. If moderate and\nconservative lawmakers continue to tout a bill that would cover 91% of the\nAmerican population as a worthy achievement, he says, the retort will be:\n\"Which nine senators intend to give up their health insurance?\"\nWhat Congress Gets\nHighlights of the Blue Cross/Blue Shield Standard Option Plan, one popular\nhealth plan in the Federal Employee Health Benefits Program\nAnnual deductible\n$200\nAnnual inpatient hospital deductible\n$250\nOut-of-pocket limit\n$3,250\nInpatient hospitalization\n100% coverage\nDoctor services\n75%\nOutpatient hospital services\n75%\nPrescription drugs\n$50 deductible,\nthen 60% coverage\nTotal premium\n$405.02 per month\nMember's shares\n$101.25\nGovernment share\n$303.77\n****\nfiled by:WSJ-(--)\non 06/25/94 at 23:17EDT ****\n**** printed by: WHPR (JEL) on 06/27/94 at 08:11EDT ****\nBC-MO-BRF--Dean-Clinton,0130\nDean Of MU School Of Medicine Invited To White House Meeting\nCOLUMBIA, Mo. (AP) The dean of the medical school at the University of\nMissouri at Columbia will travel to the White House next week for a conference\non health care reform.\nDr. Lester R. Bryant will join 60 other leaders of academic health centers\nin meetings Monday with President Clinton, Hillary Rodham Clinton and senior\nWhite House officials.\nAcademic health centers are a vital foundation of America's health-care\nsystem, \" Bryant said Friday in a statement announcing the White House visit.\nWe train the health-care providers of tomorrow, including the primary-care\nphysicians who will be integral to the growth of managed care plans.\nAs part of the meeting, participants will sign a statement endorsing\nuniversal medical coverage.\n****\nfiled by:APW-(MO) on 06/24/94 at 20:46EDT ****\n**** printed by: WHPR(JEL) on 06/27/94 at 08:14EDT ****\nBC-OK- Health Care-Okla, 310\nMeeting With Mrs. Clinton Strikes Nerve With Boren\nOKLAHOMA CITY (AP) The first lady pitched President Clinton's health care\nplan to a group of Oklahoma leaders, a move that drew raised eyebrows from\nOklahoma Sen. David Boren.\nHillary Rodham Clinton told the Oklahomans on Friday that universal\ncoverage was the critical component of the president's plan and that employer\nmandates were the most effective way of achieving it.\nParticipants said they weren't asked explicitly by the president's wife tc\nlobby Boren and other members of the Oklahoma delegation. But one Oklahoman\nsaid the implication'' was there that they should ask the delegation to\nsupport the Clinton plan.\nBoren, a Democrat, is among a group of moderate senators who put together\na compromise health care package.\nI'm always happy when Oklahomans get invited to the White House, \" Borer\nsaid Thursday. I'm all for that. But as a device to try to switch my vote,\nit's not a very effective one, because it's so transparent.\nJust coincidentally, all of a sudden, they decide to have a group of\nOklahomans come in. Purely by coincidence. Sort of a state chosen by random.\nIt's SO transparent. I would not call it a very subtle form of politics. \"\nThe alternative plan is aimed at covering 95 percent of Americans by the\nyear 2002 without forcing employers or individuals to buy health insurance.\nOklahomans interviewed after their meeting with Mrs. Clinton and other\nWhite House officials said the session was beneficial and cleared up some\nconfusion and inaccurate information that had been circulated about Clinton's\nplan. They said the moderates' plan was mentioned but not discussed at length\nbecause details weren't available.\nThe Oklahoma group included state lawmakers, hospital administrators, a\nlabor leader and others.\n****\nfiled by:APW- (OK) on 06/25/94 at 01:51EDT ****\n**** printed by: WHPR (JEL) on 06/27/94 at 08:13EDT ****\nbc-conghealth\nCONGRESS DOES UNTO OTHERS IN HEALTH CARE\nAS IT DOES UNTO ITSELF MORE OR LESS\nEds: Good thru weekend; originally moved Friday.\nBy WENDY KOCH=\nGannett News Service=\nWASHINGTON Members of Congress, fighting a nagging image of special\nprivilege, still have free parking spots at the airport and subsidized meals\nat the Capitol. But they don't get a special break on health insurance.\nLawmakers get the same options as all federal workers, including\nPresident Clinton, and many private-sector employees. They are guaranteed\ncoverage by their employer, who pays about three-fourths of the cost.\nEvery member of Congress has health care that can never be taken away\nand it is paid for in large part by our employers the American taxpayer,\nsaid Sen. Edward Kennedy, D-Mass.\nAs Congress debates health care reform, the issue of parity is becoming an\nincreasingly potent weapon for members who support the requirement that\nemployers supply health care insurance, and an embarrassing one for those who\ndon't.\nIn many of her speeches, Hillary Rodham Clinton makes a simple populist\npitch: Congress should give Americans what members get sort of Do unto\nothers\nTo counter the Democrat pitch, Senate Minority Leader Bob Dole of Kansas\nsaid he will propose that the president and members of Congress pay the entire\ncost of their health coverage.\nClinton's plan guarantees workers coverage with employers paying 80\npercent of the cost of a standard plan.\nThey wanted to find the average, said Bill Custer, research director\nof the Employee Benefits Research Institute, a private, non-partisan research\ngroup.\nBut some lawmakers are confused about their own benefits and are proposing\nplans that guarantee constituents much less.\nWhen asked about his own coverage on NBC's Meet the Press, House\nMinority Whip Newt Gingrich stumbled. He said he pays about $400\na month for his Blue Cross/Blue Shield plan.\nActually, as his office later corrected, the Georgia Republican pays\n$101.25 monthly for his family's standard option plan. Uncle Sam pays the\nrest: $303.77.\nHis plan is the most common one selected by members of Congress, said\nStuart Balderson, financial clerk of the Senate. It is the one that covers\nPresident Clinton's family.\nIts cost also closely resembles the average monthly premium paid by\nprivate-sector workers with a similar family plan. In 1991, at medium and\nlarge companies, workers paid $96.97. At small businesses they paid more, the\nLabor Department says.\nSome workers do much better. Union workers and employees at Fortune 500\ncompanies, for example, often get more generous plans. Typically, they do not\ncontribute toward their monthly premium, benefits may be broader, and they are\nlikely to continue to receive coverage after retirement.\nIf these workers were to get only what Congress gets, they would lose out.\nSo unions and some others are seeking exceptions from the White House. But\nthese are more the exception than the rule.\nMany would do as well, or better, with a Congress-type plan. For the 15\npercent without health insurance an estimated 39 million Americans getting\nwhat Congress gets would be as blessing.\nFor those on Medicaid, the federal health insurance program for the poor,\nbenefits might be narrower but reimbursement rates for health care providers\nwould rise. As a result, said Custer, quality of care probably would improve.\nMedicare beneficiaries who need hospital stays would have lower\nout-of-pocket costs. And for the 30 percent of workers with no\nemployer-provided insurance, a Congress-type plan would ensure them coverage.\nCurrently, all federal workers can enroll in the Federal Employee Health\nBenefits Program, which provides a selection of nearly two dozens plans with\nvarying premiums and benefits. Uncle Sam picks up the tab for an average of 7\npercent of a plan's cost. The worker pays the difference.\nUnlike most private-sector workers, federal employees can continue\nemployer-subsidized coverage after retirement, if they meet eligibility\nguidelines. Only one-fifth of private sector retirees retain coverage\nsubsidized by an employer.\nAmong federal workers, Clinton and his family get perhaps the best\nsupplemental care. They have round-the-clock access to a personal physician a\nthe White House.\nWe'd hope the president has the best care, said Reg McGhee, spokesman\nfor the United Auto Workers union. `If a world crisis happens, we'd hope the\npresident wouldn't be away at his dental appointment for two hours.\nIronically, Clinton's initial proposal would have scrapped the federal\nworkers' plan, hailed for its fine record of cost containment, and required\nthat they join the same purchasing cooperative as other workers in their\ngeographic area.\nYet Kennedy has put the federal plan back into a bill that passed his\nSenate Labor and Human Resources Committee. He argues all workers should be\nentitled to buy from the same system that has produced good benefits and cost\nsavings for members of Congress.\nWhat ultimately happens to health care reform if anything will be the\nresult of a long, bitter battle between Congress and the White House.\nThere are going to be lots of twists and turns in the process, said\nLorrie McHugh, the White House's health care spokeswoman.\n**** filed by:GN-F(--) on 06/25/94 at 13:52EDT ****\n**** printed by: WHPR (JEL) on 06/27/94 at 08:13EDT ****\nNew Senate Proposal Retreats\nOn Required Health Insurance\nModerates' Plan Also Drops Universal Coverage\nBy ROBIN TONER\nSpecial to The New York Times\nAl\nWASHINGTON, June 24- A bipar-\nates' proposal is widely seen as a\ntisan group of moderates on the Sen-\ngood approximation of what the com-\nate Finance Committee unveiled a\nmittee is likely to produce. Democrat-\nnew health plan today that eliminates\nic leaders are eager to get the com-\nany politically contentious require-\nmittee moving, even if it produces a\nments that individuals or employers\nplan that requires substantial revi-\npurchase insurance. But the plan also\nsion later.\nfalls short of guaranteeing universal\nThe moderates argued that theirs\ncoverage, President Clinton's bottom\nwas a politically attainable proposal\nline.\nthat would extend health coverage to\nThe group appeared to decide that\nmillions of uninsured Americans\nit was easier to give up the goal of\nthrough a system of subsidies for low-\nguaranteed universal coverage than\nincome people and new insurance\nproduce a palatable mechanism to\nregulations to make coverage easier\nattain it. The Finance Committee as a\nto get. It would also seek to restruc-\nwhole has been stalled for months\nture the health care market through\nover the issue of how to pay for\nmechanisms like insurance purchas-\nuniversal coverage, and the moder-\ning groups.\nSenator John H. Chafee, Republi-\ncan of Rhode Island and a leader of\nthe group, declared, \"We believe this\nis a very serious advance.\" He esti-\nmated that the plan could eventually\ncover as many as 20 million of the 37\nmillion Americans who now lack\nhealth insurance.\nBut the plan was quickly de-\nnounced by many advocates of health\ncare restructuring because it fails to\nmeet the goal of universal coverage.\nOne of the seven members of the\nmoderate group, Senator Bill Brad-\nley, Democrat of New Jersey, dis-\ntanced himself from the proposal,\nsaying, \"I regret this plan did not do\nmore to achieve universal coverage\nthrough a shared responsibility by\nindividuals and employers.\"\nThe group reached final agreement\nContinued on Page 9, Column I\n1/2\n2\nTHE NEW YORK TIMES, SATURDAY, JUNE 25, 1994\n3\n1\nNEGOTIATIONS\nHealth Plan\nIs Proposed\nBy Moderates\nContinued From Page 1\non the measure in a private meeting\nthis morning, after members decided\nto drop a proposal to guarantee uni-\nversal coverage by ultimately requir-\ning people to purchase health insur-\nance. That idea, known as an individ-\nual mandate, had met fierce resist-\nance from groups representing labor,\nconsumers, health organizations and\nthe elderly.\n\"I started coming to the conclusion\nnobody was for it,\" said Senator John\nB. Breaux, Democrat of Louisiana,\nthe other leader of the group. \"I just\nthought, why on earth am I support-\ning something that nobody else is\nfor?\"\nA Republican strategist close to the\ntalks, who spoke on the condition of\nanonymity, agreed, saying: \"There\nwas no constituency for it. And they\nbelieve these reforms are going to get\nto a substantial level of insur-\nance.\"\nThe 7 moderates will present their\n1 on Monday to the Senate Fl-\nnance Committee, which has 20 mem-\nbers. Many on Capitol Hill consider\nthis proposal to be the best hope of\nbreaking the logjam. The architects\nof the proposal were very much drive\nen by the need to get \"a bill that could\n, Mr. Chafee said.\nThe White House responded to the\ncompromise plan with great caution,\ncontinuing its attempt to keep legisla-\ntion moving through committees\nwhile retaining the hope of ultimately\nfixing it - by restoring universal\ncoverage before final passage.\n\"It's encouraging to see members\nwork in a bipartisan fashion,\" said\nLorrie McHugh, the White House\nspokeswoman on health. \"There will\nbe many twists and turns along the\nI\nto health care reform, but we\nare confident that the road will lead\nto the President's bottom line of uni-\nversal coverage.\"\nator Daniel Patrick Moynihan,\nDemocrat of New York, departed this\nPhotographs by Stephen Crowley/ The New York Time\nafternoon for his farm in upstate New\nAbove, Senators Daniel Patrick Monynihan, Demo-\nversal coverage. Below, from left, Senators Kent\nYork after describing the plan as \"an\ncrat of New York, left, and Bob Packwood, Republi-\nConrad, Democrat of North Dakota, John Chafee,\nextraordinarily powerful proposal.\"\ncan of Oregon, on their way to a meeting with\nRepublican of Rhode Island, John B. Breaux, Demo-\nThe Fight's Not Over\nmoderates on the Finance Committee to discuss a\ncrat of Louisiana, and Dave Durenberger, Republi-\nator Tom Daschle of South Da-\nscaled-down health insurance proposal without uni-\ncan of Minnesota, announcing the plan.\nkota, an influential Democrat on the\ncommittee and a close ally of the\nAdministration, said he doubted that\nChlopak, a spokesman for the group.\nlike allowing new insurance purchas-\nered a plan that, at that point, would\nanything substantially closer to uni-\nThe group of seven has struggled\ning pools for small companies and\nhave required individuals to pur-\nversal coverage could be passed by\nfor an agreement throughout the\nindividuals.\nchase insurance.\nthe Finance Committee. He called the\nweek in a modest room at the end of a\nThese changes, Mr. Durenberger\nproposal a \"good beginning\" and add-\nstuffy corridor on the second floor of\nargued, would make insurance more\nSeeking Middle Ground\ned: \"My guess is this is pretty repre-\nthe Capitol. They included three Re-\naffordable. He said, \"The principal\npublicans Senators Chafee, Dave\nMr. Breaux today argued that their\nsentative of the committee as a\nreason people don't get coverage is\nwhole. But I think you can expect all\nDurenberger of Minnesota and John\nbecause they can't afford it.\" The\nplan represented middle ground.\nC. Danforth of Missouri and four\n\"Our group really had a choice: of\nof the issues to be revisited on the\nplan would also increase the cigarette\nfloor.\"\nDemocrats: Senators Breaux, Brad-\ntax by $1 a pack and impose a new tax\nsiding with that group of people who\nley, David L. Boren of Oklahoma and\nwanted to do everything and do it all\nSenator John D. Rockefeller 4th, a\nKent Conrad of North Dakota.\non high-cost health plans.\nat once, or with those who wanted to\nW\nVirginia Democrat and another\nMuch of the debate has focused on\ndo almost nothing and take a long\nstaunch Administration ally, was\nThe-plan they produced would use\nwhat would happen if these voluntary\ntime doing it,\" he said.\nmore muted. \"I commend the com-\nsubsidies to help low-income people\nchanges and incentives did not\nBut there was substantial skepti-\nmit I and effort of my Finance\nbuy insurance, ultimately aiding peo-\nproduce universal coverage; or some-\ncism off Capitol Hill. The National\nCommittee colleagues, but if this is\nple with incomes up to 2.4 times the\nthing close to it. About 85 percent of\nLeadership Coalition for Health Care\nthe best they have to offer, it only\nofficial poverty level. That would help\nAmericans are insured now. Under\nReform, an alliance of 93 corpora-\nshows we have a lot of work to do.\"\na family of four with an income up to\nthe moderates' plan, if 95 percent of\ntions, unions and health groups. said\nA spokesman for the Health Care\n$35,433. It would also allow a tax\nAmericans were not covered by the\nin a statement that the plan fell\n1\nReform Project, a coalition of 56 civ-\ndeduction for people who paid any of\nyear 2002, a National Health Commis-\nin terms of both improving coverage\nic, elderly and consumer groups that\nthe cost of their insurance: And it\nsion would make recommendations\nand containing costs. That reflected\ncriticized the emerging plan on\nwould require insurance companies\nto Congress on what to do about it.\nthe widely held view in health policy\nThursday, dismissed the final plan\nto end practices like denying cover-\nCongress would have to act on the\ncircles that until everyone is brought\ntoday. \"We view this as the lowest\nage for pre-existing conditions.\nrecommendations but would not be\ninto the health care system, costs will\ncommon denominator, not even close\nIn addition, it would enact a variety\nbound to accept them.\njust be moved from one group to\nto universal coverage,\" said Bob\nof changes in the health marketplace,\nEarlier, the moderates had consid-\nanother rather than being conta\nTHE NEW YORK TIMES, SATURDAY, JUNE 25, 1994\n2/2\n4\nTHE DETAILS\nA Call for Health Cost Curbs,\nBut Not Mandatory Insurance\nBy ROBERT PEAR\nsame premiums to all people buying\nSpecial to The New York Times\ncoverage through purchasing pools in\nWASHINGTON, June 24 - A plan\na particular geographic area. But,\nendorsed today by members of the\nunlike Mr. Clinton's proposal, higher\nSenate Finance Committee is seen as\npremiums for older people would be\na way of getting some form of health\npermitted. There would be five age\nplan through a panel that has been\ncategories, and premiums for the old-\nstalled on the issue for months. Any\nest people could be no more than\nplan leaving the committee could be\ntwice the premiums for the youngest.\nsubstantially modified later.\nCompanies with more than 100 em-\nUnder the bill, private insurers\nployees would be able to buy private\nwould have to offer coverage to all\nhealth insurance or serve as their\napplicants at standard rates calculat-\nown insurers, paying claims from\ned by the Government. To help people\ncorporate assets as many companies\npay the premiums, the Federal Gov-\nnow do.\nernment would offer subsidies to mil-\nThe bill says insurance purchasing\nlions of Americans, including many\ngroups could negotiate prices with\nwith incomes substantially above the\ndoctors and hospitals but would not\nofficial poverty level, which is new\nhave to sign contracts with all doct-\n$14,764 for a family of four.\ntors and hospitals in their areas.\nThe proposal would also help peo-\nA novel feature of the Chafee-\nple buy coverage by creating a new\nBreaux proposal is a mechanism to\ntax deduction for people who pay any\nprevent any increase in Federal\nof the cost of their health insurance.\nhealth spending beyond what is at-\nUnder current law, self-employed\nready projected. If outlays exceeded\npeople can take a deduction for 25\nthose projections, Congress could\npercent of the amount they pay for\nrein in spending. If Congress took no\nhealth insurance for themselves and\naction, Federal subsidies for low-in-\ntheir families. The new proposal\ncome people would be automatically\nwould increase the deduction to 100\nreduced and higher taxes would be\npercent and make it available to all\nimposed on insurance plans. Tax de-\npeople who spent their own money on\nhealth insurance, not just the self-\nemployed.\nA plan for more\nTaxes to Cover Costs\nSenators John H. Chafee, Republi-\naffordable health\ncan of Rhode Island, and John B.\nBreaux, Democrat of Louisiana, are\nthe leaders of the effort that produced\ncoverage would not\nthe bill. They estimate that the subsi-\ndies and the new tax deduction would\nmake it universal.\ncost the Federal Government $246\nbillion over five years. The bill would\ncover part of this cost with a $1\nductions for the cost of health insur-\nincrease in the Federal cigarette tax,\nance would be limited, and consum-\nnow 24 cents a pack. It would also tax\ners could be required to pay larger\nthe 40 percent of insurance plans\nportions of their medical bills.\ncharging the highest premiums in\nConsumer Group Is Opposed\nany geographic area.\nUninsured people and businesses\nSupporters of this proposal de-\nwith 100 or fewer workers would be\nscribed It as a way to avoid increases\nable to pool their purchasing power in\nin the Federal budget deficit. But\nregional groups. Nothing in the bill\nCathy L Hurwit, legislative director\nwould require such groups or limit\nof Citizen Action, a consumer group\nthe number that could operate in a\nwith three million members, said:\ngiven area. The groups would be simi-\n\"The cumulative effect of these ac-\nlar to the regional purchasing alli-\ntions would be to increase costs to\nances proposed by President Clinton,\nconsumers or reduce their benefits.\nbut they would be smaller and have\nThose responsible for the cost in-\nless power to control health costs.\ncreases - the insurance industry,\nThe subsidies envisioned in the new\ndrug companies, some hospitals and\nbill would eventually be available to\nhealth maintenance organizations -\npeople with incomes up to 2.4 times\nget off scot-free.\"\nthe official poverty level. For a fam-\nThe bill includes several restric-\nily of four, the income celling would\ntions on medical malpractice law-\nbe $35,433 a year.\nsuits. Damages for pain and suffering\nThe Chafee-Breaux bill would set\ncould not exceed $250,000, and there\nup a National Health Commission to\nwould be new limits on fees for plain-\nassess progress toward the goal of\ntiffs' lawyers. Doctors have sought\nuniversal insurance coverage. The\nsuch changes, but consumer groups\ncommission would report to Congress\ngenerally oppose them.\nevery two years, describing the unin-\nThe new proposal would leave\nsured and the reasons they lacked\nMedicare as a separate program for\ncoverage. If more than 5 percent of\nelderly and disabled people. It would\nAmericans still lacked coverage in\nalso offer additional benefits, like pre-\nthe year 2002, the commission would\nscription drug coverage, for people\nadvise Congress on how to attain uni-\nwho joined health maintenance or-\nversal coverage. Congress would\nganizations or other private health\nhave to vote on the commission's\nplans under Medicare.\nrecommendations within a certain\nThe Senators' proposal, like Presi-\nperiod, to be specified later. At\ndent Clinton's bill, calls for substan-\npresent, at least 37 million Ameri-\ntial cutbacks in the growth of spend-\ncans, 15 percent of the population,\ning on Medicare and Medicaid, the\nhave no health insurance.\nprogram for low-income people. That\nThe commission would also define\nwould be achieved mainly by restrict-\na standard package of health benefits\ning doctors' and hospitals' payments.\ncovering doctors' services, hospital\nThe Senators' proposal would re-\ncare, prescription drugs, family plan-\nduce projected spending for Medi-\nning, X-rays and laboratory services.\ncare and Medicaid by $133 billion, or 7\npercent, over five years. The Clinton\nUnder the Chafee-Breaux bill, in-\nplan would cut $50 billion more from\nsurers would charge roughly the\nthe programs' projected growth.\nTHE NEW YORK TIMES, SATURDAY, JUNE 25, 1994\n12\nSenate Moderates Reach Compromise\non Health Care Legislatio\nBy Dana Priest\nThe rump group of moderates had\nallow final floor passage of anything\nWashington Post Staff Writer\nconvened to try to find a compro-\nnow under consideration.\nmise. Its proposal announced yester-\nSenate Minority Leader Robert J.\nAfter toiling for a week to pro-\nday would eschew employer man-\nDole (R-Kan.), who previously had\nsuce a consensus document, a bipar-\ndates, but would seek to ensure\nbacked many of the rump group's\nisan group of Senate moderates\ncoverage for all through a system of\nideas, denounced the effort this\nesterday proposed a limited health\ngovernment-funded vouchers for\nweek as a bipartisan position ap-\ncare package they hoped would\nlow-mcome Americans, new taxes\npeared near. Dole announced he\nCheak a deadlock in the influential Fi-\nimposed on higher-priced packages\nwould support a conservative, bare-\nnance Committee.\nand increased cigarette taxes, and\nbones package that would rely pri-\nSen. John H. Chafee (R-R.I.), who\nthe establishment of voluntary pur-\nmarily on changes in insurance rules\nsed the effort, said the plan repre-\nchasing groups for small businesses.\nto make coverage more affordable.\nented what the group believed was\nIf the measures failed to provide\nSenate Majority Leader George J.\nmeasure that could pass\" the Sen-\ncoverage for 95 percent of all Amer-\nMitchell (Maine) and other Demo-\nate.\nicans by the year 2002, a national\ncratic heavyweights publicly ap-\nBut in an indication of the ongoing\ncommission would recommend new\nplauded bipartisanism. But Mitch-\ndifficulties of reaching even limited\nmeasures to Congress.\nell's chief health care deputy, Sen.\ncongressional agreement on health\nThe other senators in the group\nThomas A. Daschle (D-S.D.),\nsare reform, two of the eight-mem-\nare Republicans John C. Danforth\nwarned about compromising too far.\nher group's five Democrats quickly\n(Mo.) and Dave Durenberger\n\"If we're fashioning legislation de-\ndisowned the proposal.\n(Minn.), and Democrats John Breaux\nsigned to bring about a certain num-\nIn a statement withdrawing his\n(La.), David L. Boren (Okla.) and\nber of votes, it's the wrong ap-\nsupport, Sen. Bill Bradley (D-N.J.)\nKent Conrad (N.D.).\nproach,\" he told a small group of\nsaid: \"I regret this proposal did not\nSenate Finance is one of five com-\nreporters. \"I'm prepared to support\ndo more to achieve universal cover-\nmittees-two in the Senate and\nsomething that will pass by the nar-\nage.\" The group's plan would not\nthree in the House-with jurisdic-\nrowest majority.\"\nguarantee health insurance for all\ntion over health care, and each is\nBoth the president and Hillary\nAmericans by a certain date-the\ntrying to pass its own bill. Those\nRodham Clinton continued stumping\nbottom line for President Clinton\nbills then will be melded by the lead-\nfor the Clinton plan, insisting that as\nand many of his supporters in Con-\nership, with the resulting bill in each\nfar as the White House was con-\nchamber debated and voted on.\ncerned. universal coverage was non-\ngress.\nSen. Max Baucus (D-Mont.), who\nTwo of the five committees, one\nnegotiable.\nalso withdrew from the effort, said\nin the Senate and one in the House,\nSee HEALTH, A5, Col. 1\nthe plan \"would not do anything to\nhave now passed bills-both of them\nreduce the annual growth of health\nclosely resembling Clinton's propos-\ncare costs.\"\nal, providing universal coverage for\nMeanwhile, Finance Committee\nall Americans and mandating that\nChairman Sen. Daniel Patrick Moy-\nemployers pay for most of it.\nnihan (D-N.Y.), who yesterday\nThe Senate's Labor and Human\nmorning praised the group's effort\nResources Committee, chaired by\nas \"incredibly powerful\" and said it\nSen. Edward M. Kennedy (D-Mass.),\ncontained \"a lot of good ideas,\" by af-\nearly this month passed a bill much\nternoon was said by his staff to feel\nlike Clinton's plan that is likely to be\nthe plan \"had gone so far off base\"\nattacked strongly on the floor by the\nthat little of it was acceptable.\nsame conservatives and business in-\nMoynihan plans to introduce on\nterests who have fought so hard\nMonday his own version of a health\nagainst employer mandates in the\ncare reform plan, which will include\nFinance Committee.\nslightly stronger guarantees of uni-\nOn Thursday; the liberal House\nversal coverage, according to con-\nEducation and Labor Committee\ngressional sources. The committee\npassed a similar bill, requiring em-\nis due to begin public discussions of\nployers to pay 80 percent of the cost\nthe issue next week, in hopes it\nof employee insurance. The commit-\neventually can agree on a bill.\ntee also passed \"without recommen-\nThe Finance Committee has been\ndation\" a separate bill that would\ndeadlocked for months as Republi-\nprovide tax-paid, government-man-\ncans and conservative Democrats\naged insurance for all Americans.\nrejected \"employer mandates\" re-\nBut while the congressional pro-\nquiring employers to pay for work-\ncess continued this week, and the Fi-\ners' health insurance, and more lib-\nnance Committee rump group\neral Democrats insisted that any bill\nworked painstakingly away in Cha-\nfulfill Clinton's pledge of universal\nfee's Capitol Hill hideaway office,\ncoverage. None of the plans that al-\nDemocratic and Republican leaders\nready had been proposed, including\nwere hardening their public posi-\nClinton's bill, had enough votes to\ntions and seemed further than ever\npass the committee.\naway from a compromise that would\n26\nTHE\nWASHINGTON\nPost\nSATURDAY,\nJUNE\n25,\n1\n2\nHealth Proposal May Break Deadlock\nHEALTH, From A4\nothers turned back several of their\nRostenkowski, who was ousted from\namendments, worried that the\nIn one of the more convoluted\nthe committee chair after being in-\nhealth care bill being crafted there\ntwists of health care politics, Dole\ndicted last month, had planned to\nwill be too liberal.\nsuggested in a closed-door Finance\nmake changes to the subcommittee\nGibbons \"is ardently and zealously\nCommittee meeting that the com-\nbill that would be more favorable to\nfighting to defend\" his own proposal,\nmittee publicly criticize Hillary Clin-\nprivate business.\nsaid Rep. Michael A. Andrews (D-\nton for suggesting that some mem-\nAs the committee broke up for\nTex.).\nbers of Congress are unwilling to\nthe evening last night, due to meet\nGibbons's plan, which includes the\ngive the American public the same\nagain today for a six-hour session,\nlevel of health care they accord\nemployer mandate, closely resem-\nGibbons declared. \"We're going to\nthemselves. According to congres-\nbles one approved several months\nvote out of the Ways and Means\nsional sources who were in the\nago by a Ways and Means subcom-\nCommittee before we go home for\nroom, Moynihan agreed that Clinton\nmittee headed by Rep. Fortney\nthe Fourth of July recess a health se-\nwas out of line and promised to\n\"Pete\" Stark (D-Calif.), of whom Gib-\ncurity bill for the whole nation,\" one\nspeak to the White House about the\nbons-unlike his predecessor as\nthat will cover all Americans \"from\nmatter.\nchairman, Rep. Dan Rostenkowski\nClosed-door caucuses continued\n(D-III)-is a great admirer.\nbirth to death and even before they\nyesterday in the House Ways and\n\"He's like a teacher, a coach, a\nare born with prenatal care\nprofessor,\" said Gibbons of Stark.\nWe're going to get there!\"\nMeans Committee, where some\nmoderate members, frustrated when\nThe clash of egos between Stark and\nStaff writer Spencer Rich\nChairman Sam Gibbons (D-Fla.) and\nRostenkowski was well-known, and\ncontributed to this report.\nhis administration unfairly emphasized its failures and\nignored its accomplishments.\nHe said news reporting today was `much more negative\nSenate Health Proposal Does Not Guarantee Coverage\nmuch more editorial and much less direct\" than\nfor All (Washn) By Karen Tumulty= (c) 1994, Los Angeles\never before.\nTimes=\nAnd he said the American people were subjected to a\nWASHINGTON A bipartisan group of senators on the\nconstant unremitting drumbeat of negativism and\nFinance Committee unveiled the fruits of its closely\ncynicism\" from talk radio particularly Limbaugh and his\nwatched attempt to produce a compromise health care plan\nmany imitators.\nFriday, but despite weeks of effort, their proposal failed\nHe noted that Limbaugh would follow him on the same\nto reach President Clinton's bottom-line goal of\nradio station for three hours without any opportunity for\nguaranteed coverage for every American.\nresponse or challenge.\n\"There have been created unrealistic expectations of\n`And there's no truth detector,\" Clinton said. You\nwhat can be achieved,\" Sen. John Chafee, R-R.I., the\nwon't get on afterwards and say what was true and what\nleader of the group, said in defending the new proposal.\nwasn't.\"\n`This compromise sends a clear message to the American\nLimbaugh, in his show Friday, answered the president\npeople that we will not allow health care reform to be\nmockingly, \"There is no need for a truth detector. I am\njeopardized by extremists from either party.\"\nthe truth detector.\"\nOf the five congressional committees charged with\nproducing health legislation, the Finance Committee has\nbeen viewed as the most crucial battleground for Clinton's\neffort to overhaul the health care system, in part because\nthe committee's membership closely reflects the range of\nWhite House Maintains Support for Breyer (Washn) By\nopinions on the difficult issue that exist in the Congress\nMelissa Healy and Paul Richter= (c) 1994, Los Angeles\nas a whole.\nTimes=\nAnd the moderates' failure to bridge the gap between\nWASHINGTON The White House, reacting Friday to a\nClinton and his opponents represented at least a temporary\nreport that Supreme Court nominee Stephen G. Breyer ruled\nsetback for the administration.\nin cases in which he had major financial interests,\nStill, although few expect the Chafee formulation to\ndeclared its continued confidence in the Boston judge and\nbecome law as presented, it could prove crucial in moving\nsaid that it does not expect the charges to affect his\nthe process along.\nnomination.\nTo date, only the Senate Labor and Human Resources\nBreyer, who had as much $500,000 invested in the\nCommittee has managed to produce a bill for consideration\ninsurance conglomerate Lloyds of London in the mid to late\nby the full Senate and its measure is widely considered\n1980s, ruled in several cases that dealt with companies'\nfar too liberal. That has increased the pressure on the\nliability for the clean-up of Superfund sites, according\nFinance committee's moderates to find more acceptable\nto a report in Newsday.\nmiddle ground or risk losing any chance for significant\nThe rulings may have affected the London firm's\nreform.\nexposure to liability in legal actions that involved\nThe president emphasized in speeches this week that he\nSuperfund sites, as well as in asbestos cases, the Newsday\nis sticking to his promise to veto any legislation that\nreport suggested.\ndoes not guarantee coverage for the roughly 39 million\nLegal ethicists responded with caution to the report.\npeople about 15 percent of the population who now lack\nBut Senate aides said it will almost certainly prompt a\nit.\nfurther look.\nAnd Senate supporters of the Clinton plan had insisted\n`Are alarm bells going off in the Senate? No,\" said\nthey could accept the moderates' plan only if it\none Senate staff member. Should people be concerned and\nguaranteed universal coverage.\nwill (the committee) inquire? Yes.\"\nOn Friday, however, some Clinton allies on the Finance\nClinton administration officials, however, disputed the\nCommittee shifted their ground slightly, saying they might\nsuggestion that Breyer issued rulings in cases where he\nvote for the proposal even without the guarantee as a\nknew his investments were at stake. The judge regularly\nmeans of getting the issue to the Senate floor and\ndisclosed his investment with Lloyds by filing public\navoiding the embarrassment of failing to produce a\nfinancial documents with the government, officials said.\ncommitte bill.\nAdditionally, officials said, Breyer \"went far beyond\nThe Finance Committee had been scheduled to begin\nwhat the rules require\" by instructing the broker who\ndrafting a bill on Monday, but Friday evening announced\nplaced his Lloyds investment to steer clear of units\nthat it would delay meeting in public until later next\nwithin the insurance group that had stakes in American\nweek.\ntort liability.\nBeyond those instructions, White House officials said,\n(Optional add end)\nBreyer was not in a position to learn the firms his\ninvestments were used to underwrite. Thus, they said, he\nThe conservative Democrats and moderate Republicans\ncould not knowingly have ruled in cases where he had a\nallied with Chafee had been meeting feverishly in recent\npersonal financial stake.\ndays, hoping to produce a plan that could both meet\nLloyds, one of the world's largest and most prestigious\nClinton's universal coverage test and claim significant\ninsurance firms, is made up of ``syndicates\" groups of\nsupport from both parties.\ninvestors who hope to reap returns when the insurance\nTheir initial strategy for achieving universal coverage\npremiums collected are greater than the claims made\nwas a so-called ``individual mandate\" a requirement that\nagainst them.\nuninsured workers be required to buy health insurance,\nWhite House Counsel Lloyd N. Cutler told Newsday that\nmuch the way car owners must buy accident insurance under\nthere was no case to Judge Breyer's knowledge where his\nsome state laws. The individual mandate was to kick in\nsvndicate or Llovds itself had an interest in the\nonly if voluntary efforts failed at expanding coverage to\nparticular case he was deciding.\"\n95 percent of the workforce.\nThe senators hoped that approach would be an acceptable\nalternative to Clinton's proposal for requiring employers\n48\nto pay 80 percent of the cost of their workers' health\nTimes=\ncoverage. Clinton's employer mandate has drawn intense\nStock and bond prices took another drubbing Friday\nopposition from business, which contends that the\nafter central banks worldwide failed in an effort to\nadditional costs would force smaller and weaker firms to\nbolster the dollar against other currencies, thus\nlay off workers, or shut down altogether.\nenhancing fears that the Federal Reserve Board again will\nThe senators' plan for an individual mandate was\nraise U.S. interest rates.\nattacked from both the left and the right, and ultimately,\nThe Dow Jones average of 30 industrials tumbled 62.15\nthey decided against suggesting any requirements on\nto 3,636.94 its worst daily decline since losing 72.27 on\nemployers or their workers.\nMarch 30, and dropping the blue-chip average to its lowest\nInstead, they would put into motion an intricate series\nlevel in six weeks.\nof reforms aimed at making health coverage more affordable\nIt was the average's fifth loss in six sessions, during\nand thus more nearly universal.\nwhich the industrials have skidded 174.40 points, or 4.5\npercent. This week alone, the Dow Jones industrials\nsuffered their worst pummeling since mid-October in 1989.\nLosers overall swamped gainers by nearly five to one on\nTwo Indicted in Immigration Fraud Case (Los Angeles)\nthe New York Stock Exchange, but the session was not a\nBy Patrick J. McDonnell= (c) 1994, Los Angeles Times=\nrout. Big Board volume was a moderate 261 million shares,\nLOS ANGELES In one of the largest cases of such\nwell below the average daily turnover so far this year.\nimmigration fraud, a federal grand jury Friday indicted a\nIn the credit markets, government bond prices skidded\nSouthern California couple on suspicion of filing more\nand their yields soared amid investors' expectations that\nthan 2,600 bogus claims for political asylum.\nthe Federal Reserve will now try to prop up the dollar by\nAuthorities charged that the couple doing business as\nraising U.S. interest rates for the fifth time this year.\nGeneral Office Services out of sites in the Los\nAngeles-area communities of El Monte, Azusa and Santa Ana\nThe Treasury's bellwether 30-year bond lost more than\nemployed a now-common scheme: Duping applicants, mostly\n1&1/4 points, or 12&1/2 for every 1,000 in face value,\nillegal immigrants from Mexico, into thinking they were\nwhile its yield jumped to 7.52 percent from 7.40 percent\nmerely applying for permits to work in the United States.\non Thursday.\nStocks came under pressure at the opening bell, with\nInstead, authorities said, the suspects charged clients\ntraders knowing that foreign stocks already had plummeted\nup to $1,150 to file the phony applications for political\non news that the Federal Reserve and several other central\nasylum.\nbanks had been unsuccessful in propping up the dollar by\n\"The immigrants themselves have been duped by these\ndirectly buying dollars in currency markets.\npreparers and are victims in this whole scenario,\" said\nIndeed, after only 90 minutes of trading, the Dow Jones\nRosemary Melville, who heads the Los Angeles asylum office\nindustrials had lost more than 50 points, which activated\nof the U.S. Immigration and Naturalization Service.\nthe NYSE's \"circuit breaker\" constraints designed to\nAfter obtaining clients' signature on the application\nlimit the market's volatility. The constraints stayed in\nforms, authorities said, the suspects filled in data about\nplace for the rest of the day.\nthe purported political asylum claims.\n\"The big disappointment today is we had a concerted\nMost of the documents featured identical assertions,\neffort to support the dollar, and the currency traders\nofficials said, contending that applicants were opposition\nwon,\" said Gail M. Dudack, market strategist at S.G.\nparty members in Mexico and had been beaten by Mexican\nWarburg & Co. in New York. \"Now there's this whole pallor\npolice. All feared for their lives if they returned home,\nthat just hangs over the market.\"\nthe applications stated.\nThe dollar traded late in the day at 100.45 Japanese\nMany applicants receive work permits as a result of\nyen, down 0.8 yen from levels late Thursday and near a\ntheir applications while their cases are being considered.\npost-World War II low, and at 1.584 Deutsche marks, down\nHowever, work permits in this case were later revoked and\n0.019 mark, to reach a one-year low against the German\nthe applicants subject to deportation once officials\ncurrency.\ndetermined that the asylum claims were bogus.\nThe number of asylum applicants from Mexico has been\n(Begin optional trim)\ngrowing sharply, authorities say, although Mexican\nnationals seldom qualify for political asylum. Foreigners\nWith the greenback still in retreat, investors ``are\npersecuted in their homelands because of their race,\nnervous that the Fed is going to have to raise interest\ncreed, political opinions or membership in social groups\nrates to correct the decline in the dollar,\" said Stephen\nmay qualify for asylum, allowing them to remain and work\nE. Keane, research director at the brokerage Robert W.\nin the United States.\nBaird & Co. in Milwaukee.\nCharged were Cecilia Parra Sanchez, 45, and her\nAmong other things, the dollar's weakness prompts\nhusband, Emilio Parra Garcia, 27, of San Bernardino,\nforeign investors to dump dollar-denominated stocks in\nCalif. He was arrested earlier this month at his home but\nsearch of better returns from investments based in other\nhis wife remains a fugitive, authorities said.\ncurrencies. Because they expect the Federal Reserve to\nFederal agents searching the couple's home discovered\ndrive rates higher in defense of the dollar, investors\ncopies of 2,601 fraudulent asylum cases that had been\nalso pushed bond prices lower, which in turn lifts the\nfiled with the INS, U.S. Attorney Nora M. Manella said.\nbonds' yields.\nIf convicted on all charges, each suspect faces maximum\nThere's also the concern that if U.S. rates keep\npossible sentences of 20 years in prison and $1 million in\nclimbing, they will dampen the nation's and state's\nfines.\neconomic growth and lead to disappointing corporate\nprofits that also could push stocks lower.\n(End optional trim)\nStocks, Bond Prices Tumble After Central Banks Fail to\nAfter the opening plunge, stocks stabilized for much of\nBoost Dollar By James F. Peltz= (c) 1994, Los Angeles\nthe session but then resumed their decline in the final\n49\nopportunity to change priorities offered by the collapse of the\nClinton's proposing a bill that, at 1,364 pages, was so\nSoviet Union is lost in the fog.<\ncomplicated there was never a chance people would be able\nWith the Cold War over, a real debate about the\nto keep its provisions straight. Then, when the first\nU.S. world role is needed. Instead we witness a Gresham's law\ncongressional opposition arose, White House officials\nof politics: Counterfeit partisan posturing displaces real policy\nbegan saying that everything was negotiable except for\ndebate. No wonder Americans have learned to hate politics.<\nuniversal coverage. This meant open season.\nV\nNow almost every major chairman of a relevant committee\n^end adv sun june 26<\nin the House and Senate has a reform bill most\ncobbled-together admixtures of buzzwords and loopholes. An\nexample is the \"trigger\" provision every bill suddenly\nseems to contain. Rather than an immediate requirement\nthat employers provide health insurance, \"trigger\"\nprovisions specify that if all Americans do not acquire\nAdv sun june 26\nhealth coverage five or 10 years down the road, employer\nAt the Stretch on Health Care But What's the Plan?\nmandates would be imposed. The \"trigger\" approach is a\nGregg Easterbrook is a contributing editor to Newsweek and\nclassic example of the political gimmick of taking credit\nthe Atlantic Monthly. By Gregg Easterbrook= Special to\nfor action today but postponing the hard work into the\nthe Los Angeles Times=\nfuture.\nAnyone remember the Gramm-Rudman bill? Enacted in\nWASHINGTON As a congressional vote on health-care\n1985,\nreform draws near, it is important to keep Rita's phone\nit declared with great fanfare that henceforth Congress\nnumber in mind. In 1981, when the tax-cut plan proposed by\nwould be compelled to balance the budget but postponed\nRonald Reagan was approaching its floor vote, the\nenactment of balanced budgets into future years.\nprovisions of the bill were changing so frantically that\nGramm-Rudman allegedly had \"trigger\" provisions that\nmembers of Congress never saw a printed version of the bill\nfuture sessions of Congress would never be able to dodge.\nbefore the final vote. Instead they voted yea or nay on a\nEvery one was dodged.\nsheaf of handwritten pages scrawled down by White House\nHealth-care trigger provisions appear to have about as\nlobbyists. One page included the notation, \"CALL RITA,\"\nmuch actuality as Gramm-Rudman. Because there is zero\nwith a phone number. This historic message was then\nchance that universal coverage will achieve itself\ndutifully transcribed into the U.S. Code of Federal\nspontaneously, either an employer-mandate trigger would be\nRegulations. After all it had been formally approved by\n\"hard,\" written in such a way as to be automatic, and\nCongress.\nthus would be a dishonest provision, shifting the\nIt turned out the legislators who voted on the 1981 tax\naccountability to a future Congress and White House; or\ncut bill not only did not know that it contained Rita's\nthe trigger would be \"soft,\" a Gramm-Rudman-style\nnumber, they barely understood any of the provisions:\nprovision written so it can be easily circumvented.\nchief among them that the law would create the\nThat prominent Democrats such as Sen. Daniel Patrick\nmega-deficits that have plagued the federal government\nMoynihan of New York are now speaking kindly of triggers,\nsince.\nand Clinton has said he will consider them, indicates that\nThis is the gathering dynamic on health-care reform.\nserious health-care reform is in the process of\nHardly anyone can keep the provisions of the various\nevaporating. In fact at this point it's not even clear\nmanaged competition\" proposals straight anymore. There\njust what reform Clinton's bill would achieve, let alone\nexists considerable danger that when the House\nwhat would be achieved by any of the many watered-down\nand Senate act to restructure the $900 billion health-care\nalternatives.\nindustry that, at about 14.5 percent of the gross national\nClinton's plan, all major Democratic alternatives and\nproduct, is larger than the auto and petroleum industries\nthe moderate Republican alternative backed by Sen. John H.\ncombined, many members of Congress will have only the\nChafee of Rhode Island ought to be rechristened\nfaintest notion of what is in the bill.\n``insurance-reform\" bills. All would outlaw the practice\nLet's see, there's the Clinton plan, the Cooper plan,\nof health insurers barring coverage for those with\nthe Cooper-Breaux version of the Cooper plan, the Kennedy\npre-existing illnesses; make it easy for people who change\nplan, the Moynihan plan, the Chafee plan and the Dole plan\njobs to change plans; make it easy for the self-employed to\nto cite only the major proposals. These plans call for\nbuy health insurance; impose some version of ``community\nsome version of voluntary mandated, subsidized,\nrating\" where premiums are about the same for all who\nmarket-oriented, standardized, individual,\nsubscribe to the same plan, and require standardized\ntrigger-financed, seasonally rotated, regional alliances\ninsurance packages so that consumers could make meaningful\n(with subsection D attainment zone waivers) for universal\nprice comparisons when they shop polices.\ncoverage (except for those not covered) beginning in the\nAll these are valid reforms whose enactment will\n1998-23rd Century time frame. The cost will be precisely\nbenefit consumers. Most are even reforms the\napproximately $25.95 to $500 billion, although we haven't\nhealth-insurance industry knows are needed, but that will\nyet figured out if that is annually, or per person.\nonly work if realized through uniform national legislation\nNot only are the provisions of the plans dimly\nthat keeps competition among individual companies equal.\nunderstood: They are now changing so fast even policy\nBeyond that it's not clear what, if any, health-care\nwonks have difficulty remembering what stipulation is in\nreform will be accomplished. Clinton has repeatedly and\nwhich bill. After all those months of Hillary Rodham\nrightly said the fact that the United States is the sole\nClinton's black-cloaked health-care monks coming to\nindustrial nation without universal health care is an\nnuanced positions covering minute details, now in the rush\noutrage, and that he would veto any bill that does not\nto enact something matters as fundamental as whether\ncreate universal health care. But his is the sole\nemployers will be required to pay for health coverage or\n``managed competition\" bill facing this issue head on.\nonly asked to pay are being revised on an almost daily\nSen. Edward M. Kennedy's plan waffles. The Cooper bill,\nbasis. New cost estimates are essentially being pulled out\nauthored by Rep. Jim Cooper D-Tenn pointedly dodges\nof the air.\nuniversal coverage. Moynihan's makes hazy promises about\nTo a certain extent this is a predictable result of\nrevisiting the issue in a decade or so.\nFurther on the nonreform front, Clinton's mandatory\n5\nregional health alliance requirement (whatever it means;\nno one has ever understood it) is teetering and may be\nwithdrawn. Some of the plans now call instead for creation\nof health-purchasing cooperatives, but these sound\nhauntingly like existing HMOs and PPOs.\nAnd the goal of containing health costs the goal that most\nfrightened the entrenched hospital, pharmaceutical and\nphysician interests has, to the pleasure of these groups, been\nforgotten in the ruckus. Cooper's plan contains some\nnonbinding mumbo-jumbo about how it would be nice if\nmarket forces drove down costs. Clinton's plan is gradually\nbeing stripped of what meaningful cost-control measures it\nonce had. The Kennedy, Moynihan, Chafee\nand other proposals barely mention cost controls.<\nIf what ultimately passes Congress is\nhealth-insurance reform plus some vague language about\npurchasing co-ops, the aftermath for Clinton will be strange.\nGenuine good would be done by such a bill, particularly for\nthe self-employed and those in the Kafkaesque position of\nbeing unable to obtain health insurance because they need it.<\nHealth insurance reform is a long overdue objective\nthat neither Ronald Reagan nor George Bush would have\ntouched with a 10-meter pole. Had the goal going in been\nhealth-insurance reform, Clinton would deserve praise for\nreaching it. But Clinton set for himself the high moral goal of\nuniversal coverage, and now may not attain it. This will enable\npundits and Clinton's\nopponents to portray the bill as a defeat.<\nVoters may end up thinking of the bill as a success\nfor Clinton because the insurance-reform aspects will be a\nboon to the middle class, particularly anyone who changes jobs\nor falls ill. Today middle-class complaints about health care\nturn not on costs or quality but on the problems of obtaining\nor keeping coverage. These will likely be solved by whatever\nbill Congress enacts.<\nTo the extent middle-class voters come to feel their\nhealth-care complaints have been resolved by Clinton's actions,\nthey will care less about the system's two basic faults the\nshameful lack of coverage for 15 percent of Americans, and\nthe health-cost spiral that consumes ever-more national\nwealth.<\nMeanwhile, the sole bill that does address both\nuniversal coverage and the need to control costs the\nnational-health or \"single payer\" legislation sponsored by Rep.\nJim McDermott, D-Wash., now has 91 co-sponsors. This\nmeans that despite the continuous impression given in\nhealth-care commentary that no sentiment exists in U.S.\npolitics for national health care, nearly a quarter of the House\nis now on record as favoring this approach.<\nBritish-style national health care would be a\ndisaster. But France and Germany have national-health systems\nthat provide universal coverage at a significantly lower\npercentage of GNP than the U.S. system, with no rationing, no\nwaiting lines, hi-tech care and handsome incomes for doctors.\nThese systems combine that best of market medicine private\npractice physicians, privately administered insurance pools\nwith national cost controls. National health care can work. It\nwill work someday in the United States: maybe sooner than\nyou think, especially if what is billed as sweeping health-care\nreform passes in 1994, but fails to address the system's root\nproblems of cost runaway and the uninsured.<\nV\n^End sun adv june 26<\n55\nsenawis present\nom\nse\nBy J. Jennings Moss\nTHE WASHINGTON TIMES\nPoll sees clamor for family doctors\nA group of moderate senators\non the Senate Finance Committee\nshould go to specialists.\nyesterday unveiled the details of à\nBy Kevin Robbins\nBCRIPPS HOWARD NEWS SERVICE\nI The survey found t at 89 per-\nhealth care compromise that\ncent of the respond ents have\nwould rely largely on market re-\nAmericans want more family\nsome kind of health insurance.\nforms to insure Americans and\ndoctors and a health care system\nConducted in April, the bi-\ncontrol costs but would impose no\nthat makes better use of them,\npartisan survey confirms the\nmandates.\naccording to a survey released\npopular notion that Americans\nThe proposal, crafted over the\nyesterday by the W.K. Kellogg\nprefer family doctors to medical\npast week by four Democrats and\nFoundation.\nspecialists. They also bestow a\nthree Republicans, is a significant\nA majority prefers that its tax\nbetter image on family doctors\nshift to the right from both Pres-\ndollars be used to train more pri-\nthan on specialists\nident Clinton's reform proposal\nmary care providers rather than\nAbout a third of the respon-\nand one originally crafted by Sen.\nspecialists.\ndents listed \"more expertise\"\nJohn H. Chafee. Mr. Chafee, Rhode\n\"They see a role for both,\" said\nand \"knowledge in one area\" as\nIsland Republican, was a member\nCelinda Lake, one of two poll-\nthe chief benefits of pecialists.\nof the moderate group.\nsters conducting the survey.\nWhen asked about fi mily doc-\nBut just as soon as members of\n\"But they want to keep a bal-\ntors, the largest majority - 20\nthe group began discussing the\nance\" favoring the family doc-\npercent - ranked kno wledge of\nspecifics of the plan, some sen-\ntor.\npersonal and family medical\nators - including some of the\nEighty-four percent of the\nhistory as the primar benefit.\ngroup's own participants raised\n1,000 people surveyed said \"suc-\n\"On balance, fami y doctors\ndoubts about the $250 billion plan.\ncessful health care of the fu-\ncome out with a much better im-\nSen. Max Baucus, Montana\nture\" should make more use of\nage,\" said Vincent Bre glio, a Re-\nDemocrat and an original member\nfamily doctors. Eighty percent\npublican pollster wi 0 worked\nof the bipartisan group, withdrew\nsaid more use should be made of\nwith Democrat Lake.\nhis participation on Wednesday\nnurses, while 67 percent said the\nRecalling the a chetypal\nbecause of the direction toward\nsame of \"basic health care pro-\n\"Marcus Welby\" TV episodes,\ntaxing health care benefits. The\nviders.\"\nMr. Breglio said Americans are\ntax would be imposed on the top 40\nOnly half said more use\nmore likely to enjoy a \"consis-\npercent of health plans in a re-\nPhoto Ross D. Franklin/The Washington Times\nshould be made of medical spe-\ntent, ongoing relation ship\" with\ngional area.\nCorrespondents reach for a handout after a news conference revealing the new bipartisan health care plan.\ncialists.\nfamily doctors than with spe-\nThe tax, which was included in\nA majority said more tax\ncialists.\nthe proposal, \"will be passed on by\nmoney should go toward the\nThe foundation said that from\nthe insurance companies to the\nable. As four members from the\npay most of the cost of their work-\n95 percent of the public covered\neducation and training of family\n1982 to 1992, the percentage of\nmiddle-class worker who is al-\nseven-person group briefed the\ners' Insurance while Mr. Chafee's\nby the year 2002. If that target is\ndoctors, nurses and basic health\nmedical students cheosing pri-\nready paying exorbitant health in-\npress about its details, aides to an-\noriginal health plan relied on an\nnot reached, then a national health\ncare providers. Thirty-seven\nmary care had fallen from 36\nsurance premiums,\" Mr. Baucus\nother member Bill Bradley,\nindividual mandate.\ncommission would make recom-\npercent said more tax money\npercent to 14 percent\nsaid.\nthe lawmaker who floated the orig-\nBoth the Clinton plan and the\nmendations to Congress to flx the\nMr. Chafee, at a packed news\ninal draft of what the group\nChafee plan used the mandate ap-\nproblem. Congress would have to\nconference at the Capitol, said, \"As\nadopted - distributed a statement\nproaches to reach what both said\nact on the recommendations,\nyou know on both sides there are\nadding a note of caution.\nwere their ultimate goal, to ensure\nwhich could be amended.\ncomment on the specifics of the\nforms, such as prohibiting denial\nextremists who demand that what\n\"This bill is very much a work\nthat all Americans had health in-\nSen. Daniel Patrick Moynihan,\nproposal but said the bipartisan\nof coverage for pre-existing condi-\nthey want to be in (a health bill],\nin progress. Each turn will pro-\nsurance coverage.\nNew York Democrat and chair-\nactivity was \"encouraging.\"\ntions.\nand that's why it seems to me the\nduce a slightly different product. I\nThe bipartisan group had been\nman of the Finance Committee,\n\"There will be many twists and\nExpanding the he 11th care tax\nprogress in health care reform in\nregret this proposal did not do\nleaning toward including an indi-\nand Sen. Bob Packwood of Oregon,\nturns on the road to health care\ndeduction from 25 percent for the\nthe Congress of the United States\nmore to achieve universal cover-\nvidual mandate, but Mr. Conrad\nthe committee's ranking Republi-\nreform, but we're confident that\nself-employed to 100 percent.\nto date has been chaos.\"\nage through a shared responsibil-\nsaid that idea \"was on its death\ncan, were briefed on the bipartisan\nthe road will lead to the president's\nCreating two type of benefits\nSen. Kent Conrad, North Dakota\nity by individuals and employers,\"\nbed\" by Thursday night.\nproposal. Also briefed were Ma-\nbottom line of universal coverage,\"\npackages that health plans must\nDemocrat, said the package would\nMr. Bradley said.\n\"They realized that there would\njority Leader George J. Mitchell\nshe said.\noffer that would be set by the\nexpand insurance coverage, con-\nThe New Jersey Democrat\nbe no support on the left or right,\nof Maine and Minority Leader Bob\nOther elements of the biparti-\nhealth commission The first\ntrol costs, protect consumers'\nadded that he hoped \"the Finance\nand you would take it to the floor\nDole of Kansas.\nsan plan include:\nwould be a \"standard package of\nchoices, preserve quality and em-\nCommittee will strengthen this\nand there would be a vote to take\nMr. Dole said he had not seen all\nIncreasing the cigarette tax\ncomprehensive benefits. The sec-\nphasize prevention programs.\nproposal before reporting it out.\"\nout the mandate, and it would pass\nof the details but said the proposal\nby an estimated $1 a pack, al-\nond would be a \"basic\" package\n\"This has been a serious effort\nThe chief element of the bi-\noverwhelmingly,\" he said.\n\"will be helpful to the debate.\" He\nthough this level could change.\nthat would contain higher cost-\nwith great pressures from both\npartisan proposal is that it con-\nMr. Chafee yesterday said the\nalso reiterated that he and Mr.\nProviding subsidies to low-\nsharing or fewer benefits\nsides, and I think we have achieved\ntains no requirement on either em-\nnew bipartisan plan should cover\nPackwood are developing a con-\nincome people who earn up to 240\nAllowing those on Medicare to\nan important breakthrough,\" Mr.\nployers or individuals to purchase\nabout two-thirds of the uninsured\nsensus Republican plan to offer to\npercent of the poverty level to help\neither stay with the traditional fed-\nConrad said.\nhealth insurance. The cornerstone\npopulation, which currently is es-\nthe committee.\nthem buy insurance. Subsidies\neral program for the elderly or\nJust how strong that break-\nof Mr. Clinton's reform proposal\ntimated at about 37 million people.\nWhite House health spokeswo-\nwould be phased in by 2002.\ngiving them the optio n to stay in\nthrough is, however, is question-\nwas a mandate on all businesses to\nThe proposal sets a target to get\nman Lorrie McHugh would not\nImplementing insurance re-\ntheir own private healt plan.\nThe Washi Aton Times\nSATURDAY, JUNE 25, 1994\n1994 'ST ENGLE SATURDAY'S\nThe Washington Times\nONY SNOW\nlintonCare is dead, but\ned select audience members to ask\ntems in America.\nC\ndon't tell NBC. \"To Your\nClouds\ncare maven, stormed out of the\npre-planned questions.\nRoughly two-thirds of all employ-\nevent. \"It was outrageous what\nHealth,\" the network's June\nMichael Thompson, who runs a\ners with 500 or more workers\nthey did,\" she recalled. \"We have\n21 \"town meeting\" about\nsmall marketing company in\nfinance health coverage for their\nsome serious issues that we're\nmedical industry reform, blew a\nSpringfield, Va., complained about\nworkers, as do 40 percent of all\nnowhere near settling in this coun-\ncl ce to reshape the health-care\nthe technique of using tear-jerker\nestablishments with 500 or fewer\ntry - how to moderate spending,\ndebate at a propitious moment.\nover\nanecdotes as a way to introduce\nemployees. The network contacted\nincrease access, improve quality.\nAccording to USA Today-Gallup\nstories. \"If we're going to set policy\nno experts to discuss this innova-\nThis broadcast did nothing to help\nnumbers, approval ratings for the\nby horror stories,\" he said later,\ntion.\nthe American pubic understand the\npresident's reform plan have tum-\nhealth\n\"we ought to nationalize lawyers,\nParticipants sensed the slant. A\nchoices they have to make. It was\nbled to 42 percent, while negative\nsince everybody has a horror story\nconsultant who represents large\nbiased - heavily tilted toward\nresponses have jumped to 50 per-\nabout lawyers.\"\norganizations that support the pres-\nDemocratic solutions.\ncent.\nBut NBC grandees, like much of\nident chortled: \"My people knew\n\"This was a sham as an education\nMore than four-fifths of the\nthe national press, seem to have a\nthe thing was a well-designed setup\nprogram for the American public,\nAmerican people want to keep their\nreform\nblind spot when it comes to free-\n- and they liked it just fine.\"\nand NBC ought to be ashamed.\npresent health-care arrangement\nmarket alternatives to the status\nBut conservatives in the audi-\nIt was so loaded it was unbeliev-\n- not surprising, since healers\nquo. They consider a debate bal-\nence raged. John Goodman of the\nable.\"\nhave done a better job than Con-\nanced if it describes different pro-\nNational Center for Policy Analysis\nThe Establishment, including the\ngress in controlling costs. And\nthe left wing of the polítical spec-\nposals for federal control. The idea\ncalled the event \"absolutely awful.\nnetwork and the Robert Woods\nNBC's own research shows health\ntrum. Furthermore, the network\nof private alternatives just doesn't\nAt no point was there any presen-\nJohnson Foundation (which under-\ncare has slid to third in the list of\ncanceled plans to advertise its sur-\nseem to occur to them.\ntation of a conservative or Repub-\nwrote the show), just doesn't get it.\npeople's priorities- - tied with wel-\nvey numbers in nationwide news-\nMalcolm S. Forbes Jr., editor in\nlican approach to these problems.\"\nPeople distrust government and\nfare reform, way behind fighting\npaper ads - perhaps because the\nchief of Forbes magazine, has craft-\nMichael Tanner, a scholar with\nwant to take matters such as health\ncrime and strengthening the econ-\npolls undercut the program's\ned a revolutionary self-insurance\nthe Cato Institute, dismissed the\ncare into their own hands.\nomy. Network statistics also indi-\npremise that we must do something\nplan for his company's employees.\nmeeting as a \"propaganda fest.\" He\nIf the network wants to surprise\ncate that most Americans want no\nnow about health care.\nThe scheme has reduced insurance\ngot to speak briefly but was inter-\nviewers with fresh programming, it\naction on the issue this year.\nWhatever the case, the show\ncosts by more than 40 percent in\nrupted by Harvard Professor Steffy\nought to produce a second special\nIn such circumstances, one\nlooked like a White House produc-\nthree years, and workers report\nWoolhandler, a cofounder of Physi-\n- about the story it ignored the first\nmight expect NBC to explore alter-\ntion. Panels discussed various\nfewer serious illnesses or sick days\ncians for a National Health Pro-\ntime around.\nnatives to Mr. Clinton's New Deal-\nforms of government health care.\nthan before. Mr. Forbes wasn't\ngram. Her punishment for rude-\n1, such as self-insurance, med-\nCitizens spun tales of woe. Hillary\ninvited to the show. Neither was\nness was to get the last word on the\nical savings accounts and\nRodham Clinton promised that her\nPatrick Rooney, chairman of the\nsubject.\nTony Snow is a Washington-based\npurchasing cooperatives. But no:\none-size-fits-all approach to the\nGolden Rule Insurance Co., which\nAnd mild-mannered Gail Wilen-\neditorial page columnist for the\nJust about every inhabitant of the\nproblem would save the unfortu-\noperates one of the most successful\nsky, a former Bush administration\nDetroit News and is nationally syn-\nhand-picked talk town came from\nnate. And network anchors prompt-\nemployer-operated health-care sys-\nofficial and well-regarded health-\ndicated\nGI's Widow Gets Life\nRival Health Plan\nThe widow of a guin war soldier was Mon-\nserced to life in prison without parale yesterday\nfor platting the 1991 murtier of her husband in\n-R811 in on his insurance pulicy.\n7 GOP senators omit universal coverage\nTow Call Riggs. 25. who who convicted of\nFirst-degrue aurder to Detroit on June 8. Te-\nBy Dena Bunis\nThe group would pay for subsidies by crising the\ndeived Lne mandatory sentence for couspiring\nTAIF CORRESPONDENT\ncigarette Lnx by $1 spack cutting Medicare and Mestic-\nwith her brother to kill her husband. Anthony\nWashington After a week of meetings behind\nnid spending and imposing a DEW tax on insurance\nRICES\ncinsed doors, a group of modernte Republican and\ncompany plans with higher-than-nveragr premiums.\nProsecutors had argued that Ring- hired her\nDemocratic senature einerged yeaterday with its pro-\nAller a briefing 01: the proposal, Muynihan said :\nprother. Michael Cato. to shoot her husband\nnosal to overhani the nation health care sytem.\nhad \"a Lot of gund new ideas.\" out he was noncomenit-\noutside the coupie's Detroit home just dava\nBut the plan doesn't fulfill President Bill Clinton's\nrel about IL\nRiter he returned from Sauni Ambia where he\nDiedge that all Americans be guaranteed medical in-\nMeinners of the modernte Senate group neknow\nserved Rb a Patriot missile crewinan.\nsurance, and it is not likely to form the busis of the\nenged that their proposal only pares the way for un:-\nl'on: Riggs who showed nn emotion during\nbill the key Finance Committee will begin deliberat.\nversal CUVCI but Sen. John Breaux (1)-La. said he\nthe original trial, broke down during the sen-\ntenning hearing. quoting from the Hibie and\ning next week. Senate sources said yesterday.\ndidn t believe it would necessarily mean = presidention\n\"It'm a for rese than advertised.\" one station said of\nVeln They estimated that their proposal would extend\npressung with the judge for every.\nthe plan, diafted by seven senature and released yes.\ncoverage in 3.7 additional 20 aullion Americans An\nlerday alternoon. \"I don't chink it will Dy nt all.\nestimated 39 million are currently uninsured\nElders' Ouster Sought\nThe proposal would revemb the laws under which\ninsurance companes operate, offer subsidies to low.\nincoine people to encourage them to buy health insur-\nEighty-lieven Republicin House members\nance. and cream a national health commission to\nClinton Assails\nFLOGHT the resignation of Surgeon General Joy-\nmonitor the progress the country makes toward uni.\ncelyn Elders vesterday. escalating a confiect\nveral insurance coverage.\nover Democrate attachs on right-wing Republi-\nBut unlike most Democratic plans and even the bill\ncans.\n'Negativism'\nintroduced lake year by Sen. John Chafee R-R.I. is\nThe Republicans letter to President BUT\nincomber of the modernite group. yesterday's proposal\nClinton cime two Jays after Elders, according\nTHE Area CATED PRINT\nwould Lot require anyone to have health insurance\nto newspaper accounts. referred to the \"un\n\"I am liere in tell you today and through you, the\nSt. Lanis Striking out at his conservative critics\nChristian religious right\" and anded \"Welve\nAmerican people this is the closest. We TO going to come\nin particular and the media in general President Bill\nTOU LG be strong 10 take on theme people who src\nto doing health care reform right in America at any\nClinton bitrecty complained cestering that unlair and\nsetting our collinen out in the name of reli-\nLime. Sen. David Durenburger (R-Minn.) said AC is\nnegative reports about him are feeding 0 cynical\nmon.\nnews conference outlining the moderate group plan.\n:nindaet in America\nThe Intter and not specifically mention chese\nBut aimost immediately, Finance Committee mein-\nMentioning conservative malk-snow howe Rush Lim.\nremarks but they were cated often at a Dews\nbers committed to universit coverage decried the re-\nhaugh and televangelist Rev. Jerry Felwell by name.\nconference by Ren. CHIF Stearns (R-Fla., RU-\nout if not the affort of their fellow Senators\nClinton decried \"a constant unremitting drumbeat of\nthe of the letter. ,ther inwrankers and spokes-\ncommend the effort but if this is the been they\nnegativism\nmen for conservative Christian organizations\nhave to offer, it only shows we still have lot of work to\nThe American people keep being told that chings\ndo.\" said Sen. Jay Hockefeller (D.W.Va). an ardent\nare bad and politicians are corrupt and the system\nPolice Queries Upheld\nsupporter of a comprehensive health care plan.\nbroken It's not true.\" Clinton said. Fle insisted he\nEven one of the members of the unoderate group,\nwasn't criticizing evangelical Christians overnil just\nSen. Mill Bradley (D-N said the proposal falls short\npeople who \"pul on the mantie of religion and then\nhe Supreme Cannt made it. eanier vesterday\nsaying be hopes the \"Finance Committee will\nlune it toj justify anything they say or do.\nFor police \" press criminal suspects into mak-\naurengthen this proposal before reporting it. out\"\nLimbnugh shot back on his own talk show a half-\nincriminating remarks before getting is law.\nBradley was particularly concerned that the plan did\nhour later.\nyer's help.\nnot include any mandates for coverage.\n\"The gauntlet has been thrown,\" he wild then pro-\nThe court ruled unanimously that police offi-\nSenators in the Finance Committee, chaired by Dan-\nceeded to play a tape of Clinton's remarks and cirticule\ncera do not have to stop questioning surpects\niel P Moyninan (I)-N.Y.). luve been stymied in their\nthem. \"This is not a program of negative possition.\nwho make what may be ambiguous requests for\nattempt w reach a bipartisen accord on a health care\nOne question that Clinton cited as an example of\nlegal assistance.\nbill After back-room 3 with the fall committee\nthe media's focus on barl news dealt with stories that\n**: 9W enforcement officers may continue\nproved unproductive, the seven senntors broke off in\nWhite House staff members and taken towels from\nquestioning unall and unders the suspect clearly\nin attempt to come up with n middle-nf-the-road plan.\nainterooms during their stay aboutd an aircraft carri-\nrequests all attorney.\" Justice Sandra Day\nWhat cmerged memor clumer to the kind of plan\ner in Europe earlier this month\n0 Connor wrom for the court.\nSenate Minority Leuder Bob Dole (R-Kan.) has been\n\"We're not sure that just the White House SWIT did\npushing. and ***** sources suggested that Dole exerted\nthat\" Chinton insisted. There were Drwn people.\npressure on the Republicins in the splinter group to\nthere were lots of other people on that boat who were\nAdmiral Won't Get Job\nhold the line on any mandates. Mort observers had\nnot members of the White House NERTH\nexpected the RTOUT to recommend that individuals be\n\"Lock at all the things you |could| ask me about -\nThe Navy withdrew President Bill Clinton's\nrequired to buy insurance if at least 96 percent of the\nand you asked me about that Clinton told his inter-\nchoice for Pacific communder in the wake of\nAmerican people aid not have insurance by 2002 Ip-\nviewers.\ncritic over the admiral's handling of a sexual\nstend the seven proposed that a commission. make\nFalwell issued a statement inviting Clinton to tape\nincreasment Lase.\nnonbinding recommendations to Congress if that goal\n\"personal and direct rebutting to run un \"Old Time\n^ brief statement issued late yesterday by the\nwas not renched.\nCompel Hour.' which aire On 200 stations nationwide\nNavy said Adm. Stanley R Arthur. 59.\nthat the anticipated dulay in Sennte confirma-\ntion of his nomination to be Commander in\nChief. U.S. Pacific Command, has the potential\n3 creating gap in that key billet.\"\nRacial Vein Disparity Seen\nSen. David Durenberger (D-Minn.) had\nthreatened Ln place a hold on Arthur's required\nTHE ASSOCIATED PICTS\ndilate as well as whites. he said. Dilation lulps blood\nSenate confirmation because of a turual Farass\nneut case that involved it Navy officer from\nAllanta - Veins in black people are less flexible\nget to the heart in times of demand.\nMinnesota\nand more difficult to dilate a finding that may kelp\nHigh blood pressure affects an estimated G2 million\nexplain why blacks are more likely than whites 3\nAmericans. and neart disease is the metion's No. 1\nsuffer from heart disease. researchers mid vesterday.\nkiller. High blood pressure in a najor underlying\nAIDS Victim's Award\nOne reason for the disparity may lie in the endothe-\ncause of heart attacks. heart failure, strokes harden.\nHa, the flat cells that line the inside of veins and are\nmg of the atteries and kidney failure.\nries. A team of Georgia researchers reported on the\nA New Jersey unan who gut AIDS from a\nit is \" huge health bazard for all Americans. but is\nissue its a study presenued in Cleveland nt the Interna-\ntransfurion was awarded $570,000 in the First\nworse for blucks They have the disease one-third\nConai Interdisciplinary Conference on Hypertension\nsuccessful lawsuit of its kind against the organ.\nmore with than whites, get it earlier in life and suffer\nin Blacks\ntalum three extablishes blood-screening ston-\nit far Ingro severely.\nThe findings may enable researchers to develop\ndards for the nation's blood annks.\nResearchers uren am why the meial dispariry ex-\ndrugs that treat high blood pressure and heart disense\nNEWSDAY, SATURDAY, UNF :481\nA Gergen County Superior Court jury or.\nists, but some believe it may be generic, while others\nas effectively in blacks as they do in whites. said the\ndured the American Association of Blood Bonks\nUniversity of Georgia's Dr. Handall Tackett. Inader of\npoint to environmental (actors.\nno Thursday to pay William Snyder $405.000 in\nthe study.\nThe DEW study examined portions of veins Laken\ncompensatory damager and an estimated\nThe research represents the first time that veins\nfrom the legs of 60 whites and 22 blucks underguing\n$166,000 in interest Snyder. 67. said he con.\nwere used to study racial differences in high hlood\nheart bypans surgery. Even when factors such as age\ntracted the human immunudeficiency virus\npressure. said Dr. Elijah Sunders of the University\nand acx were taken into account, racial differences\nfrom 0 blund transfusion following hunrt HUF-\nof Maryland. . co-founder of the International Society\nwere found in the veins ability to dilate, Tackett said\ngery its 1384.\non Hypertension in Blacks The results were not star-\nTackett assid the researchers believe that the racial\nCOMPILED Firm NEWS DISPATENCE\nGing but were significant, Saunders said.\ndispurity may result from differences in the reaction\nPrevious work bad found blacks arteries do not\nof endothelini cells to certain hormones in the blood.\n74\nVeto of health care compromise plan hinted\nPIMOTHY CLIPPORD\nbe separdised By extremists\nthreet b veto any that\nand Samais committees have\n$\nlive\n-\nR\nThe compromise declares\n(MM) either party.' Ben. John\ndoes not provide universal\ntaken up health care. Senate\nuniversal coverage \" its\nCharge sale.\nreverage - would and such a\nFinance is believed to be the\ngoal. But there is no have\nWASHINGTON The first\nThere WM no official White\nbill \"difficult to sign.\nplace where the bill mest\nwither\" to guarantee. n. if\nmajor bi-partisan health care\nHouse comment on the pro-\nCailing their plas a \"main-\nlikely to pace Congress Is\n25% coverage is not achieved\npropossi emerged on Capital\npossi put together by goven\nstream proposal.\" the sens-\ncrafted.\nby 2002. a commission would\nHill vasterder. but the White\nmembers on the Senate Fi.\ntere presented It te Finance\nUnder yesterday's plan, In.\nbe creeted to make recom\nreuse signated that the com-\nnance Commission four\nshatroom Sea.\nsurance reform would wake\nmendations to Coogression\npromise - water alms to COV.\nDemocrate and three Resub.\nDaniel Patrick Maysikan (D-\nhealth coverage more *****\nnew to make more progress.\nor at least 15% of Americans\nlicans - that its outhors said\nN.Y.) along with (ther hay\nsible with subsidies to Isw-in-\nthen a vale would be re\nby $002 - would face 6 presi-\neventually would cover two.\nBenate leaders.\ncome Americans The plan\nquired.\ndential veta.\nthirds of the currently 35 mil-\nThe 20-member Finance\nwould be linenses with cuts\nBut one oritis said: \"It's\n\"This compromise sends &\nlien unineared.\nCommittee. of W lich the\nin Medicare and Medicald\neven sefter than & soft trig.\ngroup of seven will form the\nclass message to the Ameri-\nBut sourses disco 10 the\nsigns with 8 #: increase in\ngor. That Just won't mane \" at\nargent blook. beginn work on\ntan people that we will not\nthe eigaree tax sad a levy on\nthe White House. We'll have\nprocess Insteted that Prest-\nallow beeith care reform to\nthe plan noxt work. Even\ndeat Clinten - given Ria\ninsurance companies solling\nto see what Moynihan will\nthough 4 number of House\nmore-expensive teverage.\ndo.\nLast flight from Haiti\na time of desperation\nPlane can't\ntake 'em all\nPRINCE\nRatu\n-\nHours\nbefore American Airlines flight\n606 to New York started boarding\npassengers late resterday, sugar and\ndesperation overtook many of those\nhoping to catch the plane.\nFor this was the last flight leaving for\nthe United States pending a return of\nPresident Joan-Harmand Aristide. The\npoorest country in the hemisphere has\nsaw - the must levisled. Sill Clin-\ntos and the world community have\ndrawn the economic 80088 tighter\naround HALL's Milliary distature.\nNo bigger paychological. blow 12A be\nimagined in this country than suiting off\nJUAN\nGONZALEZ\ndally air travel between Mare and Miami\nand New York. . ban which began at\nmidnight. and the restrictions on money\ntransfers which Clinton ordered several\nweeks age.\nWith , million Huitisns living in the\nU.S., benning als travel means separat-\nLng funilies indefiatiely.\nAndre Gil, a graff old man wearing 4\nwhile beachall cap, was one of these\noutside the entranes to use sirport ter-\nminel serambling to get on yesterday's\nlast Right His brother and cousin la the\nBroax, whom he heas't seen 5 14 years,\nsent him 8 ticket pure months ago to he\ncould ge to New York for BA operation\non his atting back.\n\"My ticket was for next week, but\nthat's no good. no more planes.' be said,\nsimeet beside himself with ADJUT. \"Thay\ntall me I have no reservations.\nAs ou argued with 88 sirtine agent,\n600708 of other Haitians waited is the\nsweltering heat u standays for & flight\nthey would never eateh A1 surbaide. I\nsmartly dreamed Heltian coupie, their\nPARTING UN: Delve Richards GRYS goodbye to dousins, Millis Prances, 2. and Seins\nthree children and Jummer piled late\nManican, 3. before putting them on last American Airlines fight OUT of Part-su-Price, Helt.\nthe backsest of their wine-colored Mar-\nAlso boardling was Desir Quantion, 11 (f.).\nredes, jumped angrily into the car and\nsped off. They bediet been Able get seats\n\"Xy dream can't get their report\nDominiess Republican\nout.\ncards from school. because we have no\nFood secure more abundant than ever\nAmong the lucky ones were the Augus-\nmoney to say the final tuition.\" she said.\namong the street-side venders, electri-\ntime. $ pose family from the village of\n\"Fifty dellars goes nowhers in Halti to\ncat blockouts are less frequent than last\nCavailian in the south. Michou Augustin\nday.\nyear. The military has area begun pay-\nmanaged to get her 87-year-old father on\nEverywhere. of course, is the tarror of\ning the countiess potholes downtown\nthe flight. The mea was volted is a tan\nthe Maiture Army. An especially nasty\nand clearing the giant pllas of\nweel federa which sat backward on his\nsoldier in from of the main terminal on.\nthat used to block scores of Intersec.\nhead, a black and gray plastripe BUIS two\ntranse be 110 beating a Hallian-Ameri-\ntime.\nsizes the big, and 4 purple de lecesly At.\ncan citizen in full view of foreign report-\nted around his nach,\nera. then invisted several of we from the\n\"I don't know was I'll ⑉ them\nairport to: daring to interview the via.\nagain,\" said the man, who refused to\nu.s.\nW\nNY, YOU ARE forced to ask. de\noutward conditions seem to be\nimproving in B country that 18\ngive his first name, as as pointed to MI-\nRestrictions on foreign reporters have\ntoday more dictatorial and more estre-\ntheu and enother daughter. \"T've 1008\nsuffered 18. means weeks. since threats\ntoo mush killing here time 10 go. It's\nclased in the world's Monomy than over\nof a U.S. tend investen to restors Aristids\nbefore? You AND left with the suspicion\n- 6M - - M - LABO-\nmore 1981 card day.\nthat this embarge to somehow more\neurs. All less my with 16 is Breakiyn, I\nEven wi the tightened International\nbluster then reality.\nhaven't was har for a year.\"\nembarge, hawever, the espital sacms\nBut his and grandchildren\nThes again. It sould be that Heltians.\nmore related than It has brian in years.\nwho are asserieurly fanatical about ser\nremain behind, and Michou, whose bus-\nCars are on the read everywhere and\nband sise us working is Breakiyn, wor-\near. have just decided to relax and pay\ngasolias 11 pleatiful - - has even\nmore attention to the World Cup games\nries about the many like can't get from\ndropped III 57 8 gallon from a bigh of B10\nin the sext few weeks man the endless\nhis because money transfere IN new\n- despite the supposed compliance\npolicies! times here and is Washington\nlimited to MO a masts\nup the neighboring\nscall La use big Invertise.\nN.Y.\nDAILYNEWS\n6-25-94\n75\n6/27/94\nSenate Finance Committee announces compromise\n(EDITORS: BEGIN OPTIONAL TRIM)\nhealth-care reform plan By Peter G. Gosselin Boston\nThe measure's authors were almost plaintive in their\nGlobe\nappeal for support Friday, using an afternoon press\nWASHINGTON Senate moderates managed to salvage a\nconference to portray their plan as the last best hope for\ncompromise aimed at averting partisan warfare over health\navoiding a kind of legislative Armageddon over health care\ncare Friday, but only after dropping key elements of the\nlater this summer.\nproposal and papering over deep differences among\n\"On both sides, there are extremists who demand that\nsupporters.\nwhat they want\" should part of the plan, `and that's why\nFollowing a series of frantic, closed-door meetings\nthe progress on health care reform in the Congress to date\nThursday night and Friday, moderate leaders announced they\nhas been total chaos,\" complained Chafee.\nhad agreed to a plan that would provide $250 billion in\n\"Give this mainstream plan a chance,\" pleaded.\nsubsidies and tax breaks over five years to help uninsured\nRepublican Sen. Dave Durenberger of Minnesota. ``It\nAmericans get health coverage. But the plan would not\nrepresents the only opportunity to enact true health\nrequire employers or individuals to help pay for it, as\nreform this year.\"\nmany health proposals in the current debate would.\n(END OPTIONAL TRIM)\nThe leaders frankly acknowledged that their proposal\nBut the prospects for the plan remained very much up in\nstops far short of the goal that President Clinton has\nthe air Friday. Aides to Senate Finance Committee chairman\nsaid any compromise must meet: health coverage for all\nDaniel Moynihan, who had been hoping the Chafee group's\nAmericans. Otherwise, the legislation risks his vetoed.\ncompromise would offer a way out for his deeply divided\n*Our goal ultimately, of course, is universal\npanel, said the New York Democrat was canceling plans to\ncoverage. But if that is not able to be achieved, then we\nbegin drafting a health bill Monday and would met\nseek to cover as many as possible,\" said Republican Sen.\nprivately with committee members.\nJohn H. Chafee of Rhode Island, who was chiefly\nMeanwhile, one of the group's own members, Democratic\nresponsible for the compromise proposal.\nSen. Bill Bradley of New Jersey, issued a statement\nThe plan was immediately damned by faint praise from\ndistancing himself from the very measure he had just\nall sides.\nagreed to, and suggesting he might withdraw his support.\nAbout the most White House spokesman Jeff Eller could\n\"I regret this proposal did not do more to achieve\nmuster was that ``it is encouraging to see work proceeding\nuniversal coverage through a shared responsibility by\nin 8 bipartisan fashion.\"\nindividuals and employers,\" Bradley said.\nDemocratic congressional leaders said they were studying\nFailure of the Chafee compromise would not necessarily\nthe proposal.\nspell the end of the health reform drive.\nMeanwhile, Senate Republican Leader Bob Dole of Kansas\nIn the Senate, Massachusetts Democrat Edward M: Kennedy\nrepeated his threat to offer an alternative, and much more\nhas already pushed a Clinton-like health plan through his\nconservative, measure. Dole is reportedly furious with\nSenate Labor and Human Resources Committee, Senate\nChafee and other Republicans for working on the\nMajority Leader George Mitchell of Maine has strongly\ncompromise, fearing Democrats will simply use the idea as\nhinted he may send the Kennedy bill to the floor next\na ticket to bring the health issue to the Senate floor and\nmonth in a move that could bring the debate to a sudden,\nthen discard it in favor of a broader plan.\npartisan head. In the House, two committees, Education and\nThe measure that Chafee outlined Friday represented a\nLabor and Ways and Means, are moving on health measures,\nsubstantial retreat from his own original plan for\npaving the way for an expected floor vote next month.\nproviding universal coverage, and dropped the one element\nBut collapse of the compromise would be a sharp setback\nthat might have led to full coverage, an ``individual\nin the search for a bipartisan middle ground on the hugely\nmandate,\" or requirement that everyone without health\ncomplex health issue, and would increase chances that the\ninsurance after a certain buy it for themselves.\nissue will be settled by the kind of highly publicized\nThe individual mandate was supposed to replace a\ncongressional showdown that many lawmakers are desperate\nClinton proposal for an employer mandate, a requirement\nto avoid.\nthat American firms pay much of the cost of expanding\nThe compromise itself illustrated how much the health\nhealth coverage, that had become a lightning rod for\ndebate has changed since its earlier, more rosy opening\nbusiness objections to the White House plan.\nphase last year.\nBut the idea created intolerable political problems for\nThen, lawmakers and commentators cited as proof that\nmoderate Democrats working with Chafee who feared it would\nsweeping change was just around the corner the fact that\nappear they were willing to fix the nation's health\nChafee, as a moderate Republican, supported the same goal\nproblems on the backs of workers, rather than of\nof universal coverage as Democrat Clinton. Many observers\nbusinesses. As a result, the group was forced to drop both\nportrayed the coming debate as mostly a technical dispute\nideas and rely on other means of financing the plan.\nover the best means to an end.\nThe final compromise depends entirely on government\nBesides Chafee, Durenberger and Bradley, others in the\nsubsidies and health insurance market changes to expand\nmoderate group who endorsed Friday's compromise proposal\ncoverage to the uninsured. About $150 billion of the $250\nincluded Democrats John Breaux of Louisiana, David Boren\nbillion in subsidies over five years would come from cuts\nof Oklahoma and Kent Conrad of North Dakota, and\nin the Medicare and Medicaid programs, with the rest being\nRepublican John Danforth of Missouri.\nraised by a $1-a-pack cigarette tax and a tax on high-cost\ninsurance policies. By contrast, the Clinton plan would\nrely on the employer mandate and elaborate cost controls,\nas well as subsidies to extend coverage.\nChafee said Friday that the group believes that its\nproposal would pick up about 20 million of the nation's 37\nNewsday: Nominee Breyer could have profited from some\nmillion uninsured. Under the compromise, if 95 percent of\ncases he ruled on By Ana Puga Boston Globe\nthe country is not insured by the vear 2002. a government\nWASHINGTON Supreme Court nominee Stephen G.\ncommission is required to propose ways for further\nBreyer had\nextending coverage. And Congress must consider its ideas,\na financial interest in the outcome of toxic waste\nbut not necessarily accept them.\nliability suits similar to some of the waste cases he\n79\nHEALTH CARE\nFinancing compromise is good alternative\nThe current health care obstacle facing\ninsurance, three reasons make the \"Individ-\nlegislators is the question of who should pay\nual mandate\" not so onerous.\nfor the coverage President Clinton insists\nFirst, the substantial number of busi-\nall Americans should have. The president\nnesses now picking up employee health\nand leading congressional Democrats want\ncosts will likely continue their practice as a\nemployers to pick up the costs, while moder-\nmeans of recruiting employees. Second,\nates and conservatives in both parties don't\nindividuals with annual incomes as high as\nwant to saddle businesses with a \"mandate\"\n$34,000 would receive some federal subsidy\nto purchase health insurance.\nto help purchase their insurance. Third, if\nA new compromise being offered by some\nemployers not now covering employee\nleading Senate Finance Committee members\nhealth costs are required to do so, won't they\ncould break the impasse. Moderate Republi-\ntake the new costs from employee salaries?\ncans John Chafee, John Danforth and David\nThe move to require individuals to pick\nDurenberger and centrist Democrats John\nup insurance costs is not necessarily new.\nBreaux and Bill Bradley hope to move the\nThe idea has been promoted in the Senate by\ndebate forward by requiring individuals to\nRepublican Chafee of Rhode Island and in\npurchase health insurance if 95 or 96 per-\nthe House by Democrat Jim Cooper of\ncent of Americans do not have health insur-\nTennessee.\nance by the year 2002.\nBut its current significance is that the\nActually. the senators contend. that\nproposal could move the important Finance\nmandate may never be necessary. Immedi-\nCommittee beyond its deadlock. Yes, some\nate reforms such as allowing employees to\ninterest groups are lining up to oppose the\ntransfer their policies from job to job could\nindividual mandate. But the idea is one the\nsharply increase the number of insured\nfull committee should support when it\nAmericans to the point where no require-\nreconvenes next week. It gives times for\nment need be placed on individuals to pur-\nother reforms to work, while proposing a\nchase coverage.\nfinancing system that will not seriously\nYet if the debate does come down to\nthreaten the small businesses that generate\nrequiring individuals to purchase their own\nso many American jobs.\nDauas Marning news\n6/25\n90\nBC-NC--Hospitals Merger, 300\nASHEVILLE (AP) Regulators' permission to allow a partial merger of two\nFlorida hospitals bodes well for similar plans at Asheville's Memorial Mission\nand St. Joseph's hospitals, officials say.\nThe U.S. Justice Department last week proclaimed an antitrust breakthrough\nin the deal involving Morton Plant Hospital and Mease Health Care, two major\nhospitals near St. Petersburg.\nUnder a proposed consent decree, the two will jointly provide some\nservices, compete on others and share some administrative functions. The\ndecree requires approval by the federal district court in Tampa.\nThe agreement was the first in the health care industry since an antitrust\nenforcement guidelines were issued by Hillary Clinton and Attorney General\nJanet Reno last September.\nThe Justice Department is currently monitoring a potential deal between\nMission and St. Joseph's for the combination of some services. In March\nofficials of the two hospitals signed a letter of intent to seek a\ncollaboration, and the consulting firm Arthur Andersen was hired to do an\nanalysis of the benefits.\n``It is really very close to the blueprint we seem to be headed toward in\nour collaboration efforts, said John Coli, president and chief operating\nofficer of St. Joseph's Health Services Corp. If they approved it for two\nhospitals in Florida, why not approve it for two hospitals in Asheville?'\nUnder the agreement, the Florida hospitals may combine medical staffs and\nform a partnership to provide such things as outpatient care, open-heart\nsurgery, radiology and laboratory services.\nMission and St. Joseph's officials have refused to release a copy of the\nletter of intent stipulating details of their plan. They said releasing the\nletter would encourage needless speculation'' by employees about what form\nthe collaboration might eventually take.\n**** filed by:APE-(NC) on 06/26/94 at 17:09EDT ****\n**** printed by:WHPR(JEL) on 06/27/94 at 08:11EDT ****\nBritish Health System Fails\nCancer Victims, Critics Say\nBy WILLIAM E. SCHMIDT\nA\n(\nSpecial to The New York Times\nLONDON, June 25 - Armed with\nmendations last month for broad\nstatistics showing that patients in\nchanges in the treatment, including\nBritain with certain types of cancer\nthe way patients are referred, so that\nare more likely to die - and die\nmore patients will be seen by special-\nsooner - than patients in the United\nists trained in cancer care.\nStates or the rest of Western Europe,\n\"The N.H.S. is brilliant when it\nhealth advocates are demanding that\ncomes to primary care,\" said Dr.\nthe national health care system do a\nKarol Sikora, the director of clinical\nbetter job in diagnosing and treating\noncology at London's Hammersmith\na disease expected to afflict 260,000\nHospital and a member of a 12-mem-\nnew people here this year.\nber specialist committee that worked\nIncreasingly outspoken groups of\nwith Dr. Calman. \"But when it comes\nsurvivors, joined by Britain's top can-\ncer specialists and largest cancer\nContinued on Page 6, Column 3\ncharities, say the Government has\nfailed to spend enough money on can-\ncer care and train enough specialists.\nWhat's more, they argue that Brit-\nain's medical establishment and the\nNational Health Service, the 46-year-\nold Government system that provides\nmost Britons with medical care,\nsometimes hinder patients from see-\ning the best people or receiving the\noptimum treatment.\nIn the face of growing pressure, Dr.\nKenneth Calman, an oncologist and\nthe chief medical officer in the De-\npartment of Health, published recom-\nTHE NEW YORK TIMES, SUNDAY, JUNE 26, 1994\nLTH\nTracking Cancer Treatment in Britain\nMortality rates\nCase burden\nBreast cancer rates\nChemotherapy treatment\nPer 100,000 people per year,\nNew patients seen per year per\nPer 100,000 people per year.\nNumber of cycles of treatment per\n1987-90.\noncologist (study published in '91)\nFigures are adjusted for age.\ncancer patient.\nCancer\nBritain\nU.S.\nBritain\n560\nBelgium\n10.8\nIncidence\nDeaths\ntype\nMale\nFem.\nMale\nFem.\nNetherlands\n250\nFrance\n9.9\n200\n1,021\n1,084\n27.9\nLung\n63.7\n21.6\n56.9\n22.7\nU.S.\n22.4\nSpain\n8.0\nColo-\n21.5\n15.5\n17.2\n12.0\nFrance\n200\nrectal\nItaly\n6.8\nSpain\n200\n86-\n87\n87\nStomach\n13.9\n6.3\n5.3\n2.5\nPortugual\n200\n90\n90\nGermany\n6.8\n88\n90\nProstate\n14.4\n15.7\nGermany\n140\nBritain\nU.S.\nBritain\nU.S.\nBritain\n3.8\nSources: Cancer Research Campaign, Britain: National Cancer Institute, U.S.; World Health Organization: International Agency for Research on Cancer: Royal College of Radiologoists, Britain; CIE Monitor-Glaxo\nThe New York Times\nBritain's Health System Faulted for Cancer Treatment\ntook two years, eight different doc-\nContinued From Page 1\ntors and a series of false diagnoses\nbefore physicians in Britain finally\nto cancer, it is very patchy. Some\nfigured out she had Hodgkin's dis-\nhospitals are world class, but others\nease, a form of lymphatic cancer.\nare far below standard, which means\nLast spring, Mrs. Miles, who is 35,\nthat for anyone with cancer, it is a bit\nfounded the National Cancer Alli-\nof a lottery.\"\nance, Britain's first public lobbying\ngroup of cancer survivors, because\nAmong most Britons, the N.H.S. is\nshe says she is determined that oth-\nrevered for offering unimpeded ac-\ners do not have to go through what\ncess to quality primary health care,\nshe did.\nand the system is often cited as a\nIn part because of the faith that\nmodel by advocates of health care\nmost Britons place in their Nati\nreform in the United States. But crit-\nHealth Service, few have a consum-\nics say the service is also plagued by\ner's attitude about medicine, and\ninefficiency and a lack of resources,\nmany do not question the judgment of\nleading to long waiting lists for pa-\nthe general practioners whom they\ntients awaiting elective surgery.\ngo to first for medical care.\n\"So the system favors the well-\nA report issued last year after a\neducated, the pushy or the wealthy\nconference of Britain's cancer chari-\nwho can afford to pay for private\nconcluded: \"The U.K. is not\ntreatment,' Mrs. Miles said. \"If\nmeeting the cancer challenge. Surviv-\nnot stood up and hollered and de-\nal rates for some types of cancer are\nmanded answers to questions about\nfar less good than they are in the U.S.,\nmy illness, I really believe the\nth\nGermany and France. Less than 40\ncare system would have just let me\npercent of cancer patients in the U.K.\ndie.\"\nare ever referred to cancer special-\nJonathan Player for The New York Times\nFighting Breast Cancer\nists.\"\nMany cancer survivors in Britain say the Government fails to spend\nInspired by the success of AIDS\nWhile Prof. Gordon McVie, the\nenough money on cancer care and train enough specialists. Becky Miles,\ngroups in lobbying for Government\nchief scientific officer for the Cancer\n35, a survivor who formed a lobbying group in London, said it took two\nmoney to fight the disease, British\nResearch Campaign charity says en-\nwomen, like women in the United\nyears, eight different doctors and several false diagnoses before physi-\nvironmental factors cannot wholly be\nStates, are demanding a larger Gov-\nruled out - the incidence of lung and\ncians figured out she had Hodgkin's disease, a form of lymphatic cancer.\nernment commitment to combating\nbreast cancer. In a letter to The\nstomach cancer, for example, are\nhigher in Britain than in the United\nTimes of London earlier this year,\nStates experts agree that the chief\nMany Britons with\nDr. Sikora said as recently as the\nLesley Elliott, a woman who said it\nreason for the differences are cultur-\nmid-1980's, it was accepted clinical\ntook doctors seven months to diag-\nal and structural barriers to the de-\npractice in Britain for doctors not to\nnose a breast lump as cancer, argued\nlivery of cancer care.\ncancer lack early,\ntell patients they had cancer.\nthat as many women are dying of\n\"It still happens today,\" he said.\nbreast cancer in Britain now as did\nA recent study by European re-\nspecialized care.\n'The doctor will say, 'You have a\nwhen her grandmother was alive.\nsearchers suggested that only 6 in 10\ncyst, dear, and we'll have to give you\n\"Mortality rates have hardly\nBritish women diagnosed with breast\nsome radiation to prevent it from\nchanged,\" she said. \"This is not a\ncancer will be alive after five years,\ncoming back.'\nlegacy I wish to leave my daughters.\ncompared to nearly 7 in 10 in the rest\nvival rates among patients who have\nCritics also point out that Britain\nLoretta Tinckham of the Cancer-\nof Europe, and nearly 8 in 10 in the\nspends only 6 percent of its gross\nRelief Macmillan Fund, one of Brit-\nUnited States. At the same time, the\naccess - and especially early access\nnational product on health care, less\nain's four major cancer charities,\nmortality rate for breast cancer\nto specialist care, and those who do\namong British women is higher than\nnot,\" said Dr. Harmon Eyre, the chief\nthan half the percentage spent annu-\npublished one of Britain's first pam-\nmedical officer for the American\nally in the United States.\nphiets on breast cancer last year.\nfor women in any other Western na-\n\"We reacted to the data, which is\ntion, even though the incidence of the\nCancer Society in Atlanta.\nNot so long ago, Dr.. Sikora said,\nappraling.\" said Mrs. Tinckham, who\ndisease is less than it is in the United\npeople from developing countries\nStates.\nShortage of Specialists\ncame to Britain to seek the best possi-\nargust that the relatively poor prog-\nAs in the United States, cancer is a\nble cancer care. \"But the best centers\nnose of many patients is directly\nAmong lung cancer patients, ac-\ncording to a survey by a Manchester\nin the third world are actually quite\nrelated to inequality in access to spe-\nmajor public health challenge in Brit-\ncialist care.\nhospital, only 15 to 30 percent of Brit-\nain, and will afflict one in every three\ngood, and probably better than small-\nish patients with small-cell lung can-\npeople here over the course of their\ner units in the U.K.,\" he said, explain-\n'Luck of the Draw'\ncer will survive for two years, com-\nlifetime. Yet Britain has only 300 can-\ning that a patient in New Delhi, for\npared with 40 to 50 percent in the rest\nexample, might be better off staying\n\"It is a lottery, the luck of draw,\ncer specialists for a population of 57\nof Western Europe and in the United\nmillion people, which is one reason\nthere.\ndepending on where you live,\" she\nsaid. \"Some women see specialists\nStates.\nonly 4 in 10 cancer patients ever see a\nSecond Opinions Discouraged\nwho know what they are doing: oth\nEarly Diagnosis\nspecialist. In the United States, by\nCritics generally say that Britain's\ners see general surgeons who\ncomparison, Dr. McVie said, there\nAmerican cancer experts say the\nhealth care system which relies on\nlittle about the disease.\"\nare about 6,000 cancer specialists for\ndebate in Britain over shortcomings\nthe skill and ability of general practi-\nShe said it was imperative to give\na population four times the size of\nin the nation's strategic approach to\ntioners to recognize symptoms and\npatients more choices and improve\nBritain's.\ncancer treatment affirms their own\nthen refer patients appropriately -\ntreatment options, while maintaining\nDr. McVie said the relatively low\nconviction that the most successful\nnumber of cancer specialists in Brit-\nhas traditionally discouraged second\nsome control over the cost.\nway to fight the disease is with early\nopinions and refused patients the op-\nResearchers in Britain and the\nain was a reflection of \"cultural\"\ndiagnosis and prompt intervention by\nportunity to choose the specialist or\nUnited States say there is a measur-\nTHE NEW YORK TIMES, SUNDAY, JUNE\nfactors, including a \"vigorous resist-\ngroups of highly trained specialists.\nthe hospital where they will be treat-\nable difference in the prognosis\nance\" not only to the idea of sub-\ned.\ncancer patients who receive care\nspecialization in British medicine but\nAs the United States contemplates\nBritain's health system did not be-\nspecialist centers and those who dos\nto the notion that most cancer pa-\na comprehensive health care system\ngin a nationwide breast screening\nnot.\nof its own, which may by necessity\ntients can be successfully treated.\nprogram for women until the late\nA recent study in Glasgow demon-\nhave to ration services to save money\nMatters of Tradition\n1980's and it is only recently that\nstrated that men with testicular can-\nand conserve resources, American\ncancer charities have inaugurated\ncer who were treated at a center\ncancer experts say they want to be\n\"The attitude toward the disease\npublic education campaigns, so wom-\nstaffed by cancer specialists were\ncertain it does not limit patients' ac-\nhas been softer in Britain,\" he said,\nen will be alert to the early symptoms\nmore than 2½ times more likely to be\ncess to the kinds of sophisticated ear-\ndescribing a belief among doctors\nof the disease.\nalive, five years later, than men who:\nly treatment that can be offered only\nthat some kinds of chemotherapy\n\"Even now, patients have no power\nwere treated at one of four other\nin specialized care centers.\ntreatment, for example, \"won't nec-\nto see the doctors they want, or get\nhospitals in the city, where doctors\n'Experience clearly shows there is\nessarily do the patient any good, and\nthe treatment they need,\" said Becky\nwere less likely to follow estable\na measurable difference in the sur-\nmay be more trouble than it's worth.\"\nMiles, a cancer survivor who said it\nprotocols for treatment.\n2/2\n110\nCONGRESS\nTHE NEW YORK TIMES, SUNDAY, JUNE 26, 1994\nHealth 5'11 Care Makes Progress on Rocky Path\nb/ By ADAM CLYMER\nwere not covered by 2002, a commis-\nnor Special to The New York Times\nsion should tell Congress how to close\nWASHINGTON, June 25 -\nThe stage is set for\nthe gap.\nThrough the grinding labors of its\nThe Finance Committee's chair-\ncommittees, Congress is on track to\ndebate, but Congress\nman, Daniel Patrick Moynihan, Dem-\na critical deadline of July 4 for\nocrat of New York, appeared uncer-\ndrafting national health Insurance\nremains split on\ntain today about where he wanted to\nlegislation. But its struggles under-\nlead the committee this week. He said\nhow difficult reaching agree-\nmemt will be.\nhealth coverage.\nhe planned to see how much support\nthe moderates' proposal could com-\nAs one committee after another\nmand If it was tilted a little more\nclears - or perhaps just runs\nstrongly toward universal coverage.\nthrough - its hurdles, Congress is\nBut It was also clear that he was\nmaking progress without coming\nHouse Ways and Means Committee\nconsulting the Clinton Administration\ncloser together. The leaders of both\nmet into the afternoon today and Is\nabout whether - and how easily - he\nparties insist that they want biparti-\nlikely to pass another such bill by\nshould give in to a proposal that plain-\nsan agreement, but they insist even\nFriday, also without Republican\nly falls short of the President's bot-\n: firmly that the legislation must\nvotes.\ntom line. It appeared that, in the end,\ntheir political bottom line. The\nThe Senate Labor and Human Re-\na bill patterned on the proposal of\nDemocrats demand insurance for all\nsources Committee Is already on\nSenators John H. Chafee, Republican\nAmericans; the Republicans reject\nboard and the House Energy and\nof Rhode Island, and John B. Breaux,\nwhat many of them concede is the\nCommerce Committee hopelessly\nDemocrat of Louisiana, and four of\nonly plausible way of getting there, a\ndeadlocked, while the Senate Finance\ntheir colleagues would emerge from\nrequirement for employers to pay\nCommittee is still unsettled.\nthe committee, perhaps by the end of\nmost of the cost.\nOne thing seems certain. Nothing\nthe week.\nach side thinks that It has the\ncan emerge from that committee\nThat would mean that two commit-\nground,\" Senator Bob Packwood\nwithout Republican votes because\ntees would have acted in each house,\ntegon, the senior Republican on\nSenator David L. Boren, one of its 11\nsetting the stage for a floor debate.\nenate Finance Committee, said\nDemocrats, has all but switched par-\nIt has been clear for weeks that\n\"Politics mixes up in It. If\ntles on this Issue. He has said he will\ngetting the bills out of committee\nCS was not involved, I think we\nnot vote for a bill that some of the\nbefore the Fourth of July vacation\nget together.\"\ncommittee's nine Republicans sup-\nwas about the minimum that Demo-\nAssociated Press\npolitics is involved, and, except\nport, effectively giving the Republi-\ncratic leaders could settle for. Even If\nRepresentative Barbara B. Kennelly, Democrat of\nB. Rangel, Democrat of New York, yesterday on\nSenate Finance Committee,\ncans his proxy.\nthe Finance Committee does not quite\nConnecticut, talking with Representatives William J.\nCapitol Hill at a meeting of the House Ways and\nhave been hardly any efforts at\nA centrist group of Senators on the\nfinish by the start of the one-week\nration.\ncommittee suggested a way out on\nrecess, It could move soon enough for\nCoyne, left, Democrat of Pennsylvania, and Charles\nMeans Committee on the health care overhaul.\nAction on Several Fronts\nFriday with a proposal that calls for\nleaders to start patching the bills\nchanges in Insurance laws to make\ntogether to get measures debated by\nThursday, with no Republicans\ncoverage more widely available and\nthe full House and full Senate this\nate, the 56 Democratic Senators, even\nversal coverage. He said requiring\nup with a group of six, \"We started\nin favor, the House Education\nsubsidies for low-income people. But\nsummer.\nif united, are 4 short of the number\nemployers to pay most of their work-\nwith eight people who philosophically\nLabor Committee voted out a bill\nit would not promise to provide all\nWidespread Praise\nneeded to force a vote.\ners' insurance cost was a \"tax on\nwere tilting in the same direction.\"\ngenerous in its benefits than\nAmericans with health Insurance. It\nOn all sides, politicians praised the\nAs Mr. Packwood said, politics is a\njobs.\" He said it would cost \"one\ndent Clinton's proposal. The\nsays that if 95 percent of Americans\nmillion jobs.\"\nEven on an Issue that seemed sim-\nefforts of the Finance Committee\nmajor factor. Republican uncertainty\nmoderates as a hopeful indicator,\nabout a filibuster results from a fear\nple to the group, like malpractice\neven If they were unhappy with their\nof being seen as obstructionist, but as\nTempers Grow Short\nlitigation, he said, \"everybody agreed\nNAPSHOT\nproduct. \"The moderate bill yester-\nthe President encounters other trou-\nThe atmosphere is increasingly Ir-\nonly on the label on the box - medi-\nday is forward movement,\" the\nbles, Republicans have been Increas-\nritable. Senator Bob Dole of Kansas,\ncal malpractice reform - and when\nWhere Coverage Comes From\nHouse majority leader, Representa-\ningly sharp in their attacks on his\nthe Republican leader, bristles when\nyou open the box, there are wide\ntive Richard A. Gephardt of Missouri,\nplan.\nHillary Rodham Clinton argues, as\ndivergences of opinion\" over details.\nsaid today. \"Obviously It is not uni-\nDemocrats say the passage of\nshe did before him in a television\nSenator George J. Mitchell of\nTypes of health care coverage among the United States population.\nversal coverage, but obviously they\nhealth care legislation would be a\nprogram Tuesday night, that Con-\nMaine, the majority leader, echoed\nare trying to act.\"\nmajor boost for their election pros-\ngress has given Itself a better health\nMr. Chafee's view. With all the atten-\nTotal with private health Insurance 70%\nHe added, \"When you've got Re-\npects. Representative Vic Fazio of\nInsurance deal - with employers\ntion on a central issue like employer\nEMPLOYER COVERAGE\npublicans and Democrats sitting in\nCalifornia, chairman of their House\npaying most of the cost - than It\npayments, he warned, it Is easy to\nrooms and negotiating, it means to\ncampaign committee, urged his col-\noffers the people.\nforget that it is \"only one of a whole\nme that there's some pretty great\nleagues to portray Republicans as\nAt a Finance Committee meeting\nseries, a large number of interlocking\ndesire to get some significant thing\n\"sticking it to the middle class\" by\nlater in the week, Mr. Dole com-\nmeasures, each of which is difficult\nTotal with public health Insurance\ndone in health care.\"\nbeing unwilling to require employers\nplained about Mrs. Clinton's tactics\nand complex.\"\nBut the Chafee-Breaux group, in\nto foot the bill.\nand proposed a step that would stifle\nIncludes Medicare, Medicaid and coverage\nthe end, commanded the allegiance of\nAgainst that background, Presi-\nher argument: ending Federal contri-\nBut he said he was encouraged,\nfor the armed services and veterans\njust six Senators, and the Finance\ndent Clinton, in his weekly radio ad-\nbutions to Insurance for members of\ndespite the issue's \"obvious complex-\nCommittee is one of the most colle-\ndress, warned Congress against\nCongress, the President and the\nNo health Insurance\nity and controversy,\" and despite the\ngial settings in Congress. There re-\n\"half-hearted\" measures \"that\nWhite House staff. Although some\nfact that it Is \"very easy to block\n15%\nmain very deep divisions, not exclu-\nwould not provide coverage to all\nDemocrats shared his annoyance at\nthings in our system and very hard to\nsively on party lines, that keep the\nfamilies.\" A senior Administration\nMrs. Clinton's anti-Congress mes-\nget things done.\"\neventual fate of legislation uncertain.\naide said the President was not refer-\nsage, the idea was dropped after Mr.\nThe Democrats have majorities in\nring in particular to the Chafee-\nMoynihan said, \"I can't afford it.\nNote: Percentages do not total 100 because some Individuals are covered\nboth houses, but they are far from\nBreaux proposal.\nEven without partisanship and bad\nby more than one source.\nsolid in favor of requiring employers\nResponding for the Republicans,\ntemper, the task of passing health\nto pay for Insurance. While it is not\nRepresentative H. James Saxton of\ncare legislation would be daunting.\nSource: Employee Benefits Research Institute\nclear that Republicans H d filibus-\nNew Jersey ham red on the means\nMr. Chafee recalled today that al-\nter a Democratic measure in the Sen-\nMr. Clinton is seeking to achieve uni-\nth\nhis compromise effort ended\nAmid Cries of/Politicking, a Widely Endorsed Plan Dies\nTHE NEW YORK TIMES, SUNDAY, JUNE 26, 1994\nmonth, blocked it in votes strictly\nGovernor Chiles said another spe-\nBy PETER APPLEBOME\nalong party lines.\nSpecial to The New York Times\nBusiness liked the\ncial session is possible. Republicans\n\"The anomaly of this is it's totally\nsay voters are more afraid of a bad\nTALLAHASSEE, Fla., June 24 - A\nupside down,\" Governor Chiles said.\nattempt by government to fix health\nlegislative deadlock that killed a\n'Chiles, a Democrat, is going to uti-\nwidely watched health care plan here\nDemocratic plan,\ncare than they are clamoring for a\nlize Federal cost savings to insure\ngood health care plan. In a Florida\nis raising two questions that could\nworking people, with no new taxes\nand no mandates. That should be a\nbut Republicans\nOpinion Poll conducted this month by\ndetermine the fate of health care\nThe New York Times Regional News-\nlegislation in Washington as well:\nRepublican utopia. There is no group,\nHow much did election-year partisan\nblocked it.\npapers, health care ranked fourth as\nnone, nada, that is opposed to our plan\nan important issue for voters, behind\npolitics dominate the process, and\nexcept the Republicans, who are\ncrime, education and immigration.\nhow much do the voters really care\nagainst it totally for politics.\"\nOnly 15 percent of respondents\nabout health care?\nGov. Lawton Chiles and other Dem-\nDemocrats' Lament\n\"The starting point of the politics\nranked it among the two most impor-\ntant issues. Still, 85 percent agreed\nocratic leaders are saying that Re-\nLieut. Gov. Buddy MacKay con-\nwas Governor Chiles's re-election ef-\npublicans, including Republicans in\nfort,\" said State Senator Locke Burt,\nthere was a health care crisis in the\ntended that state Republicans op-\nWashington, leaned on Republican\nposed it to hurt Governor Chiles in his\na Republican on the committee that\nUnited States.\nstate senators to block the proposed\nkilled the proposal.\n\"Both Lawton Chiles and Bill Clin-\nbid for re-election this fall and that\nhealth care plan, which had broad\nnational Republicans did not want\nIndeed, political experts here say\nton have found themselves with their\nbacking.\nFlorida Democrats to be able to pass\nthat the Democratic effort was a\nhands wrapped tightly around a polit-\nRepublicans have derided the\nclumsy one, with a noticeably weak\nical issue that has come to be the\na plan that would steal the thunder\nclaim that Senator Bob Dole, the mi-\nlobbying effort by supporters, and\ncenterpiece of their political ambi-\nfrom national Republicans, whose\nnority leader, and other national Re-\nemerging health care plan would\nthat Governor Chiles called the ses-\ntions, and virtually only 10 to 15 per-\npublicans worked to kill Governor\nhave many similar features.\nsion without determining whether he\ncent of the American people give two\nChiles's plan. They say it was a deep-\nIn Washington this week, Governor\nhad the votes to get his bill through.\nhoots in Hell about it,\" Mr. Slade said.\nBut State Representative Ben\nly flawed plan that many supporters\nChiles told Democratic senators that\nDismayed Conservatives\nGraber, a doctor and the Democrat\ndid not understand. Democrats have\nhe had private assurances from sev-\nStill, even many conservative\nwho helped write the bill, said that\npresented no proof that Republicans\neral Republican state senators that\ngroups were disappointed by the pro-\npolitics dominated the process and\noutside the state played a role.\nthey would vote for his plan. He said\ngram's failure. \"The real irony of this\nthat voters will not look kindly on a\nBut whether it was because of na-\nthey caved in under pressure from\nis that our plan that we supported\npurely political effort to kill the bill.\ntional or local politics, it is clear that\nthe Republican National Committee\nhere is very similar to what the Re-\n\"Although the moderate Democrats\nthe effort to pass a health care plan\nand Senator Dole.\npublicans nationally are saying is the\nand moderate Republicans could\nhere became mired in gut-level elec-\nState and national Republicans, in-\nconservative alternative to the Clin-\nhave sat down and worked it out, the\ntion-year politics.\ncluding a spokesman for Senator\nton plan,\" said Jim Brainerd, general\npolitics of this year took over,\" he\nFlorida's plan gained the backing\nDole, deny any national Republican\ncounsel for the Florida Chamber of\nsaid. \"This is a good bill, and its\nof a broad coalition of groups, from\nrole in Florida. Tom Slade, the chair-\nCommerce.\nfailure is going to hurt people.\"\nunions to businesses. It used cost sav-\nman of the state Republican Party,\nings projected to come from enrolling\nsaid that \"there's not a thread of\nMedicaid recipients in managed care\ntruth\" to Governor Chiles's allega-\nplans to provide premium discounts\ntions.\nto uninsured residents with income\nRepublicans' Critique\nlevels up to 250 percent of the Federal\npoverty level. That means an Income\nFlorida Republicans say the Chiles\nof as much as $37,000 a year for a\nplan relied entirely on speculative\nfamily of four.\nsavings and depended too heavily on\na flawed agreement with the Federal\nDemocrats said. the plan would\nGovernment They contend that Gov-\nhave helped insure about a million of\nernor Chiles is blaming Republicans\nthe 2.7 million Floridians who are\nto cover up his political ineptitude.\nunable to buy health insurance. The\n\"Chiles is blaming everybody, but\nFederal Government would have\nhe needs to blame himself,\" said\npaid for 56 percent of the costs\nState Senator Ander Crenshaw, who\nthrough Medicaid savings, with the\nis seeking the Republican nomination\nrest coming from the state, the par-\nto challenge Governor Chiles in No-\nticipants and voluntary employer\nvember. \"The reason that session\ncontributions.\nwas a disaster was that the more\nMany pro-business groups, such as\npeople found out about the Chiles\nthe Florida Chamber of Commerce,\nhealth care plan, the less they liked\nsupported the plan as a free-market\nit.\"\napproach that would not have re-\nOther Republicans say that if poli-\nquired businesses to pay. But Senate\ntics did rule the process, it was the\nRepublicans, in a general session in\npolitics of Democrats desperate to\nApril and a special session this\npass a bill.\nHealth Care Horror Stories\nCritics labeled them horror stories, and they\nhealthy or sick, at identical rates. That is fine, but\nwere. On Tuesday night, NBC presented a two-hour\nunless there is a parallel obligation for all individ-\nnews special on health reform that began by focus-\nuals, healthy families will not buy coverage until\ning on the human disasters caused by a system that\nsomeone gets sick. Premiums will thus rise drasti-\ndenies families the guarantee of adequate health\ncally for everyone else. The way around this prob-\ncoverage.\nlem is universal coverage.\nRick Reckoway works hard as an electrician.\nThere is room to disagree about tactics. Mr.\nWhen his 12-year-old son was born with respiratory\nClinton would impose an employer mandate, requir-\nand cardiac problems, he thought he did not have a\ning employers to pay most of the cost of the policies\nfinancial worry because he had bought family cov-\nchosen by workers. That makes sense because it\nerage. Mr. Reckoway discovered that his insurance\nwould build upon the system that already provides\nbenefits were capped at $100,000, leaving him\ncoverage to most Americans. It is also feasible\n$700,000 in debt. He played by all the right rules, and\nbecause, with time to adjust and the help of Federal\nfound himself impoverished.\nsubsidies, companies would be able to avoid mas-\nCathi and Perry Thoorsell both work. Yet they\nsive layoffs by passing along the costs to workers in\ndo not have $7,000 for health insurance for them-\nthe form of lower wage hikes.\nselves and their two children. When Cathi suffered a\nYet furious opposition by small employers has\ndifficult pregnancy, they were hit by whopping bills\nbottled up the idea in the Senate Finance Committee\nand went $30,000 in debt. Their lives are haunted by\nthe threat of more medical bills they cannot afford.\n- a crucial battleground because its membership\nAnd they have abandoned any thought of having a\nmirrors that of the full Senate. A. group of moder-\nthird child.\nates on the committee - led by John Breaux,\nThese horror stories, some opponents of reform\nDemocrat of Louisiana, and John Chafee, Republi-\nsay, slander the overall excellence of U.S. health\ncan of Rhode Island - put together a measure that\ncare. But the issue is coverage, not quality. The\navoids an employer mandate. Some of their ideas\nsystem is riddled with holes through which tens of\nare sound, primarily a provision to tax lavish health\nmillions fall - forcing them to scrounge to get by\ncare policies as a way of driving consumers toward\nwith no insurance or inadequate insurance. Though\ncost-effective plans. But their plan fails to lock in\nthe vast majority of Americans say they are happy\nuniversal coverage now or in the future.\nwith their health care, families like the Reckoways\nUniversal coverage can be delayed to give\nand Thoorsells are the tip of a large problem - a\nbusinesses time to adjust to voluntary market re-\nproblem that has no place in a wealthy country.\nforms. The idea can even be dropped until, say, five\nPresident Clinton has it right: Universal cover-\nor more years from now when it would automatical-\nage is needed for humanitarian reasons, and eco-\nly kick in if voluntary reforms did not achieve\nnomic reasons as well. Without it, health care\nuniversal coverage. But universal coverage cannot\nmarkets will not work properly. Most reform bills\nbe denied unless the country wants to tolerate the\nwould require insurers to sell to all applicants,\nspectacle of millions of Reckaways and Thoorsells.\nTHE NEW YORK TIMES, SUNDAY, JUNE 20, 1994\nUnnecessary Nuclear Relics\nThe Pentagon says it does not want more B-2\nrestoration and other work at military bases that\nbombers. The Energy Department does not want a\nare being closed.\nnew nuclear reactor. But there are interested par-\nThe B-2 is wasteful, but the new nuclear reactor\nties in the private sector and in Congress who want\nis downright wrong. It was originally designed as a\none or the other or both. By denying funds this week,\nbreeder reactor, which produces more plutonium\nthe Senate can stop these superfluous programs in\nthan it consumes. At a time when the world is\ntheir tracks.\nworried about nuclear proliferation and cannot\nThe B-2 bomber was designed to penetrate\nkeep track of the tons of plutonium it already has,\nSoviet air defenses and drop nuclear bombs on\nproducing more of this critical ingredient in bombs\ntargets that U.S. missiles missed. That mission is\nis perverse.\nextinct. The B-2 is now being touted as a convention-\nFinancing the Integral Fast Reactor would\nal bomber, at an exorbitant $870 million a copy. The\nsend the wrong signal to Japan and others who are\nPentagon already has 20 B-2's, and an ample num-\nplanning to produce more plutonium to fuel nuclear\nber of other bombers, to carry out that new mission.\npower plants. Energy Secretary Hazel O'Leary,\nYet B-2 backers want to spend $150 million to\nwho wants to terminate the program, put it well:\nkeep the plane's production line warm. Senator Carl\n\"We cannot credibly urge that others not use tech-\nLevin has a better way to spend the money: use it to\nnologies for separating and using plutonium if we\nmake up a shortfall in funding for environmental\nare pursuing those same technologies ourselves.\"\nSmarter, and Fairer, About Drug Crime\nBeneath the din of tough-on-crime shouting in\ntives Henry Hyde of Illínois and Bill McCollum of\nthe White House and Congress, a quiet strain of\nFlorida endorse retroactivity. Attorney General\nsober reason has begun to emerge in the fight\nJanet Reno hangs back, even though she was among\nagainst drugs. Both the House and Senate have\nthe first in Washington to denounce the rigid mini-\nvoted to ease mandatory minimum sentences for\nmum sentences. Her own Justice Department found\ncertain low-level drug offenders.\nlast year that as many as 16,000 Federal prisoners\nThat refreshing step recognizes that while the\nare in the small-time drug offender category. The\nmules and messengers of drug operations must be\nHouse bill would spring only a fraction of that\npunished, it is dumb and unfair to inflict mandatory\nnumber by reducing five-year minimums to two\nminimum sentences of 5 and 10 years. Both cham-\nyears - if prisoners' criminal records include only\nbers would remove mandatory terms for minor\nminor previous offenses and the Justice Depart-\ndrug violators. The House would apply the more\nment does not accuse them of being ringleaders.\nflexible rules retroactively to release between 1,600\nMinor offenders need punishment, but existing\nand 4,000 inmates needlessly cramming Federal\nsentencing guidelines can do the job. Otherwise,\nprisons.\nthese inmates will occupy beds needed for more\nSenate-House conferees can adopt the House's\ndangerous crime leaders and force new prison\nretroactive leniency without losing any political\nconstruction, eating up funds for police and crime\npoints. Certified crime warriors like Representa-\nprevention. The House has the right version.\nTHE NEW YORK TIMES, SUNDAY, JUNE 26, 1994\n17\nTHE WASHINGTON POST\nSUNDAY. JUNE 26. 1994\nNo Mandate\nMoynihan Health Plan\nIn Moynihan\nIs Not Quite Universal\nHealth Plan\nHEALTH, From A1\nBut Moynihan has warned Clinton\nDraft of Bill Envisions\nthat Congress will not pass a bill\nwith that mandatory provision, and\nCovering 95 Percent\nmany Republicans, conservative\nDemocrats and uncommitted mem-\nbers who object to it have been\nOf Americans by 2000\nwatching the Finance Committee\nclosely as a bellwether of what ulti-\nmately can garner a majority on the\nBy Dana Priest\nWashington Post Staff Writer\nAI\nfloor of both chambers.\nThe committee will begin public\ndiscussions of the health care issue\nA health care reform bill being\ndrawn up by Senate Finance Com-\nthis week in hopes of voting out a\nmittee Chairman Daniel Patrick\npackage before the July 4 congres-\nsional recess. Moynihan's plan,\nMoynihan (D-N.Y.) would rely on\nknown as the \"chairman's mark\" will\neconomic incentives, new insurance\nbe the official vehicle for the discus-\nregulations and government subsi-\nsion, although the committee also\ndies for the poor to provide insur-\nwill consider a compromise plan pro-\nance coverage to 95 percent of\nposed Friday by a \"rump group\" of\nAmericans by the turn of the centu-\ncommittee senators. There is con-\nry, according to a draft of the pro-\nsiderable overlap between the two\nposal.\nplans.\nUnder the Moynihan plan, which\nInitial reaction to Moynihan's pro-\ncongressional sources said will be\nposal appeared positive, and some\nproposed to the committee Monday\nin a closed-door session, neither em-\nployers nor individuals would be re-\nquired to buy health insurance. But\n\"It sounds\nif the 95 percent target is not\nreached by 2000, a national commis-\nextremely\nsion would recommend new, manda-\ntory measures to Congress. Special\npromising. It sounds\nprovisions in the bill would make it\ndifficult, but not impossible, for Con-\nlike we're on the\ngress to reject the recommenda-\ntions.\name wavelength\nFinancing and other provisions\nstill are under discussion and com-\n-he's focusing on\nmittee chief of staff Lawrence\nO'Donnell Jr. said last night that\nachieving the\nMoynihan, \"Has made no decisions.\"\nThe draft includes proposed new\nobtainable.\"\ntaxes on cigarettes, guns, ammuni-\n-Sen. John H. Chafee\ntion, certain insurance premiums\nand a 1 percent payroll tax on firms\ncommittee members said yesterday\nwith more than 500 employees.\nthey believed it has a good chance of\nA draft of Moynihan's 139-page\nbreaking the deadlock.\nproposal was obtained by The Wash-\n\"It sounds extremely promising,\"\nington Post. In many ways, its intro-\nsaid Sen. John H. Chafee (R-R.I.),\nduction will mark a new phase in the\nthe leader of the rump group. \"It\nhealth care reform debate, finally\nsounds like we're on the same wave-\npinning down the mercurial chair-\nlength-he's focusing on achieving\nman of what is arguably the most in-\nthe obtainable.\"\nfluential committee in Congress on\n\"Senator Moynihan is making a\nthe health care question.\nserious effort to lay before the com-\nThe Finance Committee, which\nmittee something they will consider\nhas a history of bipartisanship. has\n\"credible,\" said Sheila Burke, chief of\nbeen deadlocked for months over\nstaff for Minority Leader Robert J.\nhow or whether to finance what\nDole (R-Kan.), who is also a commit-\nPresident Clinton has said is his bot-\nstee member. \"Dole will see this as a\ntom line for a health care plan-\nserious effort to reach out to Repub-\nhealth insurance for all Americans.\nlicans.\"\nTwo of the five congressional\nA White House official, briefed by\ncommittees with jurisdiction over\na reporter on elements of the Moy-\nhealth care-one in the House and\nnihan proposal, said, \"the concepts\none in the Senate-already have\nsound interesting and seem to be\nadopted plans to pay for universal\nmoving in the right direction.\" The\ncoverage by requiring employers to\nofficial said it would be impossible to\nbuy insurance for their workers-\ncomment further without having an\nthe so-called employer mandate that\nimpportunity to review the complete\nis part of Clinton's original health\nplan.\ncare proposal.\nSee HEALTH, A22, Col. 1\n1/2\nColeman Shows he Grea est Potential\nFor Gains in Senate Race, Poll Indicates\n\"He is not a spectacular senator. He is not\nPOLL, From A1\na brain surgeon,\" said Robert B. McKinney,\npercent of Democrats interviewed favored\nroom for growth, his best hope may lie in a\n39, a lawyer in Louisa County in central Vir-\nNorth. and another 8 percent were backing\nginia. Nonetheless, McKinney said, \"I still\nColeman.\nclose four-way race in which less than 35\npercent is needed to win.\nfeel he is a hard-working and competent poli-\nRobb's lead would be substantially larger\nAlthough Coleman may be best positioned\ntician.\"\nif Wilder were not in the race. Wilder, the\nto pick up supporters, he also has the softest\nNorth supporters are far more enthusias-\nnation's first black governor, currently\nsupport of the four: Fewer than a third of\ntic about their candidate. More than six out\nclaims 56 percent of the black vote, while\nColeman's advocates said they strongly back\nof 10 strongly support their choice, com-\nRobb received the support of 34 percent.\npared with four out of 10 Robb backers.\nRobb is the second choice of an overwhelm-\nhim.\n\"I feel he's probably the best candidate,\"\nNorth is collecting dividends from the un-\ning number of black voters surveyed. About\nMarie Toshiko Clarke, 25, a suburban\nrelenting travel schedule he has followed in\none out of six voters in Virginia is black.\nRichmond homemaker. \"But I don't know\nthe last two years, crisscrossing Virginia to\nWilder \"pulls for the black community,\"\nwhether voting for him would be a wasted\nspeak on behalf of state and local candidates.\nsaid Latawnya Peterson. 21, a physician's as-\nvote.\"\nLately, he's been campaigning for hinself, at\nsistant in Hopewell.\nColeman also is the most popular \"second\nevery chicken fry, crab fest and pig roast in\n\"As an African American, 1 feel like he has\nchoice\"-named by 26 percent-an impor-\nsight.\nan understanding of some of the social\nconsideration if one of the candidates\n\"I have had the opportunity to hear him\nneeds,\" said Marguerite Murray. 37, who su-\ndrops out. He also benefits if some voters de-\nspeak, and I am pretty much on-line with ev-\npervises a residential mental health program\ncide their first choice can't win and go look-\nerything he says,\" said Walter Lindsay, a 20-\nin Charlottesville. think he does have an\ning for an alternative. Both Robb and Wilder\nyear-old student from Giles County on the\near for listening and some compassion\nwere the second choice of 21 percent, while\nWest Virginia border, sounding a familiar re-\nabout what the people are facing.\nHe has\nNorth was the second choice of only one out\nfrain of North backers.\na connection with some people.\nof 10:\nThe Bible-quoting North also is being re-\nAmong white voters, Robb has 36 percent\nThose statistics combine to present a.\nwarded for his hard-line antiabortion stance\nand Wilder has 9 percent. Robb's lead is\nmonumental challenge, and opportunity, for\nand his call for Christian-based family values.\nmuch narrower when it comes to North, who\neach of the candidates and their consultants.\nThe survey found that among those white\nhas 31 percent support among white voters.\nBy November, they are likely to have shared\nevangelicals who said they were deeply in-\nMany people expressed ambivalence\nin the most costly, and perhaps one of the\nvolved in their church-about 20 percent of\nabout the candidates.\nmost negative, U.S. Senate campaigns in the\nthe electorate-the former White House\n\"I don't think he's an ideal candidate, but if I\ncountry's history.\nhad to choose between the two, I would choose\nEach of the campaigns tried yesterday to\nmilitary aide is favored by 45 percent. Robb\nRobb over North,\" said Brian P. Menard, a 29-\nput the best light on the survey.\nwon support from 28 percent; 12 percent\nyear-old law student at the University of Vir-\nRobb spokesman Bert Rohrer said the poll\nback Coleman; and 4 percent favor Wilder.\nginia. \"While I won't put Charles Robb's lack of\n\"confirms what we've been saying. It looks\nEven among North supporters who aren't\nintegrity in the same category as Oliver North.\ngood, but we are taking nothing for granted.\nsure he did the right thing in the Iran-contra\nclearly he has shown to me at least a lack of\nIt's going to be a long, difficult campaign.\"\naffair, there is a feeling, as Roy Eugene Phil-\ndiscretion and a lack of good taste.\"\n\"Any challenger who is within 10 points of\npotts Jr., of Martinsville, put it, that \"he was\nKimberly Rilma, a recent high school\nan incumbent five months out has to be\njust following orders from the higher-ups.\"\ngraduate from Hampton who described her-\npleased,\" said North spokesman Mark Mer-\n\"He's a war hero,\" said James R. Glenn,\nself as moderate Republican, said: \"Honestly,\nritt. Recalling that in last year's gubernatori-\n64, a farmer from Nickelsville in Southwest\nI feel that Oliver North is a crook. And I feel\nal race, in which the Republican nominee-\nVirginia. \"I think [the arms-for-hostages\nthat Charles Robb is a crook, also, but I think\nand eventual winner-badly trailed the\ntrade] was done under orders and that the\nhe's a productive crook.\"\nDemocrat at the start of the summer, Mer-\nnews media set him up.\"\nEven though the candidates don't satisfy\nritt said, \"George Allen would have given his\nNorth's support isn't limited to the Chris-\neveryone, interest in the race is high.-With\nright arm for these numbers.\"\ntian Right. Susan P. Jones, a, 29-year-old\nthe election more than four months away,\n\"It's clear voters are looking for an alter-\nhomemaker from Standardsville, is attracted\nnearly three out of four voters said they're\nnative to Robb and that North is not it,\" said\nto his campaign because of his opposition to\nalready closely following the race.\nColeman campaign manager Anson Franklin.\ngun control.\nOverall, 56 percent of those interviewed\n\"The most remarkable and consistent find-\n\"I think they are taking too many rights\nsaid they were satisfied with the candidates\nings in the early polls is the unacceptable\naway,\" Jones said. \"They are going about gun\nrunning. In December, before Coleman and\nquotient [of the other three], especially after\ncontrol the wrong way. The criminal can al-\nWilder entered the race. an equally large\nRobb and North spent millions to get their\nways get a gun, but your average citizen can't\nmajority were dissatisfied with the candi-\nnominations.\"\ngo buy a gun now without it being a hassle.\"\ndates in the field.\nWilder campaign manager Glenn David-\nOn the other hand, North has yet to at-\nA total of 1,000 randomly selected regis-\nson, noting that an earlier poll by another or-\ntract many Democratic defectors. Only 4\ntered voters were interviewed by telephone\nganization showed the race much closer,\nJune 19-23. Margin of sampling error for the\nsaid: \"It's difficult for us to put our confi-\noverall results is plus or minus 3 percentage\ndence in either poll. And as the governor\npoints.\nlikes to say, the only poll that counts is the\none that's taken on Election Day.\"\nSenior polling analyst Sharon Warden\nRobb is running best among women, older\ncontributed to this report.\nvoters, independents and political moder-\nates.\nAnd according to extended interviews by\npoll takers with 40 of the respondents, Robb\nis benefiting from a forgiving electorate, low-\nered expectations and opponents who often\nare viewed even less favorably.\nNearly everyone interviewed was aware\nTHE WASHINGTON POST\nof Robb's personal problems, which began\nSUNDAY.\n11\nduring his term as governor in the 1980s.\n26.\n1994\nHe attended parties with drug users in Vir-\nginia Beach and acknowledged marital indis-\ncretions.\n\"He had such great promise. How sad that\nhe didn't live up to it,\" said Frances Richard-\nson, 77, of Falls Church, who is more dis-\nheartened than she is angry with Robb. \"I\nthink he could have gone on and been a good\nsenator and maybe even run for president\nsome time. But he blew it.\"\n35\n2/2\n\"Clinton, in his weekly radio ad-\nBut at the heart of the bill is a reli-\nress yesterday, continued an ongo-\ndrumbeat of White House insis-\nance on a \"managed competition\" ap-\nonce on universal coverage. \"We've\nproach to reform, including changes\nCard a lot about measures lately\nin the rules insurance companies\nVitit wouldn't provide coverage to all\nmust follow, a standard benefit pack-\nTHE WASHINGTON POST\n\"families,\" he said. \"But, make no mis-\nage and the ability of small firms and\ntake, measures that are halfhearted\nindividuals to pool their purchasing\nd, at best, guarantee that things\npower and bargain with insurers for\nSUNDAY, 26. 1994\nStay only about as good as they are\nbetter rates.\nnow; the poor would get health care,\nIn committee hearings, Moynihan\nMare wealthy would get health care,\nhas shown a preference for letting\nthe middle class would get it some-\nthe private market fixes work before\ntimes and not get it sometimes.\"\nallowing the government to get in-\nMoynihan, who was out of Wash-\nvolved. On more than one occasion\nington yesterday, could not be\nhe has revisited the government's\nreached. His staff did not return\nfailure to accurately predict the cost\nelephone calls.\nof the Medicare program for the el-\nThe employer mandate has been\nderly. Government actuaries pre-\nproved by the Senate Labor and\ndicted when it was first enacted in\nfiman Resources Committee and\n1965 that Medicare would cost $9\nHouse Education and Labor\nbillion in 1990. It cost the govern-\ncommittee, and is believed to have\nment $106 billion in 1990.\nenough support to pass in the House\n\"Over the last quarter of a centu-\nry we have all been wrong\" in pre-\nWays and Means Committee, which\ndicting the true cost of entitlement\nis still debating its bill.\nprograms, Moynihan told First Lady\nBut the House Energy and Com-\nHillary Rodham Clinton when she\nTHE MOYNIHAN COMPROMISE\nmerce Committee is deadlocked on\ntestified before the Finance Commit-\nthe issue, and many members do not\ntee in October.\nFollowing are the key provisions of the health reform bill propo\nfavor it. Major elements of the busi-\nby Finance Committee Chairman Daniel Patrick Moynihan (D-N.)\ncommunity have mounted an\nunprecedented district-by-district\nWHO PAYS\ngrass-roots and media campaign to\nVoluntary. No requirement that employers or individuals buy\nlobby against it.\ninsurance.\nOn the other side, labor unions,\nconsumer and senior citizens groups,\nThere are government subsidies for low-wage firms that pay 8\nhealth professionals and elements of\npercent of their workers' insurance cost.\nthe insurance industry favor the em-\nSmall businesses that pay at least 50 percent of their workers'\nployer mandate to pay for what they\nhealth costs can enroll in the existing Federal Employee Health\nagree with Clinton is the bottom line\nBenefits Program.\nof an acceptable plan-one that pro-\nFull government subsidies phased in for low-income people.\nvides universal coverage.\nEmployers must offer at least three health plans, including a\nFinding a middle ground that is\nfee-for-service plan.\nacceptable to enough members on\nboth sides of the issue is the ultimate\nUNIVERSAL COVERAGE\nof whether the legislation will\nIf 95 percent of all Americans do not have insurance by 2000, tl\npass.\na National Health Care Commission would recommend ways to\nMoynihan, according to congres-\nachieve that goal. If Congress did nothing, the recommendations\nsional sources, believes he has found\nwould take effect. If Congress substituted other measures, it WOU\nacceptable middle ground by pro-\nhave to vote on them by the specified deadline-helped by fast-t\nviding a mechanism to achieve uni-\nprocedures. If it wanted to reject the recommendations, it would r\nversal coverage-redefined as 95\nto hold a full debate and vote to do so before the deadline.\npercent of the population-that is\nBENEFITS\nflexible and still allows Congress a\nway around compulsory insurance\nAll insurance plans would have to offer a standard package of\npayments by employers or individu-\nhealth benefits equivalent to the Blue Cross/Blue Shield Standa\nals.\nOption plan available to federal employees, currently worth abo\nThe plan would give a new nation-\n$4,800 for an annual family policy.\nal commission-a seven-member\nThere would be annual limits on out-of-pocket exper\ninclu\nbody nominated by the president and\nco-payments, deductibles and coinsurance.\napproved by the Senate-authority\nA \"catastrophic\" option with a deductible of at least $5,000\nto determine why more people are\nwould also be available.\nnot insured and the flexibility to tai-\nlor a remedy. It may turn out, propo-\nCOST CONTROLS\nnents of the proposal argue, that\nAnnual insurance premium targets would be set. If exc led.\nthere is some unforeseen problem\nNational Health Cost Commission would recommend to Congre\nthat an employer or individual man-\nways to meet targets. Congress must vote on recommendations\ndate would not fix. Congressional\nfast-track procedures.\nability to reject the recommenda-\nControls against deficit spending would be imposed, automat\ntions would be limited.\nreducing subsidies if government health spending increased the\nThe Moynihan plan contains sev-\ndeficit, unless Congress finds some other way to eliminate the\neral incentives for employers to vol-\ndeficit spending.\nuntarily provide coverage for their\nINSURANCE MARKET REFORMS\nworkers. It would offer subsidies, for\nexample, to employers of low-wage\nNo termination or nonrenewal of coverage, except for\nworkers, but only if the employers\nnonpayment or fraud.\nvoluntarily pay 80 percent of their\nNo exclusion from coverage of a preexisting condition for mo\nworkers' insurance costs.\nthan six months from the date of enrollment.\nUnlike Clinton's plan, and the ma-\nInsurers would be required to \"community rate\" with limited\njor congressional variations of it,\nvariations for geography, family size and age.\nMoynihan's proposal also stops short\nof government-imposed controls on\nVoluntary insurance purchasing cooperatives would be availa\nfor individuals and for firms with fewer than 500 workers.\nincreases in the price of insurance\npremiums. Instead, it would set an-\nMEDICAID AND MEDICARE\nnual targets for such increases and\nMost Medicaid recipients treated like other low-income peop\ngive a new National Health Cost\nProvisions to facilitate enrollment of Medicare recipients in +\nCommission authority to recom-\nand other certified managed care arrangements.\nmend ways to reduce costs, such as\nscaling-back the standard benefit\nFINANCING\npackage or imposing premium ceil-\nMoney for subsidies would come from Medicare and Medica\nings. Congress would have to vote\nsavings, a tax on cigarettes, cigars, guns, ammunition, insurers\non the recommendations using fast-\na 1 percent tax on firms with more than 500 employees.\ntrack provisions with limited debate.\n37\n2/2\nTHE WASHINGTON POST\nSUNDAY. 26. 1994\nCarter's Call\nFrom N. Korea\nCARTER, From A1\nLooms Large\nlated states out of its ambition to join\nthe select ranks of nations posses-\nsing nuclear weapons.\nConcession to Ex-President\nThe key to this abrupt policy shift,\naccording to several participants in\nCreated Opening for U.S.\nthe White House meeting and many\nothers familiar with the events, was\nWashington's decision to seize a\nBy R. Jeffrey Smith\nsmall North Korean concession to\nand Ann Devroy\nCarter and try to enlarge it.\nWashington Post Staff Writers\nThat meant taking Kim's limited\nPresident Clinton and his top nation-\nand somewhat vague pledge to Cart-\nal security aides were well into the sec-\ner, and transforming it into a more\nond hour of discussing a plan to build\nconcrete and slightly wider North Ko-\nup U.S. military forces in South Korea\nrean promise to put on hold its most\nwhen a secretary interrupted to say\nworrisome nuclear activities. Gallucci\nJimmy Carter was on the phone.\nwrote a one-page letter Monday to his\nThe former president was calling June\nNorth Korean counterpart, Vice For-\n16 from the capital of North Korea,\neign Minister Kang Sok Ju, saying\nwhere he had met with president Kim Il\nWashington would enter talks if Kang\nSung-the man who ordered the 1950\nconfirmed Washington's interpreta-\ntion of Kim's statement to Carter.\ninvasion that started the Korean. War.\nA\nant Secretary of State Robert L.\n\"We didn't have a good message\nGallucci hurriedly left the White House\n[from North Korea]-we made it up\"\nCabinet room to take the call about\nby turning North Korea's offer into\n10:30 a.m., idling the discussion.\nsomething that provided an opening\nGallucci returned 30 minutes later\nfor negotiations, one official said. The\nand diplomatic sanctions against\ndecision was to \"frame our answer [to\nwith a startling message: Carter would\nNorth Korea faced tough opposition\nCarter's public statement] in terms of\nshortly appear live on Cable News No\nfrom China, and had at best lukewarm\nwhat we wanted to hear,\" another\nwork to convey what the former presi-\nsupport from Russia, Japan and South\nofficial said.\ndent considered a dramatic break-\nKorea.\nKim had pledged to Carter that\nthrough in the long-standing dispute\nMoreover, the significance of the\nNorth Korea would leave international\nover North Korea's suspected develop-\ncoming Geneva talks remains an open\ninspectors in place at North Korea's\nment of nuclear weapons.\nquestion. If North Korea is bent on\nYongbyon nuclear complex, and freeze\nVice President Gore, Secretary of\nbuilding a nuclear arsenal, its involve-\nits accumulation of plutonium if Wash-\nDefense William J. Perry, Secretary of\nment in new diplomacy will eventually\nington entered high-level talks. Pluto-\nState Warren Christopher and the oth-\nbe seen as a clever but devious move.\nnium is a key ingredient of nuclear\ners filed into a cramped, adjoining of-\narms. This offer had been made be-\nBy playing a good host to a former\nfice, equipped with a television set, to\nfore.\nU.S. president, the country was able\nwatch Carter. They were flabbergast-\nto derail the U.S. drive for sanctions.\nIn response to the Gallucci letter,\ned when the former president de-\nhowever, Washington obtained North\nAnd, as some congressional critics\nscribed Kim's promises as a \"very posi-\nKorean promises not to refuel the\nhave emphasized, one of North Ko-\ntive step\" and urged the administration\nYongbyon atomic reactor and specifi-\nrea's principal promises, not to repro-\nto withdraw a two-day-old proposal for\ncally not to conduct more reprocess-\ncess used fuel to make plutonium, has\nmild sanctions against North Korea.\ning of used nuclear fuel to make pluto-\nno immediate effect. That's because\n\"It looked as if we were contracting\nnium. The United States also obtained\nthe fuel is so radioactive, or \"hot,\" that\nout our foreign policy, like we were by-\na less tangible but critical piedge by\nit cannot be reprocessed anyway for\nstanders\nand had totally lost con-\nNorth Korea to maintain \"the continu-\nawhile while it is cooled in a storage\ntrol of it,\" a White House official later\nity of safeguards\" at the nuclear\npond. If North Korea wants to, it can\nrecalled.\nsite-a phrase Washington internets\nfind a reason to withdraw from the\nFor many in the room, nothing\nto mean that the inspector\ndo\ntalks in several months and have\nseemed new in what Kim reportedly\nwhatever they please.\nenough plutonium by the end of the\nhad said. But after the shock and frus-\nThe United States granted North\nyear for four to five nuclear weapons.\ntration had waned, with Go urging\nKorea the diplomatic talks that the\nSuch an outcome would make\neveryone to set aside their emotions,\ncommunist nation strongly desires,\nCarter and the Clinton administra-\nClinton and other officials cleared their\nwhich North Korea hopes will demon-\ntion look like dupes.\nafternoon schedules and held a two-\nstrate that it plays an important role\nIf on the other hand the new talks\nhour discussion that sharply altered the\nin world affairs. The talks, between\nsucceed in shutting off the North\ndirection of U.S. policy on Korea.\nGallucci and Kang, are scheduled to\nKorean nuclear effort, the Clinton\nHaving begun the day in a grim\nbegin in Geneva on July 8 or 11.\nadministration's decision to seize the\ncouncil of war-discussing sending\nAdministration officials likened\ndiplomatic opening provided by Cart-\nnew planes, ships and troops to South\ntheir strategy to the one that Attor-\ner's awkward visit will be seen as a\nKorea for a possible horrible conflict-\nney General Robert F. Kennedy had\nmaster stroke that brought the Ko-\nthe senior officials had by mid-after-\nadvised during the 1962 Cuban mis-\nrean peninsula back from the brink\nnoon switched to a new embrace of di-\nsile crisis. Then, Moscow made a\nof another conflict.\nplomacy.\npromising but unsatisfactory offer to\nIf the man calling from North Ko-\nAfter quick consultations with key\nsettle the crisis that Washington in-\nrea in the middle of the White House\nU.S. allies and lawmakers, the military\nterpreted to mean what it wanted.\nmeeting had been any other of the\nbuildup plans were put on hold, so\nTo be sure, the administration was\nmany Americans who have gone there\nWa ington could again try to talk one\nmaking the best of a difficult situation.\nrecently. the White House could have\nof the world's most xenophobic and iso-\nIts drive for United Nations economic\nignored him. But an ex-president of\nSee CARTER, A10, Col. 1\n12\nTHE WASHINGTON POST\nSUNDAY, JUNE 26. 1994\nDoctors Score Victories\nIn Battle on Health Bill\nAMA-Approved Provisions Advance on Hill\nBy Spencer Rich\nother services for an illness that an\nWashington Post Staff Writer\nHMO could treat by less costly\nmethods.\nIn the struggle over a new health\nIn a \"pure\" HMO, the patient\nsystem, doctors have won some ma-\nmust use only the accepted doctors.\njor congressional battles in recent\nTo succeed, the HMOs contend they\nweeks.\nmust be able to exclude wasteful\nThe aim, in the view of the Ameri-\ndoctors.\ncan Medical Association, is to pre-\nJost says a new \"point of service\"\nvent HMOs and other insurers from\nrequirement approved by the Ways\nimposing undue constraints on physi-\ncians' freedom to practice good\nand Means Committee Thursday\nmedicine and patients' right to\nnight on an amendment by Rep. Bill\nchoose a doctor.\nBrewster (D-Okla.) would \"gut\" the\nAMA President Lonnie R. Bris-\n\"ability of HMOs to manage care.\"\ntow charged recently that to control\nIt requires all HMOs to allow any\ncosts, insurers are increasingly leav-\npatient at any time to use any doctor\ning doctors and patients with less\noutside the HMO's panel of doctors,\ncontrol over their health treatment\nwith the HMO required to pay part\ndecisions and are setting up rules\nof the fee. \"Anyone could go out to\nthat make it difficult for doctors to\nany specialist and get a procedure,\nexercise their medical judgment.\ntest or operation whether we think\nElements of what the AMA calls\nhe needs it or not.\nthe \"Patient Protection Act\" but crit-\nThe effect is to turn every HMO\nics have labeled largely a doctor-pro-\ninto an old-style fee-for-service\ntection act have been incorporated\nplan,\" Jost said. Many HMOs, do of-\nin three major health bills moving\nfer plans that have an option of this\nthrough Congress. Other AMA-fa-\ntype, at a premium that reflects the\nvored provisions that HMOs contend\nadded cost to the HMO, she added,\ncould severely damage their opera-\nbut for quality care at the lowest\ntions have been adopted by the\nprice, it is essential for HMOs to re-\nHouse Ways and Means Committee.\ntain the HMO-doctors-only option.\nDiana Jost, vice president of the\nThe Ways and Means Committee\nGroup Health Association of Ameri-\nalso approved, 20 to 17, an amend-\nca, an HMO umbrella group, said,\nment by Rep. William J. Jefferson\n\"These provisions go straight to the\n(D-La.) requiring every HMO (ex-\nheart of what makes an HMO an\nHMO, and destroy our ability to pro-\ncept those using salaried doctors and\nKaiser and HIP of New York) to ac-\nvide high-quality care at lower\ncosts.\"\ncept as part of its doctor network\nThe disputed issues include the\nany doctor willing to accept its fee\nright of HMOs to hire and fire doc-\nschedule.\ntors, to allow their patients to use\nJost said that if this \"any-willing-\nonly the doctors deemed able to pro-\nprovider\" requirement is absolute-\nvide good service without waste, and\nand would apply even in cases where\nto set treatment rules.\nthe HMO does not need any more\nPrepaid HMOs (health mainte-\ndoctors-it would wreck an HMO's\nnance organizations) such as Kaiser,\nability to choose only the most effi-\nwhich provide all services needed for\ncient doctors. But House aides said\na fixed annual fee, historically have\nthe Jefferson amendment applies on-\nkept their costs lower than fee-for-\nly to unfilled slots.\nservice policies.\nWhat is clearly driving this dis-\nThey do this in part by managing\npute, said a House staffer, is public\nthe care they provide to see a pa-\nfear that people will be unable to\ntient does not wander from one doc-\nchoose their doctors. \"The freedom-\ntor to another. repeating tests or ob-\nof-choice argument has gone over\ntaining surgery, hospitalization or\nbig and people are worried about it.\"\nRobb Says He'll Ask Clinton to Help in Campaign\nBy Peter Baker\nBut facing a four-way race in\ncountry, I suspect.\nIt's very\nin the party expected Reilly to side\nWashington Post Staff Writer\nwhich a third of the vote may be\nmuch on his radar screen. I'm not\nwith Wilder, she appeared today\nenough to win, Robb is targeting\ngoing to run away from him at all.\"\nwearing a Robb button and declar-\nCHARLOTTESVILLE, June\nhis appeal to more liberal party loy-\nBy wrapping himself in the Clin-\ning herself in his camp.\n25-Sen. Charles S. Robb (D-Va.)\nalists who support Clinton, accord-\nton cloak, however, Robb feeds in-\n\"Chuck won fair and square,\" she\nplans to invite President Clinton to\ning to analysts.\nto the strategy of Republican Oli-\nsaid of this month's Democratic\ncampaign with him in Virginia this\n\"I know it energizes our friends\nver L. North, who regularly attacks\nprimary. But she acknowledged\nfall, a move that could help shore\non the other side, but I look for-\nRobb as a rubber stamp for the\nthat endorsing him \"was the most\nup his Democratic base but also\nward to working with and running\npresident's liberal social and tax\ndifficult decision I ever had to\nTHE WASHINGTON POST\nmake it easier for Republicans to\nwith\nSUNDAY. JUNE 26. 1994\na very able and dedicated\npolicies.\nmake. I mean, I love Doug Wilder. I\npaint him as a Clinton clone.\nand hard-working president of the\nRobb's appearance before the\nthink he'd make a wonderful sena-\nIn any other year, appearing\nUnited States,\" Robb told a meet-\ncentral committee prompted a dis-\ntor.\"\narm-in-arm with Clinton could be a\ning of the state party's central\nplay of party unity for the incum-\nHoping to prevent many defec-\nmistake for a Democratic candidate\ncommittee today.\nbent. The audience of 200 passed a\ntions, party Chairman Mark R.\nin this generally conservative state,\nIn an interview after his speech,\nresolution supporting his reelection\nWarner sternly warned those who\nwhich went for Republican George\nRobb said he had spoken to Clin-\nand gave him repeated standing\nplan to support Wilder to quit their\nBush in 1992 and, according to\nton about his reelection campaign\novations.\nparty posts immediately.\npolls, thinks even less of the presi-\nseveral times in the last week. \"At\nAmong those on hand was Mame\n\"We're going to expect them to\ndent today.\nsome point I expect that he will be\nReilly, a member of the Democrat-\ndo the honorable thing and resign,\"\nAs recently as last fall, guberna-\nmaking an appearance,\" Robb\nic National Committee and a long-\nhe told the crowd.\ntorial nominee Mary Sue Terry\nsaid.\ntime confidant of former governor\nAlthough most stood to applaud\npointedly did not invite Clinton to\n\"Each time, he's talked about it,\nL. Douglas Wilder, who has bolted\nWarner's admonition, about one-\nVirginia and repudiated some of his\nand he's following the race as\nfrom the party to run against Robb\nthird of the crowd remained seated\npolicies.\nclosely as any other race in the\nas an independent. Although many\nand silent.\n69\nMARY McGRORY\nGood Soldier Sam\nMcGRORY, From C1\npapers, where lobbyists sit grimly sizing up their prey\nImmediately, the bickering Democrats fell in line,\nthe incident-\"insignificant, a footnote,\" he said. At a\nand where Republicans offer amendment after\ngiving chairman Gibbons a run of straight party-line votes\ncaucus scheduled to last into the night, Democrats\nown-and had to back up when the Congressional Budget\namendment to a bill they have announced they will vote\nthat set Democratic leader Richard Gephardt to praising\npromised it would never happen again.\nOffice could not do the arithmetic until mid-July, long\nagainst.\nthem for \"doing a great job in a tough situation.\"\nGibbons says it is fitting that the lower House prod the\nafter the deadline he had set had passed.\nThe Democrats were slogging along when they\nBut if Grandy could give, he could also take away.\nlordly Senate into action. \"All the really big\nLast week it was Gibbons's turn for the standing O. He\nsuddenly got a break. A Republican blurted out the\nThere followed one of those episodes that makes health\ngave the meeting of Democratic whips a report about his\nprograms-Social Security, Medicare, Fair Housing.\nworst-kept secret in town: His party's leaders, despite\ncare so confusing and the outcome hard to predict.\ncommittee's progress on the bill that Bill Clinton says he\nhave originated in the House. They always put on the\nmuch protest that they really wanted health care reform,\nGrandy introduced an amendment calling for hearing aids\nhas to have. Colleagues had been reminded that the\nbetter show over there [in the Senate], but we do the\nwere behind the scenes urging members to sabotage it.\nfor poor children. Rostenkowski, who sometimes forgets\nmodest chairman had been one of the brave warriors at\nRep. Fred Grandy, a moderate Republican from lowa and\nhe is no longer chairman, reared up and reminded Grandy\nheavy lifting.\"\nNormandy. He jumped with his unit on D-Day. The\nmembers of the Ways and Means Committee, who like\nco-sponsor of the Cooper bill, told the world that Minority\nthat Ways and Means has a pay-as-you-go rule-no\nHe likes being (acting) chairman even better than he\nhim, led the applause.\nWhip Newt Gingrich had given him his \"marching orders\"\nproposals without funding provisions. Grandy retreated.\nthought he would. He thinks he's up to it.\nGibbons is surrounded by a large staff of professionals\nnot to cooperate in any changes that might improve the\nBut 24 hours later, he was back with the hearing aids and\n\"I think I am trained for it,\" he said. That is what made\non the committee, many of whom mean Rostenkowski\nbill and its chances for passage.\na one-half-of-1-percent reduction in insurance subsidies\nus do so well in Normandy, the immense amount of\nwhen they refer to \"the chairman.\" He presides at long,\n\"We now have a leadership that preempts policy with\nto pay for them. He peeled off six Democrats, who voted\ntraining. You tend to do automatically what other people\ngrueling sessions in a hearing room the size of an airplane\npolitics.\" Grandy said in a sound bite that was music to\nagainst his funding scheme but for his proposal. Was this\nhave to pause and think about. You listen, decide, try to\nhangar, where people are constantly darting about with\nDemocraticiears.\nthe beginning of the end of discipline? Gibbons dismisses\nlead.\"\nTHE ASHINGTON POST\nMIN. 26. 1991\nMARY McGRORY\nGood\nSoldier\nSam\nNE OF THE FEW genuinely\nhappy Democrats on Capitol\nHill is 74-year-old Sam\nGibbons of Florida. He is living a\ndream come true. After 25 years of\nyearning, he has become acting\nchairman of the House Ways and\nMeans Committee. When Dan\nRostenkowski was indicted, the gavel\npassed to Gibbons, an unassuming man\nwhose ears stick out and whose eyes\nwater and whose philosophy is that of\nthe infantryman: one step at a time. He\nknows that colleagues in both\nchambers think he is dreaming when\nhe says that a health care bill will come\nout of committee next week. pass the\nHouse, go to the Senate soon after and\nland in a House-Senate conference that\nwill give the Clintons most of what\nthey want. They think the euphoria he\nfeels at being in charge at last is\naffecting his judgment.\nWith health care, you never know.\nTwo months ago, George Mitchell\nwent to a Democratic retreat and\nbrought his fellow senators to their\nfeet, cheering his fight talk on his\nswan-song push for health care. The\nspotlight then swiveled to Jim Cooper.\nyouthful author of an alternative bill\nthat roused Hillary Clinton's ire, then\nto Senate Finance Committee\nChairman Pat Moynihan, who told the\npresident there was no way to get\nemployer mandates. He announced the\nneed for speed, promised a bill of his\nSee McGRORY, C3, Col. 1\nMary McGrory is a Washington Post\ncolumnist.\nNCTON POST\nSUNDAY, JUNE 26, 1994 C7\nWilliam J. Bennett\nCredit the Christian Right\nI have been an ally of the conserva-\nstandpoint of politics and religion.\nthe self; and does not endorse unfet-\ntive Christian political movement for\nAnd some of the \"Christian right\" are\ntered freedom. Christianity is about\nthe last decade. If the portrait now\nguilty of overheated, offensive and\nright and wrong. And politics is, too.\nbeing painted of it were anything\nreckless statements. But every politi-\n(\"It is the cardinal issue of goodness\n€\nto being true, I would have long\ncal movement has extremists who do\nor badness in the life of the polis\nago dissociated myself from it. But in\nnot represent the movement as a\nwhich always engages the attention of\nfact, Christians active in politics are\nwhole. What is fundamentally unfair is\nany state that concerns itself to se-\nnow on the receiving end of an ex-\nthe attempt to take the fringe ele-\ncure\ngood laws,\" according to\ntraordinary campaign of bias and prej-\nment of this (or any) movement and\nAristotle.)\nudice.\nargue that it is central and defining.\nMany Christians assume that the\nConsider a few recent examples.\nThe vast majority of conservative\nDemocratic Congressional Campaign\ncharges leveled against them are\nChristians are promoting a responsi-\nCommittee Chairman Vic Fazio la-\nbased on a misunderstanding of-the\nble (and mainstream) political agenda.\nbeled conservative Christians the\nfundamental aims of their political\nWhat do they seek? Things like safe\n\"fire-breathing Christian radical\nmovement. It may be that the critics\nstreets, good schools, strong families,\nunderstand all too well the aims-the\nright.\" Texas Gov. Ann Richards calls\nnonintrusive government and commu-\nmoral aims-of the movement. And\nthem \"hatemongers.\" The Anti-Defa-\nnities where people care for one an-\nthat is what gives offense.\nmation League published a book ac-\nother. Good things all. And not, one\ncusing the \"religious right\" of bringing\nA cultural divide exists in this na-\nwould think, particularly controver-\n\"a rhetoric of fear, suspicion and even\ntion. Where we can bridge the di-\nsial or \"divisive.\"\nhatred\" to cultural disagreements. A\nvide-where liberals and consérva-\nDuring the last three decades a lot\nrecent New York Times editorial re-\ntives can find common ground-we\nhas gone wrong in America. Our soci-\nferred to conservative Christians as\nshould. Where we cannot, we should\nety is far more violent and vulgar than\n\"sir er,\" \"retrograde\" and \"exclu-\nengage in a robust, spirited, civilized\nit used to be. We have experienced\nsionist.\"\ndebate. But people of goodwill should\nenormous increases in violent crime,\nThis is not political discourse. It is\nnot allow this vital national debate to\nout-of-wedlock births, abortions, di-\nargument by invective. It is worth\nbe sidetracked by mudslingers.\nvorces, suicides, child abuse and wel-\nreflecting on how liberals and the\nOur political culture has sunk to the\nfare dependency. The answer to\nmainstream media would respond if\npoint where people who have time-\nmuch of what ails us is spiritual and\nsimilar things were said by conser-\nhonored religious beliefs that inform\nmoral regeneration. Yet some liberals\nvatives about, say, homosexuals. Or\nwould have us believe that the great-\ntheir politics now become the object\nfeminists. Or blacks. Or Jews. Or\nof scorn and ridicule. On the issues,\nest threat to our Republic are people\nvirtually any group actively engaged\nthe \"religious right\" now stand where\nwith strong religious convictions who\nin politics except conservative evan-\nmost Americans stood 30 years ago.\nare actively involved in politics. This\ngelical Christians. Such criticisms\nThe irony is that the critics of the\nis nonsense.\nwould of course unleash, and rightful-\n\"Christian right\" are often guilty. of\nThe attempt to discredit the con-\nly so, a tidal wave of criticism and\nthe things they profess to be offended\nservative Christian movement is an\ncondemnation. But when it comes to\nby: intolerance, mean-spiritedness, di-\nattempt by some to discredit its un-\nChristians, apparently it is open sea-\nvisiveness and even bigotry.\nderlying philosophy. Christianity\nson.\nmakes normative claims; stands\nThe writer, a former secretary of\nThere are inherent dangers in po-\nagainst moral relativism; is the anti-\neducation, is co-director of Empower\nliticizing religious faith-from the\nthesis of the modern age's worship of\nAmerica.\n63\nHarry and Louise Get Queasy\nDie Harder: A Clinton Health Plan Conservatives Will Love\nBy Robert Hirschfeld\nI\nn a calculated effort to attract\nconservative support for his\nhealth care proposal, President\nClinton today announced new provi-\nsions including a tough stance on\nheart treatment he referred to as\n\"three strokes and you're out-pa-\ntient.\"\nThe policy would actually broadly\napply to any serious ailment requir-\nONLY\ning intensive care. Citing the need to\ncut medical costs, Clinton explained\nthat the government can no longer\nafford to pay for those who need\ncontinuing medical care. \"We simply\ndon't have the money for the\nhangers-on,\" the president stated in\nthe White House press room. He\nwas wearing a dark blue suit with\npleated cuffs complemented by a\ncrisp canary yellow tie and black Ox-\nfords.\nClinton also proposed a five-day\nwaiting period for all surgery to al-\nlow for a background check by a\nteam of government bureaucrats to\nascertain whether cheaper alterna-\ntive procedures would be appropri-\nate, such as blood-letting. During\nthis time patients would be heavily\nsedated to alleviate any discomfort\nthey may feel when informed of how\nmuch of the surgery's cost will have\nto come out of their own pockets un-\nder the new guidelines.\nThe president expressed new\nflexibility toward his previous insis-\nBY ROB SHEPPERSON FOR THE WASHINGTON POST\ntence on universal coverage, which\nhas met resistance in Congress.\nthe healthy. Businesses shouldn't be\nhan thought a scaled-back version\nClinton indicated that he would be\nforced to divert profit to prop up the\nconsisting of bandages and aspirin\nwilling to accept coverage just for\nweak, the feeble and a bunch of\nhad a better chance of passage.\nearth now and allow the other plan-\nmealy-mouthed hypochondriacs,\" he\nOpposition to the Clinton plan is\nets in the universe to be phased in\nstated gruffly.\nalso being fueled by the influence of\nover a prescribed amount of time.\nConcerns about funding for the\nthe insurance industry's \"Harry and.\nThe reaction on Capitol Hill was\nplan were raised by a revised report\nLouise\" TV campaign. In the latest\nswift and not what the president\nfrom the Congressional Budget Of-\nad, the couple who spend their lei-\nmay have hoped for. Senate Minori-\nfice. Contrary to its previous esti-\nsure time reading the Clinton pro--\nty Leader Bob Dole said it wasn't\nmates for revenues generated by\nposal are shown sterilizing a Ginsu\nenough to head off a stalemate in\ncigarette taxes, the latest figures\nknife set with a do-it-yourself sur-\nCongress. \"We have to face the fact\nproject a decline by nearly one-half.\ngery book in supposed preparation\nthat health care assistance perpetu-\nA CBO researcher explained that\nfor the enactment of the plan. The\nates illness. We have allowed whole\nthey had forgotten to factor in the\nfilming of the spot, which took place\ngenerations of Americans to develop\nshortened life expectancy for smok-\nin Los Angeles, was evidently inter-\na dependency on the government for\ners. A tobacco industry spokesman\nrupted when the actors fled the stu-\nthis. It has caused people to lose\ndisputed that assumption and assert-\ndio in order to wave to OJ. Simpson\ntheir incentive to work toward stay-\ned that it is increased taxes that\nas he drove by on an adjacent free-\ning healthy,\" Dole explained before a\ncauses death.\nway.\ngroup of reporters gathered outside.\nPerhaps the most serious setback\nOne influential senator, who asked\nnot to be identified, requested ano-\nA\ndding to the grim outlook for\nto the president's efforts for health\naction on reform, Sen. Daniel\ncare reform came unexpectedly from\nnymity and spoke off the record, was\nPatrick Moynihan, appearing\nformer President Jimmy Carter, who:\neven more critical. \"We have got to\non \"Beat the Press,\" said that even\nappeared to belie the White House:\nstop pussy-footing around with re-\nwith the new provisions, the presi-\ncontention of urgency for passage. Af-\nform. Health care should only be for\ndent's plan is so lavish and overly\nter meeting privately with Republican\ngenerous that it's nearly as expen-\nopponents to the plan, Carter ap-\nSatirist Robert Hirschfeld is a\nsive as the health care program\npeared on CNN and announced that\nfreelance television producer.\nmembers of Congress have. Moyni-\nthe health care crisis is over.\n66\nGeorge F. Will\nGood Limits, State Limits\nThe Supreme Court, which last week agreed to rule\nConstitution, nor prohibited by it to the States, are\non the constitutionality of state-imposed limits on the\nreserved to the States respectively, or to the people\"),\nnumber of terms members of the U.S. House and\nthat the states cannot add qualifications. And they say\nSenate can serve, sits across the street from the\nterm limits constitute a fourth qualification. But wait.\nCapitol. So when the justices consider the Arkansas\nFifteen states have passed term-limits laws. Up to\nSupreme Court's ruling that that state's term-limit law\nseven more may pass them this fall. The courts denying\nis unconstitutional, nine pairs of eyebrows may be\nthe constitutionality of state-imposed limits make much\nraised concerning the crucial four sentences:\nof a manifestly inapplicable case, the one concerning\n\"If there is one watchword for representation of the\nthe late Rep. Adam Clayton Powell of New York.\nvarious states in Congress, it is uniformity. Federal\nIn it the Supreme Court ruled that one house of\nlegislators speak to national issues that affect the citizens\nCongress, when exercising its power to \"judge\" the\nof every state. Additional age restrictions, residency\nqualifications of members, unconstitutionally adds to\nrequirements, or sundry experience criteria established\nthe enumerated three qualifications if it excludes a duly\nby the states would cause variances in this uniformity and\nelected member because of his behavior. But this case\nlead to an imbalance among the states with respect to\nis irrelevant to the question of state powers to regulate\nwho can sit in Congress. This is precisely what we believe\nelections.\nthe drafters of the U.S. Constitution intended to avoid.\"\nWhat is relevant is the history that the Arkansas\nWell. The second sentence is refuted by a glance at the\ncourt ignored. As the Supreme Court noted 20 years\nfederal budget or the workings of a congressional office.\nago, states have evolved comprehensive and complex-\nAnd even were the second sentence true, the first\nand different-codes regulating not only the time,\nsentence is false, the third is an opaque non sequitur, and\nplace and manner of elections but also \"the selection\nthe fourth is disproved by what was done contemporaneous\nand qualification of candidates.\" States began doing so\nwith the drafting of the Constitution, and subsequently.\nimmediately after ratifying the Constitution. They\nRegarding the second sentence, the justices surely know\nwrote laws requiring, for example, candidates to be\nwhat transpires across the street. The Founders' under-\nproperty holders and-the Constitution is silent on\nstanding of federalism-Congress would concern itself only\nthis-to live in the district they wish to represent.\nwith truly national issues; states would do most of the\nDid the Framers mean to prohibit states from doing\nlegislating regarding domestic matters-bears no resem-\nwhat states immediately did? Not likely. The Framers\nblance to today's practice. Today senators and representa-\nknew how to prohibit state actions when they wanted to\ntives occasionally speak to truly national issues, but most\n(which, being believers in federalism, they rarely did).\ndevote most of their time to the parochial business of\nAnd the most important Framer, Madison, was elected\nbenefits for their state or district, and constituency service.\nto Congress under a Virginia law stipulating the qualifi-\nThe Arkansas court did not, because it could not, cite\ncation that candidates must be freeholders.\nthe Constitution's text, or the Constitutional Convention\nIn modern times millions of Americans have been\ndebates or the states' ratification debates to prove that\ndisqualified from running for Congress by \"little Hatch\n\"uniformity\" among the states in regulating elections is a\nacts\" by which some states prohibit public employees\nfundamental constitutional value. And the Arkansas court\nfrom being candidates. These and many other state\nwas arbitrary and murky in asserting that uniformity is\nlaws restricting ballot access (to persons who win\nsupremely important because \"imbalance among the\nprimaries, or otherwise demonstrate support, or have a\nstates\"-whatever that might mean-is bad.\nparty affiliation, and so on) have passed constitutional\nOpponents of term limits say the three qualifications\nmuster.\nfor federal legislators enumerated in the Constitu-\n\"Uniformity\" has never existed regarding states'\ntion-age, citizenship, state residency-are not mini-\nregulations of candidacies for the national legislature.\nmal but exclusive. They say, based on nothing the\nFurthermore, it is an aspiration antithetical to the spirit\nFramers said, and in disregard of the 10th Amendment\nof federalism, the revival of which is an ancillary benefit\n(\"The powers not delegated to the United States by the\nof the term-limits movement.\n65\n6/26/94\nlies not in more talk from the president and his advisers\nby moderate Republicans and Democrats on the Senate\nwhich tends to confuse and alarm the public but less,\nFinance Committee, that was unveiled this week but fell\naccording to former White House press secretary Marlin\nshort of meeting the president's bottom-line demand on\nFitzwater. `The problem is every time he tries to show\ncoverage.\npeople he knows the subject, he defeats his own purpose,\"\nThe much-discussed compromise would require neither\nsaid Fitzwater, who was spokesman for Presidents Bush and\nemployers nor individuals to buy health insurance but\nReagan. \"He should know enough to be careful not to say\nwould rely on market reforms, tax breaks and vouchers for\ntoo much.\"\nthe poor to achieve coverage for 95 percent of Americans\nWhether the crisis of the day is in Pyongyang or\nby the year 2002.\nSarajevo or Kigali, the president should explain American\n``Half measures, quick fixes, things that sound better\ninterests in an easily understood form and refrain from\nthan they actually will work will only make matters\nmusing aloud about complex, fast-changing international\nworse,\" the president said. ``Make no mistake, measures\ncrises, Fitzwater said.\nthat are halfhearted would, at best, guarantee that things\n\"In the absence of policy, too often your\nstay only about as good as they are now\ncommunications are swept up in response to questions and\nthe poor would get health care, the wealthy would get\nthey always relate to action and threats,\" he said. ``All\nhealth care and the middle class would get it sometimes.\nwe've seen is either (Vice President) Gore or the\n\"We have to help middle-class Americans whose\npresident making threats of one kind or another. My advice\neconomic success is the key to America's prosperity know\nto them would be to settle on two or three brief points\nthat they will always have health security, even if they\nthat make a case for our policy and, whatever the\nhave to change jobs or if they lose their jobs,\" he said.\nquestion, repeat those points and reassure the public\nHis remarks came as the House Ways and Means Committee\n(that) they are staying on top of the issue.\"\nheld an unusual Saturday session in an attempt to finish\nwork on its modified version of Clinton's plan by the end\n(Optional add end)\nof this week, before Congress leaves on its Fourth of July\nbreak.\nFollowing Fitzwater's advice might have spared Clinton\nActing mainly along party lines, the panel beat back a\nembarrassment over the last year as he has been forced to\nseries of Republican attempts to modify the bill,\nretreat from threats and evolving policies around the\nrejecting a proposal to make prescription drug coverage\nglobe:\noptional for Medicare beneficiaries.\nHad Clinton not promised vociferously to revoke China's\n\"We are making very substantial progress on this\nmost-favored-nation trading privileges if Beijing did not\nlegislation,`` said Rep. Sam Gibbons, D-Fla., acting\nimprove its human rights record, he would not have had to\nchairman of the committee. But Gibbons said the\nsheepishly back down a year later.\ncontroversial topic of cost containment would be taken up\nIf he had not threatened Haiti's coup leaders with\nwhen the panel resumed its mark-up sessions on Tuesday.\nmilitary action, he would not have had to face the\nThe president, noting that 15 percent of the U.S.\nignominy of weeks of inaction while the Haitian generals\npopulation lacks health insurance, said even those who are\nconsolidated their power and did great harm to their\nnow covered cannot be sure they will be protecter against\nenemies.\nmedical costs in the future.\nIf he had not noisily brandished the sanctions weapon\nagainst North Korea and hinted at the possibility of war\n(Begin optional trim)\non the Korean peninsula, he would not have had to explain\nhow Carter's brief visit to Pyongyang could produce\n``Actually, not all Americans face this kind of risk,\"\n``hopeful signs\" that the crisis might be ended quickly\nClinton added in a message apparently aimed at the\nand peacefully.\nlawmakers who are considering health care reform.\nOne senior White House official said Clinton aides\n``Members of Congress, along with the president and all\nunderstood from the beginning of his presidential campaign\nfederal government employees we have a great deal right\nthat Clinton's habit of thinking aloud would be a major\nnow.\nchallenge.\n\"Now I believe every working American deserves these\nWe hoped at first that all of you, the press and\nsame benefits and that same guarantee,\" Clinton said,\nWashington in general, would adapt to his style and\nappealing to his listeners to tell members of Congress\nunderstand that he likes to try out ideas in public,\" the\nthat they share his belief.\nofficial said. \"But we got over that hope pretty\nquickly.\"\n(End optional trim)\nThe heart of Clinton's plan mandating employers to pay\n80 percent of health care costs was assailed by Rep. H.\nJames Saxton, R-N.J., as a job-killing, wage-cutting\nprovision that was unacceptable to the American people.\n``Mr. President, it's not that the American people are\nClinton Denounces Half Measures on Health Reform\nunwilling or unable to understand your plan,\" Saxton said\n(Washn)\nin a Republican response to the president's radio talk.\nBy William J. Eaton= (c) 1994, Los Angeles Times=\n``It is that the American people have rejected your\nbig-government, high-tax approach.\"\nWASHINGTON President Clinton said Saturday he hoped\nto\n(Optional Add End)\nprovide all working Americans with the same ``great deal\"\non health insurance that he shares with\nThe GOP spokesman argued that Congress should pass more\nmembers of Congress and other federal employees.\nlimited legislation to bar denial of health insurance\nIn his weekly radio address, the president stood firmly\ncoverage for pre-existing conditions, to reform medical\nbehind his renewed call for universal coverage and\nmalpractice laws and to allow smaller firms to pool risks\ndenounced \"halfhearted measures\" that he said would not\nthat would lower their insurance costs.\nassure medical insurance protection for all families.\nClinton clearly was referring to a new proposal, backed\nLos Angeles Times first-edition Page 1 for Sunday, June\n26, 1994:\nMuch Talk, Little Substance Mark Clinton Foreign Policy\nTop of page:\n(Washn)\nBy John M. Broder= (c) 1994, Los Angeles Times=\nCol 1: When voters in 1988 agreed to slap an additional\n25-cents-a-pack tax on cigarettes, they also launched an\nWASHINGTON Late last month, in the aftermath of yet\nunprecedented state-wide experiment in persuading\nanother administration foreign policy embarrassment the\nCalifornia smokers to kick their nicotine habit. Using\nabrupt reversal over linking trade with China to human\nthe new tax in the cause of public health, the state's\nrights improvements there President Clinton said there\ntobacco control program has set out to ban tobacco.\nwas nothing wrong with his foreign policy that better\ncommunication could not solve.\nCol 2: Southern California's role in the gay rights\nClinton acknowledged in a recent interview with the Los\nrevolution.\nAngeles Times that his inability to articulate his\nadministration's foreign policy goals \"is not inspiring\nCols 3-5: Russia was critical to liberating Berlin in\npeople's confidence in me.\" He said that, if he were\nWorld War II, but now that post-Cold War occupation forces\nbetter able to communicate his goals, Americans would be\nare going home, the Russians are not invited to celebrate\nmore comfortable with his policies.\nwith the other Allies. (With art.) (GERMANY-RUSSIANS,\nSo in recent weeks, the White House has hired a new\nmoved.)\nforeign policy spokesman, begun regular high-level\ncommunications strategy meetings and put the president on\nCol 6: President Clinton holds firm to his demand that\ndisplay more often to demonstrate his grasp of foreign\nhealth care reform include universal coverage, as the\naffairs.\nHouse Ways and Means Committee continues its deliberations\nBut while Clinton may believe that failure to\non a health care bill. (HEALTH, moved.)\ncommunicate is at fault, others see a more troubling\nproblem the tendency to communicate more while having\nAbove fold:\nless to say.\nClinton's new expansiveness has exposed the sometimes\nCol 2: Taco Bell's decision to keep its 1,000\ntortuous path that his thinking takes to arrive at foreign\nheadquarters jobs in Southern California rather than flee\npolicy decisions. Many outside observers and some senior\nto Texas is being heralded as an important corporate\nWhite House aides believe Clinton would be more\nendorsement of a new, smarter and more business-friendly\nconvincing if he would reserve comment on foreign affairs\nCalifornia.\nuntil after he has made up his mind what to do.\nDespite recent attempts to improve the presentation of\nCols 3-4: With less than a week to prepare for O.J.\nadministration policy, the dispute with North Korea has\nSimpson's preliminary hearing, prosecutors hunker down to\nbeen marked by crossed signals, mixed messages, empty\nsift through evidence and set their strategies for the\nthreats and the unusual spectacle of a current and a\nunanticipated ``mini-trial\" in which a judge will rule\nformer president at odds over American policy.\nwhether there is probable cause to believe the former\nThe performance is reminiscent of earlier foreign\nfootball superstar murdered his ex-wife and her friend.\npolicy troubles in Bosnia-Herzegovina, Somalia, Haiti and\n(SIMPSON-TIMES, moved.)\nChina in which Clinton and his advisers talked tough but\ndid not follow through with forceful action.\nBelow fold:\nAs he did with Bosnia last year, Clinton talked about\nputting together an international coalition to punish\nCol 4: At the Iowa Republican Party's 1996 presidential\nNorth Korea before he had done the groundwork with\nstraw poll, the delegates cast just over 26 percent of the\nAmerican allies. Both attempts at concerted international\nballots for Senate Minority Leader Bob\naction failed.\nDole. (GOP-TIMES, moved.)\nWhite House aides, concerned that Clinton had not\nclearly spelled out American interests in Korea and the\nBottom of page:\nadministration's policy for dealing with North Korea's\nnuclear ambitions, persuaded the president to disrupt his\nCols 1-2: For some of the most emotionally gripping\nschedule and make an unplanned appearance in the White\nscenes in the rapidly unfolding drama of O.J. Simpson, the\nHouse briefing room last week.\nman at center stage has been Robert L. Shapiro, an\nClinton gave a rather long talk on why Americans should\nattorney known as a discreet advocate who is particularly\ncare about what happens in Korea and explained that he was\ndeft at damage control. (SIMPSON-SHAPIRO, moved.)\ntrying to put together an international coalition to\nthwart North Korea's efforts to produce nuclear weapons.\nCols 5-6: Los Angeles Mayor Richard Riordan, who\nBut within a day, his effort to rally U.S. allies to\npledged during his campaign to separate his substantial\nimpose sanctions against North Korea was undercut by\nbusiness holdings from any official actions, helped win\nformer President Carter's statement that sanctions would\napproval last year for a rail project that has brought\nbe counterproductive and should not be part of American\nhundreds of thousands of dollars to a company in which he\npolicy.\nholds a major stake.\nClinton appeared in the briefing room again Wednesday\nto announce the good news\" that North Korea had agreed\nSent: 10:30 p.m. EDT. For questions, call (800)\nto freeze its nuclear programs while Washington and\n283-NEWS, ext. 77832.\nPyongyang engage in high-level talks. But the president\nacknowledged that North Korea may not be sincere and said\nLos Angeles Times-Washington Post News Service=\nhe would reassess American policy again if Pyongyang\nreneges on its promises to open its nuclear facilities to\ninspection.\nThe answer to Clinton's communications difficulties\n75\nThe Washington Times\nSUNDAY, JUNE 26, 1994\nPETE DU PONT\nark Twain concluded\nthat bind the rest of us.\nM\nthat \"There is no dis-\ntinctly native criminal\nRosty,\nWorkplace safety rules, civil\nrights acts, sexual harassment poli-\nclass except Congress.\"\ncies, minimum wage laws, union\nWith Rep. Dan Rostenkowski's\nindictment on 17 criminal counts,\nCongress\nrules, Equal Employment Oppor-\ntunity Commission regulations,\nthe American people may be ready\nhandicapped discrimination pro-\nto believe it.\nand the\nhibitions, the Family Leave Act -\nI was elected to the House of\nall apply to us, but not to them.\nRepresentatives in 1970 and served\nOnce newly elected congress-\nthree terms. Congress was, of\nmen arrive in Washington, secure\ncourse, partisan and political in\nevery action it took. It also had sig-\nrule of law\nin the knowledge that the election\nrules will see 98 percent of them\nnificant corruption problems even\nre-elected for life, and see they are\nthem Three of the five subcommit-\nresponse to the Rostenkowski\nabove the law in some areas, they\ntee shairmen with whom I worked\nindictment - \"health care is more\nsoon come to believe they are above\nwould later serve time in jail. Rep.\nimportant than any one person\" -\nthe law in others.\nJim Wright, Texas Democrat, the\nsuggests that if one is politically\nTo put it bluntly, if congressmen\nMajority Leader, would become\ncorrect on the issues, 17-count\ncan avoid workplace health and\nspeaker of the House and resign in\nindictments don't matter much.\nsafety rules in their offices, sexual-\ndisgrace. Since 1970, 24 members\nThe problem in Congress is\nly harass the women on their staffs,\nof Congress have been convicted of\ntwofold: The corruption of holding\nand discriminate against minori-\nvarious crimes and served prison\npower for too long, and the tempta-\nties and the handicapped in hiring,\nsentences. Nearly two dozen more\ntion of congressmen exempt from\nwhat's a few thousand dollars from\nhave pleaded guilty, plea bargained,\nsome laws to believe they are\nthe till?\nor religned to avoid prosecution.\nexempt from all laws.\nWhat it is, of course, is a breach\nRep. James Burke of Massachu-\n\"Power tends to corrupt, and\nof trust that is undermining the\nsetts when asked how he could vote\nabsolute power corrupts absolute-\nentire structure of representative\nfor every spending increase and\nly.\" The truth of Lord Acton's apho-\ngovernment.\nagainst every tax increase to pay for\nrism is seen in the absolute cor-\nThe endless corruptions will not\nthem, replied, \"You think this place\nruption of a Congress controlled by\nend until we - the people - make\nis on the level?\" Mr. Burke was talk-\none party for 40 years. Closed rules,\nit crystal clear to them - the con-\ning politics then. We are talking\nforbidding floor\ncorruption now and the place is\namendments to\nhardly on the level.\nlegislation,\nWithin the last few years we have\nwere in the\nMIKETIONPON\nseen the House Bank Scandal,\n1970s a rarity.\ninvolving dozens of members of\nNow 79 percent\nCongress kiting checks, and the\nof the bills con-\nHouse Post Office scandal, which\nsidered in the\nhas already resulted in eight\nHouse\nare\nemployees pleading guilty to drug\nunder closed\nor embezzlement charges. The\nrules. Twice the\n\"Keating Five\" S&L scandal\nHouse, on party\nrevealed equivalent corruption in\nline\nvotes,\nthe Senate.\nrefused to even\nNow comes Mr. Rostenkowski,\ninvestigate the\nIllinois Democrat, another power-\nvery Post Office\nful committee chairman, indicted\nscandal that\nfor warnming more than $500,000\ndethroned Mr.\nDan Rostenkowski\nfrom\nhe people through phantom\nRostenkowski.\nemployees on the payroll, private\nRep. Henry Gonzales, Texas Demo-\ngressmen - that we expect higher\ngifts paid for with public monies,\ncrat, chairman of the House Bank-\nethical standards. Term limits\nusing House stamp vouchers to\ning Committee, directed the Reso-\nwould send that message. So would\nobtain cash for personal use, etc.,\nlution Trust Corp. and the Office of\nadoption of a bill by Rep. Christo-\netc.\nThrift Supervision not to supply to\npher Shays, Connecticut Republi-\nCongress has lost its moral com-\nRep. Jim Leach, Iowa Republican,\ncan, to apply all the laws of the land\npass, but is it because we are elect-\npublic documents that should be\nto congressmen. But those are com-\ning crooks to public office or turn-\navailable to every member of the\nplex things to accomplish. Throw-\ning citizens into crooks once they\nCongress. Fearful for their budgets,\ning the rascals out is easy, and each\nget to Washington?\nthe two agencies are so far com-\nof us has an opportunity to do so on\nbe fair, the problem is not just\nplying.\nNov. 8.\nin the Congress. President Richard\nBut the nub of the problem is\nNixon's \"I am not a crook\" was not\nthis: Since congressmen by their\nthe best phrase to inspire a nation\nown votes are exempt from the\nPete du Pont, former governor of\nto high standards of public morali-\nworkplace laws governing the rest\nDelaware, is policy chairman for\nty. \"I didn't inhale\" isn't much bet-\nof us, they have come to believe\nthe National Center for Policy\nter. The Clinton administration's\nthey also are above the ethical laws\nAnalysis.\n87\nThe Washington Times\nSUNDAY, JUNE 26, 1994\nWALTER MEARS\nenerations of con-\nG\ngressional seniority\nwill be erased by\nretirements and elec-\nTerm limits and turnover on a quickening roll\ntions before the\nSupreme\nCourt\nity and senility. But it was more\nwhether that's the only route, or\nArkansas court held that the state\nWhile those legal arguments are\nof congressional powers and per\ndecides whether state-imposed\nthan 40 years before the issue took\nwhether the states can impose the\ncould not add limited tenure to the\nbeing heard and settled, here will\nand with the sagging confider\nterm limits are constitutional.\nhold, and states began to vote in lim-\nlimits they've already adopted.\nqualifications set by the Constitu-\nbe another display of political mus-\nratings that show up in the pu¹\nBut changing faces won't blunt\nits on their own officeholders and,\nThe decision will come in 1995,\ntion for service in Congress, age 25\ncle in a movement whose sponsors\nopinion polls.\nthe campaign for legal ceilings on\noften, on congressional terms.\non an appeal from an Arkansas\nfor the House, 30 for the Senate,\nsay career members of Congress\nThe odds are that where to\ntenure in the House and Senate.\nThe Supreme Court never has\nSupreme Court ruling that over-\nU.S. citizenship, and residence in\nlose touch with everyday America.\nlimits go on the Nov. 8 ballot, the\nThe aim of that movement is to\nruled on the question of whether\nturned state-set term limits. The\nthe state represented.\nThat meshes with voter re entment\nbe approved - to apply later\nchange attitudes\nstates have that\nCongress that is changing marl\nas well, so new-\npower. When the\nly right now.\ncomers will know\nThere'll be another\nterm limits push\nThere are 117 first-term Hot\nthe limits when\nbegan it was\n©1992 The Grand Rapid Press\nmembers in this Congress, incl\nthey get to the\ncrowd of newcomers\nwith an implied\nassumption that\nSTANTS\ning two Republicans who have\nCapitol and won't\nnext year; 50 are\nwon special elections to Demo\nthink of Congress\nthey did not,\ntic seats, both as supporters of \"\nas a career.\nguaranteed even before\nsince the first\nlimits.\nFifteen states\nproposal was to\nThere'll be another crowd\nnow have the con-\nthe off-year elections,\nset a 12-year\nnewcomers next year; 50 are gu\ngressional term\nceiling, two\nanteed even before the off-y\nlimits that are at\n48 by retirements,\nterms in the\nelections, 48 by retirements, no\nissue in the\nnearly half to seek\nSenate or six in\nly half to seek other offices; two\nSupreme Court\nthe House, by\nprimary defeats. Among\ncase and by the\ntime it is decided,\nother offices; two by\namending the\nretirees are more than 20 memb:\nConstitution.\nwhose seniority had made the\nat least seven\nprimary defeats.\nThat's the\nchairmen of committees and SI\nmore are likely to\nhard way. There\ncommittees. One had been the\nhave joined them.\nAmong the retirees are\nstill are such\nsince 1941.\nLimits are a pop-\nmore than 20\nproposals pend-\ning, which is\nare next to\nRAID!\nThe off-year elections will ad-\nular cause; once\non the ballot, they\nmembers whose\nhow they'll\nunstoppable.\nseniority had made\ntake two-thirds\nWaal\nthat turnover; incumbents won\nper cent of their races last time.\nremain. It would\nthat was down a bit, and their\nof return could slip again.\nIn Utah, where\nmajorities of the\nthem chairmen of\nThat adds up to a House will\na referendum\nHouse and Sen-\nmajority well within any term lim\ncampaign is\nunder way, a poll\ncommittees and\nate, unattainable\nincluding the six-year ceiling\neven if sponsors\nArkansas law would set.\nshowed 3-to-1\nsubcommittees.\ncould get the\nNine senators are retiring\nsupport for term\namendments\nthere will be major changes in\nlimits, although\ncleared\nfor\nlineup there, too, with elections\nsponsors acknowledge the vote\naction, to send an amendment to the\nyear for 34 seats.\ncount would be closer than that.\nstates for ratification.\nThe sentiment is typical.\nThe limit the advocates point to,\nThe idea has been around for a\ntwo terms for a president, was set\nQW\non\nWalter R. Mears is vice presid\nwhile. Harry S. Truman once said\nby constitutional amendment in\nand columnist for the Associ\nthat term limits would cure two ter-\n1951.\nPress.\nrible diseases in Congress, senior-\nNow the court will decide\nDOLLARS\nCENTS\nGains for Tobacco in Health Care Fight\nRaising\n1\nX\non\nTobacco\nCurrent Federal taxes on tobacco products, and what they would be under various proposals to raise\nthose taxes. State taxes on tobacco are not included. For example, state taxes on cigarettes typically\nCigarette Industry and Allies in Congress Aim for Lower Tax Rise\nadd an additional 20 to 30 cents to the price of a pack.\nCIGARETTES\nPIPE TOBACCO\nCHEWING TOBACCO\na swing vote on the Ways and Means\nbers of Congress said, the pivotal\nBy NEIL A. LEWIS\nCommittee.\nfactor has been the unified front of\nKEY\nPer pack\nPer 1.5-ounce pouch\nPer 3-ounce pouch\nSpecial to The New York Times\nThe President had proposed a 75-\nthe tobacco-state members. And at\nWASHINGTON, June 24 - Within\ncent-a-pack increase on cigarettes,\nthe heart of that strategy is Mr.\n$0.24\n$0.06\n$0.02\ndays after President Clinton's speech\nwhich are now taxed at 24 cents a\nPayne, an affable, 47-year-old Demo-\nCLINTON\n$0.99\n$1.23\n$2.36\nlast fall outlining his health care pro-\npack by the Federal Government,\ncrat who has represented the south-\nposal, tobacco-state members of Con-\nand equivalent increases on other to-\nern tier of Virginia, known as South-\n$2.00*\n$2.81\n$5.52\ngress and tobacco companies mobi-\nlized to battle one of the plan's princi-\nbacco products. The White House es-\nside, since 1988. Southside is second\ntimated the revenue from the tax\nonly to eastern North Carolina in pro-\nHOUSE WAYS\n95\n$0.39\n$0.10\n$0.04\npal elements: a sharp increase in\nincreases at $10 billion, and predicted\nducing flue-cured tobacco, which is\nAND MEANS\ntobacco taxes.\nused for cigarettes, Mr. Payne said.\n99\n$0.69\n$0.18\n$0.07\nan additional health dividend in that\nAs the health care plan moves\nthrough a crucial period this month, it\nthe increases would discourage many\nAs the Ways and Means Committee\nconsidered the health care plan, Mr.\n\"Some members have proposed a $1 increase to the current tax. tWould phase in higher taxes between 1995 and 1999.\nIs apparent that their efforts have\npeople from smoking.\nPayne found himself in the politically\nwon some Important victories. Al-\nenviable situation of discovering that\nSource: American Cancer Society\nBut in a vote last week, the Ways\nthough the industry has failed to elim-\nand Means Committee opted for a\nhis fellow Democrats needed his vote\nThe Nev. York Times\ninate tax increases altogether, pros-\nlower tax Increase of 45 cents a pack,\nto give them a working majority.\npects for a steep rise in tobacco taxes\na rise that would not be fully phased\n\"I made it very clear to people on\nhave faded in the Ways and Means\nthe Ways and Means Committee that\nRepresentative Benjamin L. Car-\nthat he needed their votes if he hoped\n45 cents a pack, phased in over six\nCommittee, which, as the House tax-\nthis was not an abstract issue to me\ndin, a Maryland Democrat who is a\nto produce a health care bill.\nyears. The amendment was part of a\nwriting panel, is expected to have\nand the people in my district,\" said\nmember of the Ways and Means\npackage of several other changes in-\nenormous influence on the issue.\nMr. Payne, whose constituents in-\n\"The message at the meeting was,\nA likely swing vote\nCommittee, called Mr. Payne highly\n'Don't assume we won't be there\ntended to win votes for the health\nThe success on the legislative front\nclude nearly 5,000 tobacco growers.\nskilled at exploiting his position.\nwhen you need us,' said a senior\ncare plan.\ncomes as the tobacco industry has\nbeen strongly challenged by Govern-\non a House panel\nThe Vital '20th Vote'\n\"He's.a very good legislator who\nRostenkowski aide who recalled the\nknew that he could drive a hard bar-\nTobacco Industry's Role\nmeeting. \"And they also made it\nment regulators who are trying to\nMr. Payne became known as \"the\ngain,\" Mr. Cardin said. \"And he did\nclear they would move as a bloc.\"\nMr. Payne said the tobacco compa-\nrestrict smoking, and even talking\nplays a key role.\n20th vote,\" the committee member\nso. He said very early, 'Look, this is\nny lobbylats have been important in\nabout regulating the nicotine in tobac-\nwhose support was imperative to win\nwhat I need.'\nWithin short order, the proposed\nproviding information to use as am-\nCO as a drug. In this two-front war the\na majority on a committee with 38\nincrease in the cigarette tax was re-\nmunition in the legislative battle.\nindustry's well-placed allies in Con-\nmembers.\nMr. Cardin said that his Virginia\nduced to 60 cents a pack in the com-\nRepresentative Gerald D. Kleczka,\ngress have kept one flank, the tax\n\"I never wanted to destroy health\ncolleague also made it plain that he\nmittee's draft.\na Wisconsin Democrat who 13 a mem-\nissue, relatively secure.\nin until the end of the century. Other\ncare reform,\" he said. But he also\nspoke not just for himself on tobacco\n\"Rostenkowski considered the to-\nber of the Ways and Means Commit-\ntobacco products would have only\nsaid he could not vote for health care\ntax and health care, but also for more\nbacco tax one of the variables he\ntee, said that while the tobacco com-\nTwo-Tlered Approach\nmodest increases. Most states add 20\nlegislation if it contained steep tobac-\nthan 20 other members of the House.\ncould deal with In forming a majority\npanies had influenced the issue by\nThe campaign against tobacco tax\nto 30 cents a pack to the 24 cents that\nCO taxes.\nIn March, major tobacco compa-\nfor health care,\" said one Democratic\norchestrating a campaign to have\nincreases has deftly combined two\nnow goes to the Federal Government.\nMr. Payne's resolve to fight the\nnies like R. J. Reynolds and Philip\nmember of the committee. For him,\nsmokers telephone and write to Con-\napproaches. First, the tobacco com-\nThe Finance Committee, which is\ntobacco tax was stiffened last Octo-\nMorris gave their workers the day off\nthis was part of the process of round-\ngressional offices, \"the main players\npanies brought growers and tobacco\nconsidering the tax portion of health\nber after a confrontation with Hillary\nand brought more than 15,000 of them\ning up needed votes.\"\nin this fight right now are the mem-\nfactory workers to Washington to put\ncare legislation in the Senate, has.\nRodham Clinton, who led the group\nto Washington to demonstrate\nA few weeks ago, when Mr. Rosten-\nbers themselves.\"\na human face on the the industry.\npegged the tax increase at $1.76 a\nthat devised the White House plan.\nagainst the proposed tax Increase and\nkowski was forced to relinquish the\nThe tobacco industry has also\nSecond, House members from to-\npack and has been preoccupled with\nto lobby members of Congress. The\nchairmanship of the committee after\nmade itself felt through hefty cam-\nbacco-growing states combined to de-\nother elements of the health plan. But\nWhen Mrs. Clinton appeared before\nsame month, 22 members of the\nhe was Indicted on felony corruption\npaign donations to the members of\nliver a blunt message to Congression-\na bipartisan group of senators on the\nthe Ways and Means Committee, Mr.\nHouse met with Representative Dan\ncharges, the tobacco caucus met with\nthe committee.\nal leaders: Unless increases in the\ncommittee today proposed pegging\nPayne said he was troubled by \"the\nRostenkowski, the Chicago Democrat\nhis successor, Representative Sam\nIn 1993, the 13 political ac Ion com-\ntobacco tax are held to modest levels,\nthe tax Increase at $1 a pack.\nunfairness\" of having tobacco bear\nwho was then chairman of Ways and\nM. Gibbons of Florida, to press the\nmittees readily identified with the\nthey would vote as a bloc against the\nWhatever tax increase the Senate\nthe burden of the costs. Mrs. Clinton\nMeans Committee.\nargument with the acting chairman.\ntobacco Industry contributed more\nfinal health care plan that emerges\nends up with will have to be recon-\npraised him for his loyalty to his\nAt the time, some committee mem-\n'When we changed chairmen we\nthan $130,000 to members of the Ways\non the floor of the House.\nciled with that of the House, which is\nconstituents, but then added firmly,\nbers had succeeded In raising the\nreinforced the message again,\" Mr.\nand Means Committee, acc ording to\nReinforcing that ultimatum was\nlikely to reflect the level sought by\n\"There will be a tobacco tax to pay\ntobacco tax to $1.25 in the draft bill.\nPayne said of that meeting.\nthe Center for Responsive Politics.\nthe fact that one of the tobacco-state\nthe Ways and Means Committee.\nfor this legislation.\"\nBut the delegation, led by Represent-\nLast week, in a 24-to-14 vote along\nThat was about about twice as much\nmembers, Representative Lewis F.\nWhile the lobbying effort by the\nMaybe, but it will probably not be\native Charlie Rose, a North Carolina\nparty lines, the committee approved\nas they had contributed in the elec-\nPayne Jr. of Virginia, was likely to be\ncompanies has been important, mem-\nas large as Mrs. Clinton had hoped.\nDemocrat, told Mr. Rostenkowski\nthe proposed cigarette tax Increase of\ntion cycle two years earlier\nTHE NEW YORK TIMES, SATURDAY, JUNE 25, 1994\nHEALTHY CONCERN\nFIRST LADY\nHillary Rodham Clinton and House Majority Leader Richard\nGephardt of Missouri meet at health care reform seminar yesterday in the\nn's\ncapital. It was sponsored by HealthRIGHT, a nonprofit coalition of organizar\nsupporting the Clintons' health care reform program.\nWS\nHealth-Care -2-: Congress\nToying With Alternatives\nThose costs won't disappear, however. As big companies shed them, insurance\npremiums for smaller employers will be forced up. This probably will lead\nmore of them to stop offering insurance, to limit coverage for workers'\nfamilies or to rely more on part-timers and temporary workers who often don't\nget health insurance. Already, the fraction of adults who work but have no\npublic or private health insurance has risen to 17.5% in 1992 from 15.3% in\n1988, the Census Bureau says. And employment is growing fastest in industries\nthat tend not to offer health insurance.\nToday, many who lack insurance still get health care if they get sick\nenough, either through federal or local government programs or through\ncharity. But as employers squeeze the health system harder and the number of\nuninsured grows, free care probably will be harder to find, and the quality\nis likely to deteriorate. And the government's costs, from the Medicaid\nprogram for the poor to emergency rooms at municipal hospitals, will climb.\n\"Supermarkets don't go out and give free food to poor people. They can't\nafford to. They'd go out of business,' says Harvard health economist David\nCutler. \"That's the danger of making the health market real competitive\nwithout bringing people in.\" So most of the pending health-reform plans would\nspend tens of billions of dollars a year so low-income families or their\nemployers can afford insurance.\nComing up with such funding without a broad-based tax is tough. So Congress\nis toying with lower-cost alternatives that would subsidize insurance for\nsome, but not all, of the 39 million who lack it. The plan crafted last week\nby Senate Finance Committee moderates would offer subsidies to the poorest\nAmericans, and gradually move up the income ladder. By 2002, subsidies would\nbe available to families of four with incomes of $34,500 (in today's dollars).\nSo far, Bill and Hillary Clinton reject such a step toward the goal of\nuniversal coverage. Despite advice from moderates like counselor David Gergen,\nTreasury Secretary Lloyd Bentsen and economic adviser Robert Rubin, the\nClintons want a guarantee that the goal will be achieved -- even if that\ndemand means no health-reform bill at all this year.\nSome Clinton advisers argue he can pin the blame on Republicans; others\nfear he and other Democrats will suffer the wrath of voters disgusted with\ngridlock. But the social and economic consequences of once again retreating\nfrom far-reaching reform are clear: more uninsured Americans and higher costs\nfor the government.\n(END) DOW JONES NEWS 06-27-94\n6 41 AM\n****\nfiled by:TAPE(--)\non 06/27/94 at 06:48EDT ****\n**** printed by: WHPR (JEL) on 06/27/94 at 08:09EDT ****\nIN DEALING WITH CONGRESS, CLINTON PLAYS DOWN DETAILS ON HEALTH STRATEGY\nBy ROBERT PEAR\n1994 N.Y. Times News Service\nWASHINGTON - Even though the battle over health care has moved into a\ncritical time of striking deals and compromises, President Clinton and his\nadministration have deliberately avoided detailed negotiations with Congress,\npreferring to give only technical assistance'' while affirming the general\ngoal of universal coverage.\nThat is partly by design and partly by default.\nFor the president, it is clearly a tactical choice. Clinton loves to\ndiscuss the intricacies of health policy, but his statements over the last two\nweeks have been disciplined, sticking to broad themes and goals. Hillary\nRodham Clinton has taken much the same approach.\nBut below that level, some of the disengagement is less calculated. With a\nfew exceptions, the administration's health experts do not have the political\nexpertise or authority to negotiate with Congress. The senior officials who do\nhave the political experience and acumen know little about the details of\nhealth policy, by their own account.\nClinton's legislative strategy puzzles some members of Congress, who say\nthe White House should negotiate over the substance of legislation. But it\npleases others, who do not want the White House to interfere.\nRep. Pete Stark, the California Democrat who heads the Ways and Means\nSubcommittee on Health, is one of the latter. ``I give the administration high\nmarks, he said. I feared they would meddle in our work.\nBut another California Democrat, Rep. Lynn Schenk, who has a crucial swing\nvote on the Energy and Commerce Committee, said: I haven't heard from a soul\nin the administration in months. Maybe they lost my phone number.\nSen. John B. Breaux, D-La., argued for more administration involvement.\nIt's not enough just to sit back and say, `Let Congress do its will, he\nsaid.\nIn the last week, the administration has encouraged bipartisan efforts in\nthe Senate Finance Committee and has urged Congress to keep up the momentum on\nhealth care.\nThe administration's strategy was described by Harold M. Ickes, deputy\nchief of staff at the White House, in an interview: ``We have not been\ndickering with Congress. We let the committee chairmen do the work they need\nto do to get bills out of their committees. We provide technical assistance,\ncomputer runs, statistical data. We can discuss the implications of various\noptions, but we will not say whether one is better than another.'\nIckes noted that three committees in the House and two in the Senate had\nbeen trying to write health care bills. For us to be bargaining against\nourselves with five different committees would be self-defeating, he said.\nIn interviews, Clinton officials and members of Congress said the\nadministration had encountered difficulty in three areas:\n- Some members of President Clinton's team of sub-Cabinet officials,\nincluding some experts on health policy, are eager to provide more guidance to\nCongress, but they have generally been forbidden to do so because decision\nmaking is concentrated in the White House.\n- The administration was overly optimistic in assessing congressional\nsupport for major elements of the president's original health care plan and\nset unrealistic deadlines. Lawmakers say they have received mixed signals\nabout the administration's willingness to compromise, with Mrs. Clinton\nusually expressing less flexibility than the president.\n- The Democratic National Committee had ambitious plans to sway votes in\nCongress by orchestrating a groundswell of support for the president's plan\nwith television commercials and grass-roots lobbyists, but that effort fell\nshort.\nRichard F. Celeste, the former governor of Ohio who spent eight months\nsupervising the Democratic effort to drum up support, said: Originally there\nwas an expectation that there would be a big national campaign. But there was\na substantial recalibration as people realized that resources were limited and\ntime was limited.\n`Our campaign was diffuse because we had an issue so big and complicated,\nwe couldn't characterize it easily, Celeste said. He left the campaign a few\nmonths ago and returned to Ohio.\nThere is still some resentment in Congress over the secrecy employed by\nthe administration when it drafted the president's health plan last year with\nthe help of more than 500 advisers. The White House aide who supervised that\nprocess, Ira C. Magaziner, has no significant role in dealing with Congress\nnow.\nMany elements of the president's bill, including one that would have\nrequired most people to get health insurance through purchasing cooperatives\nknown as alliances, have sunk from view on Capitol Hill.\n`We have not tried to defend every tiny piece of the bill except in the\ninitial hearings, said Donna E. Shalala, the secretary of health and human\nservices. We have narrowed down what is of fundamental importance.\nIn an interview, Shalala defended the administration's tactics, saying:\nAnybody who argues we should give Congress more guidance doesn't know much\nabout Congress. It is a separate branch of government. One must respect\nthat.\nBut members of Congress, including Democrats who want to help the White\nHouse, say the administration's lobbying has suffered from a lack of\ncoordination.\nThey also say that only one White House official combines a detailed\nknowledge of health policy with a feel for the politics of the issue. That\nofficial, Jack Lew, worked for Thomas P. O'Neill Jr. when he was speaker of\nthe house in the 1980s.\nIn dealing with Congress, the administration has focused on congressional\nleaders and committee chairmen. It has not made much effort to lobby\nbackbenchers in the House, even if they sit on major committees with authority\nover the legislation.\nIn their public remarks, Mr. and Mrs. Clinton try to avoid the jargon and\ndetails of the health care debate - issues like employer mandates, triggers\nand community rating of insurance premiums - so they can emphasize universal\ncoverage.\nSara Rosenbaum, a lawyer who specializes in health care at George\nWashington University and who supervised the process of turning policy\ndecisions into health legislation for Clinton, said, ``The president is doing\nexactly what presidents should do: defining his bottom line, what's needed to\npreserve the fundamental integrity of this legislation.\nBut Ms. Rosenbaum, a longtime adviser to Mrs. Clinton, said Cabinet\nofficials were perhaps being underused.\nPeople at the White House have held them back because this is a\ncentralized operation, she said. ``The White House has felt strongly that\nall decision making should rest at the White House. That may have slowed down\nthe legislative process because the White House is a small place, too small\nto cope with that amount of decision making, and does not always have the\nexpertise to give guidance to Congress.\n-END-OF-AUTOBREAK(1)\n-AUTOBREAK (2) -FOLLOWS\n****\nfiled by: on 06/27/94 at 02:03EDT ****\n**** printed by: WHPR (JEL) on 06/27/94 at 08:10EDT ****\nHEALTH INDUSTRY\nIS CHANGING ITSELF\nAHEAD OF REFORM\nWAVE OF CONSOLIDATIONS\nConcerns Arise as Huge Deals\nLink Providers and Buyers\nin U.S. Medical System\nAl\nBy MILT FREUDENHEIM\nA wave of mergers and alliances is\nContinued From Page Al\ntransforming the nation's trillion-dol-\nlar health care system. Without wait-\ngroups. For example, employers in\ning for the outcome of the Congres-\ndozens of areas, from Long Island to\nsional health debate, providers of\nSan Francisco, have formed alliances\nmedical care - including hospitals,\nto buy medical care for their work-\nphysician groups and nursing homes\ners, the better to negotiate satisfac-\n- are joining to form bigger and\ntory deals with the growing medical\nbigger networks.\nnetworks.\nSome of the combinations are being\nBut what does it mean when both\nput together by hospitals, like the\nproviders and purchasers of health\n$1.08 billion deal in which the coun-\ncare coalesce, when a system in\ntry's largest for-profit hospital chain,\nwhich total spending is expected to\nColumbia/HCA Healthcare, agreed to\nexceed $1 trillion this year is increas-\nbuy the largest chain of surgery cen-\ningly controlled by large entities?\nters, Medical Care America, last\nFor the patient, care could improve\nmonth. Another such combination is\nas the growing medical networks in-\nNew York Hospital's regional alli-\nvest in sophisticated computerized\nance with seven other nonprofit hos-\nsystems that analyze the care re-\npitals, two nursing homes and four\nceived by their many thousands of\nwalk-in clinics, all of which send their\npatients and find ways to improve it.\nTHE NEW YORK TIMES, MONDAY; JUNE 27. 1994\nmost complicated cases to the big\nThe systems could also save money\nUpper East Side hospital.\nfor patients and their insurers by\nOther deals are being struck by\nidentifying the kinds of treatments\nphysicians, who have been abandon-\nthat do little good.\ning solo practices to join medical\n\"The quality of care will inevitably\nimprove as we begin to gather these\ngroups and now fear that even those\npeople under the same roof,\" said Jon\ngroups are not strong enough. One\nGlaudemann, a vice president of Aet-\nexample: Mullikin Medical Enter-\nna Health Plans, one of the largest\nprises, owned by 200 physicians in\nmedical networks.\nSouthern California, is acquiring the\n'Who Will Discipline Those Guys?'\npractices of other medical groups\nBut the consolidation, taken to the\naround the state. It is also negotiating\nextreme, could also cause problems.\nan alliance with a West Coast hospital\n\"If two or three health care compa-\nchain under which the hospitals\nnies have sewn up all the doctors and\nwould lower their fees for patients\nthe hospitals and the health system\nadmitted by Mullikin doctors.\ngets oligopolized, who will discipline\nInsurance companies and health\nthose guys?\" said Uwe E. Reinhardt,\nmaintenance organizations are also\na Princeton University health econo-\nracing to form larger medical net-\nmist.\nworks, signing up hospitals and\n\"The trouble with oligopolies,\nwhere there are only a few buyers\ngroups of doctors and sometimes\nand sellers, is that they become very\neven joining with each other. Two\nsloppy,\" he added. For example, he\nweeks ago, Metropolitan Life Insur-\nsaid, doctors will say that managed-\nance and Travelers announced a joint\ncare companies raise prices and keep\nventure that will provide health in-\nthe difference. Some California insur-\nsurance for 13 million people nation-\ners already allot only 70 cents of\nwide; the companies hope that many\nevery premium dollar for health\nof these people will receive their care\ncare. \"The rest they keep,\" he said.\nthrough the new venture's medical\nAnd unlike other industries, Profes-\nnetworks. And FHP International and\nsor Reinhardt warned, the health\nTakecare, two California-based\ncare business may not have outside\ncompetitors to push it to improve\nH.M.O.'s, recently combined to cover\nitself, the way, say, Japanese car\n1.6 million people in eight Western\nmakers pushed Detroit to improve its\nstates.\nperformance.\nThe goal of all these combinations\nThe poor may also suffer, as\nis to become large enough to offer the\ngroups of employers insuring many\ncomprehensive and conveniently\npeople in a community gain the size\navailable services and the reasonable\nto negotiate harder with hospitals and\nprices needed to assure a steady flow\nreduce the subsidies for patients\nof patients from the increasingly de-\nwithout health coverage, said Bruce\nC. Vladeck, who directs the Govern-\nmanding groups that buy medical\nment's Medicare and Medicaid pro-\ncare.\ngrams.\nThose buyers are themselves join-\ning in larger and more powerful\nFewer Hospitals, Fewer Workers\nOther potential losers include\nContinued on Page D4, Column 3\nmany people in the medical business,\nlike nurses and other hospital em-\nployees, who would lose their jobs as\nThe Missing Voice: Clinton\nthe industry consolidated and elimi-\nAs Congress strives to produce\nhealth care proposals by week's\nend, President Clinton and his Ad-\nministration are deliberately avoid-\ning detailed negotiations. Page A12.\nTHE ogether\nTHE BIGGEST DEALS\nACQUIRED\nVALUE (billion)\nMerck (drug)\nMedco Containment\n$ 6.6\n(managed care drug distributor)\nbiggeri\nColumbia (hospital)\nHCA\n5.7\nColumbia\nGalen Health Care\n3.2\nSmithKline Beecham (drug)\nDiversified Pharmaceutical\n2.3\n(managed care drug marketer)\nFHP (H.M.O.)\nTakecare\n1.1\nColumbia*\nMedical Care America\n1.1\n(surgical centers)\nHealthtrust (hospital)\nEpic Holdings\n1.0\nHealth Net (H.M.O.)\nQual Med\n0.7\nT2 (home care) - Merger\nCuraflex, Healthinfusion, Medisys\n0.5\nUnited Healthcare (H.M.O.)\nRamsay-HMO\n0.5\n'Pending\nSource: Irving Levin Associates\nThe New York Times\nnated, for example, the 250,000 under-\nTO be sure, the fragmented health\nto close half of their remaining beds.\"\nused hospital beds, 30 percent of the\ncare industry is still a long way from\ntotal. At least 15 percent of the 5,500\nthe concentration of an industry like\nAmong the most visible players in--\ncommunity hospitals may close, Gov-\nautomobiles. But in some places, the\nthe consolidation of the health care\nernment officials say. The endan-\nconsolidation has been striking.\nbusiness is the Columbia/HCA\ngered-species list may also include\nIn the Minneapolis-St. Paul area,\nHealthcare Corporation. The giant\nthousands of \"surplus\" physician\nfor example, 1.7 million people - 70\nhospital chain has already assembled\nspecialists who could not find a place\npercent of the total - are now mem-\nthe leading medical care network in\nin any of the medical networks being\nbers of just three big health mainte-\n10 Sun Belt markets - Miami, Tam-\nformed.\nnance organizations, each of which\npa, the Florida panhandle; Atlanta,\nFinally, several hundred small in-\nowns its own medical facilities. Each\nRichmond, Nashville, Dallas, Hous-\nsurance companies and many region-\nof the H.M.O.'s is the product of merg-\nton, El Paso, and Louisville, Ky. -\nal health maintenance organizations\ner after merger.\naccording to Richard L. Scott, chief\nare at risk. \"Even among the largest\nThe Path of Consolidation\nexecutive.\ninsurance companies, who will sur-\nvive is in doubt,\" said Kevin Moley, a\nFor doctors and their patients, the\nconsolidation has meant frequent\nInvestor-owned hospital chains like\nformer senior health policy maker in\nthe Bush Administration.\nchange. Take Dr. Eric Anderson, a\nColumbia are also buying venerable\nMinneapolis internist. His longtime\nnonprofit community hospitals and\nThe consolidation trend is most evi-\npatients have followed him as he\nclosing some of them. Other nonprofit\ndent in places where managed health\ncare is strong, like Minneapolis-St.\nmoved from a neighborhood one-man\nhospitals have formed managed-care\nventures and alliances with Blue\noffice that was affiliated with several\nCross and Blue Shield associations in\nhospitals to a larger hospital-owned\nsystem that in turn will be absorbed\nPhiladelphia, Kansas City, Mo., and a\nnumber of states.\nThe hope is that\nnext month by an even larger health\ncare network called Allina.\nSeventy-one percent of 1,200 hospi-\nbigger will mean\nAllina and the two other big health\ntals recently surveyed by Deloitte &\nnetworks, Health Partners and Blue\nTouche, the accounting and consult-\nbetter, cheaper and\nCross, compete for the business of\ning firm, said they were joining an\ntwo employer groups. One concen-\nintegrated system that included other\ntrates the buying power of the largest\nhospitals, outpatient units or physi-\nbusier.\n25 companies; the other represents\ncian group practices. In the survey,\nsmall businesses.\nreleased last week, one-third of the\nhospitals said they had acquired or\nBadgered by the large buyers, the\nwere acquiring physician practices.\nPaul and Southern California. But\nbig H.M.O.'s have held the line on\neven in New York, 47 of 57 hospitals\nprices this year. Indeed, the state\nSome other traditions are crum-\nsurveyed in March had already\nannounced on Friday that Allina had\nbling in medicine as doctors abandon\njoined local hospital networks or sys-\nreduced its insurance rates for state\ntheir one-person offices to join group\ntems. The survey, by the Greater\nemployees by 25 percent.\npractices. And some physicians stand\nNew York Hospital Association, re-\nto profit. For example, many prima-\ncorded ties among hospitals and with\n\"We're in the middle of a major\nry-care doctors are selling their prac-\nnursing homes, neighborhood health\ncost war,\" said George Halvorsen,\ntices to hospitals or insurance compa-\ncenters, home health programs and\nchief executive of Health Partners.\nnies for hundreds of thousands of\nphysician groups.\n\"The hospitals have announced plans\ndollars.\nTHE NEW YORK TIMES. MONDAY, JUNE 27. 1994\n2\nA12\nTHE NEW YORK TIMES\nKey Voice\nIN BRIEF\nIs Missing\nThe Debate Over Health Care\nOn Health\nDEVELOPMENTS LAST WEEK\nThis is the last week before the July 4 recess, the informal deadline\nfive Congressional committees with jurisdiction on health matters set\nWhite House Lets\nfor producing their proposals for national health insurance They\nmust act by then - or soon after that if the full House and Senate\nOthers Negotiate\nare to complete work on the legislation before Congress adjourns for\nthe fall election campaign.\nIN THE SENATE\nBy ROBERT PEAR\nSpecial 10 The New York Times\nLABOR COMMITTEE With 10 Democrats and one Republican voting\nWASHINGTON, June 26 - Even\nin favor, the committee has approved a proposal much like President\nthough the battle over health care has\nClinton's health plan.\nmoved into a critical time of striking\ndeals and compromises, President\nFINANCE COMMITTEE A bipartisan group of committee members\nClinton and his Administration have\nworked last week to come up with a bill that they say would lead to\nberately avoided detailed negotia-\ntions with Congress, preferring to\nuniversal coverage but without requiring employers to pay for\ngive only \"technical assistance\"\nworkers' coverage. Members of the group considered a plan\nwhile affirming the general goal of\nrequiring that uninsured people pay for their own insurance, but the\nTHE new YORK TIMES, MONDAY; JUNE 199,\nuniversal coverage.\nidea provoked such outrage they dropped it, leaving a plan based\nThat is partly by design and partly\nlargely on new insurance regulation changes and promises of\nby default.\nCongressional action if too many Americans remained uninsured.\nFor the President, it is clearly a\ntactical choice. Mr. Clinton loves to\ndiscuss the intricacies of health poli-\nIN THE HOUSE\ncy, but his statements over the last\nEDUCATION AND LABOR Generally considered a liberal committee,\ntwo weeks have been disciplined,\nsticking to broad themes and goals.\non Thursday it approved a variation on the Clinton plan more\nHillary Rodham Clinton has taken\ngenerous than the President's proposal.\nmuch the same approach.\nBut below that level, some of the\nWAYS AND MEANS The committee worked through Saturday on its\nvariation of the Clinton plan.\nIn an interview, Dr. Shalala de-\ndisengagement is less calculated.\nfended the Administration's tactics,\nWith a few exceptions, the Adminis-\nENERGY AND COMMERCE Under Representative John D. Dingell, the\nsaying: \"Anybody who argues we\ntration's health experts do not have\nshould give Congress more guidance\nthe political expertise or authority to\nMichigan Democrat who has long favored health reform, the\nnegotiate with Congress. The senior\ncommittee had been expected to lead the battle. Instead, it is\ndoesn't know much about Congress.\nIt is a separate branch of Govern-\nofficials who do have the political\ndeadlocked over Mr. Dingell's variant of the Clinton plan.\nment. One must respect that.\"\nexperience and acumen know little\nabout the details of health policy, by\nAT THE WHITE HOUSE\nAsking for Help\ntheir own account.\nBut members of Congress, includ-\nMixed Reception\nHillary Rodham Clinton made forays to Capitol Hill to test the waters\ning Democrats who want to help the\nand gave speeches to supporters to keep morale up.\nWhite House, say the Administra-\nMr. Clinton's legislative strategy\ntion's lobbying has suffered from a\npuzzles some members of Congress,\nWHAT TO EXPECT THIS WEEK\nlack of coordination.\nwho say the White House should nego-\nThey also say that only one White\ntiate over the substance of legislation.\nHouse official combines a detai\nBut it pleases others, who do not want\nToday the Senate Finance Committee takes up the moderates' plan.\nknowledge of health policy with a feel\nthe White House to interfere.\nThe committee seems likely to approve some version of it.\nfor the politics of the issue. That\nRepresentative Pete Stark, the Cal-\nThe House Ways and Means Committee still faces several\nofficial, Jack Lew, worked for Thom-\nifornia Democrat who heads the\nas P. O'Neill Jr. when he was Speaker\nWays and Means Subcommittee on\ncontentious issues, including holding down costs. Representative\nof the House in the 1980's.\nHealth, is one of the latter. \"I give the\nSam Gibbons, the Florida Democrat who heads the committee, says\nIn dealing with Congress, the Ad-\nAdministration high marks,\" he said.\nthe panel will produce a bill for the full House by week's end\nministration has focused on Congres-\nred they would meddle in our\nsional leaders and committee chair-\nwork.\"\nmen. It has not made much effort to\nBut another California Democrat,\nRepresentative Lynn Schenk, who\nteam of sub-Cabinet officials, includ-\nThe New York Times\nlobby other members, even if they sit\nhas a crucial swing vote on the Ener-\ning experts on health policy. Some\nThere is still some resentment in\non major committees with authority\ngy and Commerce Committee, said:\nare eager to provide more guidance\nCongress over the secrecy employed\nover the legislation.\nhaven't heard from a soul in the\nto Congress, but they have generally\nby the Administration when it drafted\nIn their public remarks, Mr. and\nAdministration in months. Maybe\nbeen forbidden to do so because deci-\nMrs. Clinton try to avoid the jargon\nthey lost my phone number.\"\nsion making is concentrated in the\nand details of the health care debate\nSenator John B. Breaux, Democrat\nWhite House.\n- issues like employer mandates,\nof Louisiana, argued for more Admin-\n9The Administration was overly\noptimistic in assessing Congressional\nClinton has yet to\ntriggers and community rating of in-\nistration involvement. \"It's not\nsurance premiums - so they can\nenough just to sit back and say, 'Let\nsupport for major elements of the\nCongress do its will,' he said.\njump into the\nemphasize universal coverage.\nPresident's original health care plan\nIn the last week, the Administra-\nand set unrealistic deadlines. Law-\nSara Rosenbaum, a lawyer who\ntion has encouraged bipartisan ef-\nmakers say they have received\nCongressional fray\nspecializes in health care at George\nforts in the Senate Finance Commit-\nmixed signals about the Administra-\nWashington University and who su-\ntee and has urged Congress to keep\ntion's willingness to compromise,\nwith Mrs. Clinton usually expressing\non health care.\npervised the process of turning policy\nup the momentum on health care.\ndecisions into health legislation for\nThe Administration's strategy was\nless flexibility than the President.\nMr. Clinton, said, \"The Presi is\ndescribed by Harold M. Ickes, deputy\n9The Democratic National Com-\ndoing exactly what Presidents should\nchief of staff at the White House, in an\nmittee had ambitious plans to sway\ndo: defining his bottom line, what's\ninterview: \"We have not been dicker-\nvotes in Congress by orchestrating a\nthe President's health plan last year\nneeded to preserve the fundamental\ning with Congress. We let the commit-\ngroundswell of support for the Presi-\nwith the help of more than 500 advis-\nintegrity of this legislation.\"\ntee chairmen do the work they need\ndent's plan with television commer-\ncials and grass-roots lobbyists, but\ners. The White House aide who super-\nBut Ms. Rosenbaum, a longtime\nto do to get bills out of their commit-\nadviser to Mrs. Clinton, said Cabinet\nthat effort fell short.\nvised that process, Ira C. Magaziner,\ntees. We provide technical assistance,\nhas no significant role in dealing with\nofficials were perhaps being under-\ncomputer runs, statistical data. We\nRichard F. Celeste, the former\nCongress now.\nused.\ncan discuss the implications of vari-\nGovernor of Ohio who spent eight\nMany elements of the President's\nous options, but we will not say wheth-\nmonths supervising the Democratic\n\"People at the White House have\nbill, including one that would have\nheld them back because this is a\ner one is better than another.'\neffort to drum up support, said:\nrequired most people to get health\nMr. Ickes noted that three commit-\n\"Originally there was an expectation\ncentralized operation,\" she said.\ninsurance through purchasing co-\ntees in the House and two in the\nthat there would be a big national\n\"The White House has felt strongly\noperatives known as alliances, have\nSenate had been trying to write\ncampaign. But there was a substan-\nthat all decision making should rest\nsunk from view on Capitol Hill.\nth care bills. \"For us to be bar-\ntial recalibration as people realized\nat the White House. That may have\n\"We have not tried to defend every\ngaining against ourselves with five\nthat resources were limited and time\nslowed down the legislative process\ntiny piece of the bill except in the\ndifferent committees would be self-\nwas limited.\nbecause the White House is a small\ninitial hearings,\" said Donna E. Sha-\ndefeating,\" he said.\n\"Our campaign was diffuse be-\nplace, too small to cope with that\nlala, the Secretary of Health and Hu-\nIn interviews, Clinton officials and\ncause we had an issue so big and\namount of decision making, and di\nman Services. \"We have narrowed\nmembers of Congress made these\ncomplicated, we couldn't character-\nnot always have the expertise to give\ndown what is of fundamental impor-\npoints about the Administration's\nize it easily,\" Mr. Celeste said. He left\nguidance to Congress.\"\ntance.\"\ndealings on health care:\nthe campaign a few months ago and\n9The President has assembled a\nreturned to Ohio.\nBradley Takes Shot\nOn Health Care\nHelps Shape an Alternative Plan\nBy TODD S. PURDUM\nmove ahead,\" Mr. Bradley said with\ncoverage.\nSpecialto The New York Times\npointed understatement in an interview\nIn that sense, he lost. But by lending his\nWASHINGTON, June 26 - Since he\non Friday, effectively acknowledging that\nheft to the effort of John H. Chafee, Re-\nfirst awed Princeton basketball fans by\nif he did not speak up, it would soon be 100\npublican of Rhode Island, and John\nsinking over-the-shoulder shots with his\nlate to have an effect on one of the most\nBreaux, Democrat of Louisiana - fellow\nback to the basket 30 years ago, William\nimportant issues of the day.\nmembers of the Finance Committee who\nWarren Bradley has usually had an un-\nFour years ago, voters angry at his re-\nhad been working on the issue much long-\ncanny sense of where he is. Where he put\nfusal to take a stand on Gov. Jim Florio's\ner - Mr. Bradley may have helped jump-\nhimself last week was right in the middle\ntax increases - then the hottest topic of\nstart a fragile process with a backhanded\nof one of the biggest legislative issues in\nthe day nearly turned the Senator out\nmove his Princeton coaches might have\nhis 16 years in the United States Senate.\nof office, and he has since spoken out in-\ncalled a \"hope pass.'\nUntil then, it was not clear that this\ncreasingly on topics from race relations\n\"Bradley's play has just one somewhat\ngame would include the senior Democrat-\nto trade policy to crime.\nunsound aspect, and it is the result of his\nic Senator from New Jersey, who suf-\nHis health plan set a goal of covering 95\nfered a soul-searing near-defeat for his\npercent of Americans by 2002, through\nsubsidies for low- and moderate-income\nContinued on Page B5\nseat in 1990 and sat out the 1992 Presiden-\npeople financed by taxing high-cost insur-\ntial race. This year, while speaking out on\ners, and it relied ultimately on making\nother issues, he had been mostly on the\nworkers pay for insurance if their em-\nbench in the rancorous debate over re-\nployers would not.\nshaping the nation's health care system.\nHis stance took his colleagues by sur-\nThen, beginning Monday, Mr. Bradley\nprise, and drew the scorn of some Con-\nbroke with his President, announcing that\ngressional liberals, unions and consumer\nTHE TIMES, MONDAY, JUNE 27.\nhe could not support forcing employers to\ngroups, who saw it as a sellout of the mid-\npay for health insurance. He then re-\ndie class and real reform, while others\nshaped and absorbed as his own an alter-\nsaw it as an acceptable way to keep the\nnative plan aimed at assuring universal\nbill alive. By week's end, the centrist\ncoverage that had been percolating\ngroup had rejected requiring either work-\namong several centrist Democrats and\ners or employers to buy insurance and\nRepublicans trying to hammer a compro-\nMr. Bradley had distanced himself from\nmise bill out of the stalemated Senate Fi-\nits proposal, which is now a likely compo-\nnance Committee.\nnent of the full committee's bill, saying he\n\"I thought that this was the moment to\nwanted to do more to assure universal\nAfter Quiet Start, Bradley Jumps Into Health Care Fray\ncould loom disproportionately large\nlittle new, but consistent with the way\nContinued From Page B1\n- which he tracked so closely that he\nin subsequent debate.\nlots of Democrats feel they have to\neven took the highly unusual step of\nBut Mr. Bradley's move was con-\ndefine themselves on this issue. The\nwalking over to the House side of the\nmania for throwing the ball to his\nsistent with his behavior since his\nmiddle class feels put upon, and I\nCapitol to lobby members there -\nteammates: he can't seem to resist\nnear loss to Christine Todd Whitman\nthink Bradley would like to make\nand a 1992 bill to reshape the Califor-\nthrowing a certain number of passes\nfour years ago freed him, he says, to\ncertain that he is someone who is\nnia water system, in which he helped\nthat are based on nothing but theory\nspeak out more, and Bill Clinton's\nseen as recognizing the costs and\npreserve provisions for environmen-\nand\ne,\" John McPhee wrote in his\nvictory relieved him of the endless\nburdens on middle-class people.\"\ntal and wildlife protections in the face\nfamous 1965 profile in The New York-\nspeculation about what his every act\nA common criticism of Mr. Brad-\nof strong agricultural lobbying.\ner of Mr. Bradley's Princeton years.\nmeant for his presidential ambitions,\n\"They happen, usually, when some-\nsince he will be 51 next month and\nley is that he is a better talker than\nIn his last campaign, Mr. Bradley\nthing has gone just a bit wrong.\"\neveryone now assumes he cannot\ndoer, that he fizzled as a prospect for\nspent more than $12 million and won\nSometimes, the writer added, \"a hope\nhave any until at least 2000.\nthe presidency, and some of his Sen-\njust 50 percent of the vote to Mrs.\npass goes flying into the crowd, but\n\"After 1990 I came to speak as\nate colleagues complain that his aloof\nWhitman's 47 percent. So far, he has\nmost of the time they hit the receiver\nmuch from my heart as from my\n6-foot-5-inch presence can create the\njust a couple hundred thousand dol-\nright in the hand, and a gasp comes\nmind, right?\" he said, ending his sen-\nimpression that he thinks he is smart-\nlars in his campaign treasury, but\nfrom several thousand people.\"\ntence with the friendly interrogative\ner than they are (and sometimes, of\nasked if he will run for re-election in\ncourse, he is). For all his fame as a\nhe uses where other politicians might\n1996, he replies, \"Uh, I have abso-\nTaking His Best Shot\nstar of the Knicks (whose retired No.\nsay \"you know.\"\nlutely.' He says he has held off major\nIn the tortured progress of health\nThis year alone, Mr. Bradley has\n24 hung above the podium at the\nfund-raising, both in the belief that he\nDemocratic National Convention at\nlegislation, of course, things have\naccused the White House of \"gratu-\ndoes not have to spend so much and\ngone more than a bit awry from the\nitous brinksmanship\" in its get-tough\nMadison Square Garden in 1992), he\nthat he can raise enough in the next\nDemocrats' viewpoint, and Mr. Brad-\ntrade policy with Japan, argued that\ncan be standoffish with reporters and\ntwo years.\nley, a Rhodes Scholar expert on tax\nhuman rights in China could best be\nnot much of a glad-hander in public.\npolicy and, along with the Finance\npromoted by active trade engage-\n\"Well, I'm certainly not smarter\nThe Senator said he is less con-\nCommittee chairman, Daniel Patrick\nment rather than a rigid withholding\nthan a lot of Senators.' he said as he\ncerned about what the White House\nMoynihan, one of the Senate's deeper\nof trade benefits, and warned that the\ngulped down a cup of coffee and a\nor his colleagues think of his views\nthinkers, seemed to be taking his best\nelection-year omnibus crime bill\ncoconut doughnut before heading to a\nthan how they act on them.\nshot.\n(which he supported) should not be\nmeeting in Senator Chafee's office. \"I\n\"I'm interested in what they do at\nHis maneuver put him in an unac-\nseen as an easy solution to increasing\ndon't know what to say about that. I\nthe end of the day on the issue that I\ncustomed spot, since he is known far\nviolence.\njust try to come to work every day\nspoke out about,\" he said. \"I think to\nfor tactical dealing than for end-\nSuch independence has sometimes\nand call it like I see it\"\nbe silent is not to give your best to\n/ mulling things over in his own\nprompted the White House to wonder\nHis biggest legislative achieve-\nyour own party and your own Presi-\nmind, after which he announces his\nabout the depth of Mr. Bradley's\nments are the Tax Reform Act of 1986\ndent.\"\nviews, however they tend to fit politi-\nfriendship, though he has generally\ncally.\nbeen one of the President's most reli-\nIndeed, in the interview he ex-\nable supporters in Congress. Asked\npr\n1 some puzzlement at why re-\nlast week if Mr. Bradley's move on\nquiring employers to pay the bulk of\nhealth care had been surprising,\nCorrection: Cuomo Is Quoted on I.T.A.\nith care costs had become such an\nGeorge Stephanopoulos, the senior\nanathema. He also said he thought\npresidential adviser, smiled slightly\nBecause of a mechanical error, an\nof politics and business as usual in\nemployers and workers must share\nand said, \"Not particularly.\"\narticle yesterday about Peter E.\ngovernment.\nthe costs, and would not rule out\nStangl's role as chairman of the Met-\nforcing employers to pay for health\n'Down-to-Earth Agenda'\nropolitan Transportation Authority\nA second affected passage should\ncare if such a measure managed by\nDavid P. Rebovich, a professor of\nhad three lines out of place in some\nhave read:\nsome miracle to make it to the Senate\npolitics at Rider University in Law-\neditions, scrambling two passages.\nThe Governor is as adroit as the\nfloor.\nrenceville, N.J., said Mr. Bradley's\nThe first passage, in which the Gover-\nHouston Rockets' Hakeem Olajuwon\nAt a meeting last Thursday, a coali-\nspeaking out on health care reflected\nnor expresses irritation at the\nis in positioning himself for a re-\ntion of groups representing labor, lib-\nthe growing emphasis he has placed\nM.T.A.'s lack of political restraints,\nbound. This is how he described the\nerals and the elderly complained to\non domestic concerns since a series\nshould have read:\nlineup in the L.I.R.R. negotiations:\nMr. Bradley that the centrists' pro-\nof speeches on race relations in which\np\nhe warned - before the Los Angeles\n\"I am not insulated from the pub-\n\"Stangl speaks for the M.T.A.,\" and\ndid not meet the test of univer-\nsal coverage, and that his support for\nlic,\" Mr. Cuomo said shortly after\nEdward Yule Jr., general chairman\nriots - of the potential for outrage\ntaking office in 1983. \"They'll get me\nof the 2,300-member United Trans-\neventually requiring people not other-\ncreated by situations like the Rodney\nwise covered to buy their own insur-\nKing beating.\nfour years from now. Authorities are\nportation Union, \"speaks for organ-\nance was onerous. When he, said his\ninsulated.\"\nized labor.'\n\"This is part of a move toward a\nmore domestic and down-to-earth\nThe usual justification for authori-\n\"I was there,\" he declared, \"as a\nconcern was to keep the process mov-\nties, of course, is precisely that: to\nthird party, speaking as a woman\ning, they countered that if such a bill\nagenda,\" Mr. Rebovich said. \"The\ncame out of the Finance Committee it\nneoconservatism of his position is a\naccomplish things beyond the reach\nfrom Suffolk, as a man from Nas-\nsau.\"\nforced up. This probably will lead more of\nThe Outlook\nthem to stop offering insurance, to limit\ncoverage for workers' families or to rely\nmore on part-timers and temporary workers\nHealth-Care Inaction\nwho often don't get health insurance. Al-\nready. the fraction of adults who work but\nCan Carry a High Cost\nhave no public or private health insurance\nhas risen to 17.5% in 1992 from 15.3% in 1988,\nthe Census Bureau says. And employment is\nWASHINGTON\ngrowing fastest in industries that tend not to\noffer health insurance.\nWhen it comes to health-care re\nToday, many who lack insurance still get\nform, the credo of the cautious on health care if they get sick enough, either\nCapitol Hill is: First, do no harm. What through federal or local government pro-\nsome overlook is that doing nothing can grams or through charity. But as employers\ncause harm, too.\nsqueeze the health system harder and the\nManeuvering in Congress may yet pro-\nduce a compromise that President Clinton\nMore Uninsured Workers\naccepts. But the persistence of partisan\nPercentage of all U.S. workers without any\nbickering. the hard line the White House is\nprivate or public health insurance\ntaking and genuine disagreement over fun-\n19%\ndamental issues raise the odds that no major\nhealth reform will be enacted this year. One\n18\nenemy of far-reaching reform is the growing\nlevel of comfort with doing nothing, or\n17\nnearly nothing. \"The reason negotiations\nare so impossible in health care is that\n16\neveryone's second choice is the status quo,\"\nsays Deborah Steelman, a health lobbyist\n15\nand former Reagan budget official.\nIn some quarters, the prospect of nothing\n14\nmuch coming out of Congress this year is\n1988\n'89\n98\n'91\n92\nmet with little more than a shrug. \"Competi-\nSource Census Bureau, Employee Benefit Research institute\ntive forces are reducing the increases in\nhealth-care costs dramatically,' says Edgar number of uninsured grows. free care proba-\nWoolard, DuPont's chief executive. \"It's bly will be harder to find, and the quality is\nalready happening.\" If more big companies likely to deteriorate. And the government's\nget health-care cost-control religion and costs, from the Medicaid program for the\nstate experiments proliferate, perhaps the poor to emergency rooms at municipal hos-\nhealth-care system will begin to heal itself.\npitals,\nwill\nclimb.\nTHE WALL STREET JOURNAL MONDAY, JUNE 27, 1994\nBut big employers' success in slow-\n\"Supermarkets don't go out and give\ning their own health-care spending may\nfree food to poor people. They can't\nalso foster an unjustified complacency.\nafford to. They'd go out of business,\"\nIf all the players in the health system\nsays Harvard health economist David\ncontinue to do what is in their self-inter-\nCutler. \"That's the danger of making\nest under the current law, more Ameri-\nthe [health] market real competitive\ncans are likely to be without any health\nwithout bringing people in.\" So most of\ninsurance. And even if corporate\nthe pending health-reform plans would\nhealth-care spending slows, govern-\nspend tens of billions of dollars a year\nment health spending probably will con-\nS0 low-income families or their em-\ntinue to climb rapidly, with worrisome\nployers can afford insurance.\nimplications for the deficit.\nComing up with such funding without a\nFor years, employers not only have\nbroad-based tax is tough. So Congress is\npicked up the health-insurance tab for their\ntoying with lower-cost alternatives that\nown workers, but also have helped finance\nwould subsidize insurance for some, but not\ncare for those without insurance and for\nall, of the 39 million who lack it. The plan\nthose covered by Medicaid and Medicare,\ncrafted last week by Senate Finance Com-\nwhich pay less than the full cost. \"The cost\nmittee moderates would offer subsidies to\nshifting has been borne by people who\nthe poorest Americans, and gradually move\nvolunteered to pay,\" says Walter Maher.\nup the income ladder. By 2002. subsidies\nhealth-care strategist for Chrysler Corp.\nwould be available to families of four with\nThe volunteers with the deepest pockets.\nincomes of $34.500 (in today's dollars). So\nthe big companies, are pulling out. By using\nfar, Bill and Hillary Clinton reject such a\ntheir clout with health-care providers to\nstep toward the goal of universal coverage.\ndemand lower costs, big employers help\nDespite advice from moderates like coun-\nsqueeze out inefficiencies. But they also stop\nselor David Gergen, Treasury Secretary\nhelping hospitals care for those with no\nLloyd Bentsen and economic adviser Robert\ninsurance or with government insurance.\nRubin, the Clintons want a guarantee that\nThose costs won't disappear, however.\nthe goal will be achieved - even if that\nAs big companies shed them, insurance\ndemand means no health-reform bill at all\npremiums for smaller employers will be\nthis year.\nSome Clinton advisers argue he can pin\nthe blame on Republicans: others fear he\nand other Democrats will suffer the wrath of\nvoters disgusted with gridlock. But the social\nand economic consequences of once again\nretreating from far-reaching reform are\nclear: more uninsured Americans and\nhigher costs for the government.\n-DAVID WESSEL\n63\nSenators Focus\nFor individuals at 150% of poverty. for\nexample, the vouchers would be worth\nContinued From Page A3\nvotes, or better than a third of the commit-\nOn How to Fund\nábout 65% of the cost of their premiums.\nFor those at 200% of poverty. the voucher\ntee. Among the Republicans. Missouri Sen.\nshare falls to 30%. To stretch available\nJohn Danforth was described as adamant\nresources and make coverage affordable.\nin opposing any type of assessment on\nHealth Reform\npreliminary estimates assume the initial\nemployers. But the most conservative\npremiums can be kept in the range of $1,800\ninfluence, perhaps, was from the Demo-\ncratic side-Oklahoma Sen. David Boren.\nto $2.100 annually for an individual. But\nFinance Panel Is Assessing\nthese costs could double for families, and\nThe drift right reflects the strong influ-\nworking-class households earning between\nence of business, and a major question now\n$23,000 and $35,000 may still find insurance\nis whether the committee can summon\nU.S. Costs in Absence\nunaffordable, given the declining subsi-\nsupport for the tax provisions needed to\nOf Employer Mandate\ndies in their income brackets.\npay for the subsidies. Critics of the em-\nployer mandate argue that it is itself an\nThe vouchers would dovetail with ex-\ninefficient means to finance reform be-\npanded tax deductions to help cover the\ncause it requires subsidies to ease the\nBy DAVID ROGERS\nGost of health insurance, but these are\nburden on small companies. But in an\nStaff Reporter of THE WALL STREET JOURNAL\nmuch less valuable to families in lower tax\nelection year, the alternative of a direct\nWASHINGTON - The Senate Finance\nbrackets. Self-employed persons, many\ntax on business will be a hard sell.\nCommittee. having all but abandoned the\nwith higher incomes, would benefit, and\nThe administration had hoped to avoid\nemployer-based financing of President\nthere may be pressure from liberals to\nsuch a fight by claiming huge savings from\nClinton's health-reform plan, now must\nphase in the deductions more slowly or\nthe cost-containment provisions in its plan.\nconfront the huge government cost of\nchange the tax provision to a credit for\nBut here too, the White House must give\nexpanding coverage without a large contri-\nworking families.\nground as the insurance industry has\nbution from business.\nIn announcing their proposal Friday.\nmounted a strong lobbying campaign to\nmoderates left themselves considerable\noverturn proposed controls on private\nA compromise plan put forward by\ncentrists on the panel would commit more\nflexibility on these deductions, but re-\ninsurance plans.\nthan $246 billion over a five-year period,\ncent estimates indicate that even a more\nMr. Moynihan has never hidden his\nand even this could be inadequate to fund\nscaled-back version could cost as much as\nskepticism about the premium caps pro-\nthe subsidies needed to achieve the stated\n$40 billion over five years, leaving about\nposed by the administration, and Demo-\ngoal of providing health insurance to 95%\n$200 billion in the plan for the vouchers. If\ncrats on the House Ways and Means\nof Americans by 2002.\nthe savings from Medicaid - a program\nCommittee are plainly divided on the is-\nalready aimed at the are subtracted,\nsue. The panel, which worked into the\nThe same budget relies on nearly\nthe proposal provides about $150 billion in\nweekend, hopes to complete action on\n$56 billion in Medicaid savings that pose a\nnew resources to expand health care for\nits own health-care bill before the July\nproblem for states like New York, home of\nlower-income families. And more than half\nFourth recess, but acting Chairman Sam\nthe Finance Committee chairman, Sen.\nof these funds would in fact come from\nGibbons (D., Fla.) cut off votes on a\nDaniel Patrick Moynihan. And in addition\nnearly $78 billion in savings from Medi-\nstandby cost-control plan until party cau-\nto a new tax on high-cost health-insurance\ncare, the health program for the elderly.\ncuses this week.\nplans. the package includes a $1-a-pack\nIn contrast with the finance panel,\nincrease in cigarette taxes - more than\nDespite its misgivings, the Clinton\nthe Ways and Means bill depends heavily\ndouble the level accepted SO far by the\nadministration is wary of doing any-\non mandated contributions from business.\nHouse Ways and Means Committee.\nthing now that would jeopardize the\nBut to preserve this provision, Mr. Gibbons\nchances of advancing a health-care bill in\nChairman Moynihan has delayed any\nalready has had to give ground on tobacco\nthe Finance Committee. And though labor\ndecision until after a meeting this after-\ntaxes and insurance-market changes. In a\ninterests appeared to play a role in pulling\nnoon of committee members. But even\nseries of tradeoffs, the committee agreed\ntwo Democrats. Sens. Bill Bradley of New\nbefore release of the compromise plan last\nto give more flexibility in setting rates for\nJersey and Max Baucus of Montana, away\nFriday, the clear drift in his panel was\ncompanies with more than 100 employees.\nfrom the proposed compromise last week,\naway from the administration's require-\nIn addition, the bill was restructured to\nunion leaders also want to give the reform\nment that all employers help pay for their\nagain allow companies with between 50\neffort more time.\nworkers' insurance.\nand 100 workers to participate in a pro-\nThe finance panel's centrist faction.\nposed Medicare-like program for small\nThe high costs underscore the un-\nincluding Sens. Bradley and Baucus, in-\nbusinesses that can't get private coverage\ncertainty of the whole endeavor. An esti-\ncludes eight Republican and Democratic\nfor their workers.\nmated 39 million people are now unin-\nPlease Turn to Page A8, Column 4\n-Mary Agnes Carey contributed to this\nsured, and Congressional Budget Office\narticle.\nfigures indicate nearly three-quarters\ncould qualify for some subsidy under the\nplan put forward by moderates. A proposed\nsystem of vouchers would cover the full\ncost of insurance premiums for those be-\nIbw poverty, about 15 million persons,\nand this subsidy would be gradually\nphased out until reaching 240% of the\npoverty level.\nTHE WALL STREET JOURNAL MONDAY, JUNE 27, 1994\n64\nTouchy time for\nhealth reform\nMoynihan\noffers his\nplan today\nBy Jessica Lee\nUSA TODAY\nHealth-reform legislation en-\nters a delicate stage today as\nthe Senate Finance Committee\ngets its first look at a bill that\npromises health coverage for\nall Americans, without making\nemployers pay for it.\nSen. Daniel Patrick Moyni-\nhan, D-N.Y., the committee\nchairman, unveils his official\noutline for financing health re-\nFOLL\nform with a combination of\ntaxes and savings in Medicare\nand Medicaid.\nMoynihan's proposal over-\nshadows a bipartisan plan de-\nBy Shayna Brennan, AP\nveloped last week by Sen. John\nEXTRA HOURS: Reps. J.J. Pickle, D-Texas, left, Dan Rostenkowski, D-111. and acting House Ways\nChafee, R-R.I., and five other\nand Means Chairman Sam Gibbons listen to discussion during a rare weekend committee meeting.\nfinance panel members.\nBoth plans share Clinton's\nward in his committee, and we\ncomposition - 11 Democrats,\nHillary Rodham Clinton meet\ngoal of universal coverage but\nare encouraged to see the pro-\nnine Republicans - reflects\ntoday with leaders of medical\nreject his device for guarantee-\ncess move forward,\" she said.\nthat of the full Senate.\nschools and teaching hospitals.\ning it - a requirement that\nMoynihan's financing in-\nRepublicans' strength on the\nMoynihan, who's running for\nemployers pay 80% of their\ncludes a $2-a-pack cigarette tax\nfinance panel gives them the\nre-election this year, has a\nworkers' insurance premiums.\n(up from 24 cents) and a 1.75%\nbest shot they're likely to have\nnumber of influential medical\nMoynihan's plan aims for\ntax on all insurance premiums.\nto influence the health-reform\ncenters in his state.\n95% of Americans to have\nMeanwhile, Senate Republi-\nfinancing legislation that goes\nLast week, Dole rejected the\nhealth insurance by the year\ncan leader Robert Dole, R-\nto the Senate floor.\nChafee proposal as one that\n2000 after new regulations\nKan., argued for cautious\nOn the other side of the aisle,\n\"has too many taxes for me\"\nmake insurance more accessi-\nhealth-reform action as some\nsome Democrats are less con-\nand probably would not win\nble and affordable.\nDemocrats pushed for moving\ncerned with details.\nsupport among a majority of\nIf the goal isn't reached, a\nahead without GOP backing.\nSen. Tom Daschle, D-S.D., is\nRepublicans.\ncommission would set specific\n\"Let's get it right,\" Dole in-\nurging Moynihan to pass a bill\nHe says he'll write his own\nsteps to achieve it.\nsisted in a TV interview on C-\nand send it to the floor -\nplan with Sen. Bob Packwood,\nThe steps would take effect\nSPAN. \"I think we can do a lot\nwhere the Democratic major-\nR-Ore., ranking Republican on\nautomatically unless Congress\nof things this year, but if we try\nity can rewrite it to the presi-\nthe Finance panel, and prom-\nvoted them down.\nto take the whole loaf, it may\ndent's liking and pass it, with or\nises it will be one most Republi-\nWhite House economics ad-\nbe that no health-care bill\nwithout Republican votes,\ncans can support.\nviser Robert Rubin stressed\npasses this year.\"\nwhile the public looks on.\n\"That would be straight\nSunday that Clinton stands by\nDole's argument comes at\nThe \"employer mandate\"\nalong partisan lines,\" Pack-\nhis insistence on universal\nthe start of a week when both\nClinton proposes has been ap-\nwood says.\nhealth-insurance coverage as\nthe tax-writing Finance Com-\nproved by two committees -\nSuch a bill, he says, risks sti-\n\"an integral part\" of his overall\nmittee and its counterpart, the\nthe Senate Labor and Human\nfling bipartisan efforts and\neconomic strategy.\nHouse Ways and Means Com-\nResources panel and the House\ncould end in passage of a weak-\nHealth-reform spokeswom-\nmittee, will be immersed in\nEducation and Labor panel.\nly supported law that gets re-\nan Lorrie McHugh said Clinton\nwriting outlines of the health-\nBackers of Clinton's employ-\nvised every couple of years.\nis flexible on the route to uni-\nreform legislation to be voted\ner mandate also are expected\n\"Unfortunately,\" Packwood\nversal health coverage but not\non by each chamber.\nto hold sway in the Ways and\nsays, \"it may end up that Dole\non the destination.\nMany senators look to the Fi-\nMeans Committee, where all\nand (Senate Majority Leader\n\"Chairman Moynihan is try-\nnance Committee for political\ntax bills originate.\nGeorge) Mitchell end up writ-\ning to move the process for-\nguidance because the panel's\nThe president and first lady\ning\" the health-reform bill.\nUSA TODAY MONDAY, JUNE 27, 1994\n85\nChafee stakes out middle ground\nBy Judi Hasson\nregulations imposed by the government.\nUSA TODAY\n\"It is a centrist effort,\" says Chafee, 72.\n\"On both sides there are extremists who\nSen. John Chafee is known on Capitol\ndemand that what they want be it, and\nHill as a bridge-builder and a longtime\nthat's why it seems to me the progress in\nhealth-care crusader.\nhealth-care reform in the Congress of the\nLast week, those traits merged as the\nUnited States to date has been total chaos.\"\nRhode Island Republican forged a health-\nSen. David Durenberger, R-Minn., part of\ncare reform compromise among fence-sit-\nChafee's small group of Democrats and\nters on the Senate Finance Committee who\nRepublicans who came up with the plan,\noppose requiring employers to pay for\nsays it was Chafee's persistence that\ntheir workers' insurance.\nbrought about the compromise some law-\nChafee's plan - which drops the most\nmakers hope will break the Senate logjam.\ncontroversial part of President Clinton's\n\"I give John Chafee the credit for all of\nproposal, the so-called employer mandate\nit,\" Durenberger says.\n- is attracting the attention of Sen. Daniel\nBut Clinton allies say the Chafee com-\nPatrick Moynihan, D-N.Y., the Finance\npromise is no plan at all because it doesn't\nCommittee chairman. Today Moynihan is\nguarantee coverage for everyone.\nexpected to introduce his own version of\nSays the Consumers Union's Bob Car-\nreform, without a mandate of any sort.\nolla: \"We're appalled. It's legislative gim-\n\"There is no point in coming out with\nmickry at its worst. The mainstream is ac-\nsomething no one is for,\" says Chafee.\ntually selling consumers down the river.\"\nDecades before Clinton put health re-\nRon Pollack, spokesman for Families\nform at the top of the national agenda, it\nUSA TODAY\nUSA, a liberal consumer group, calls the\nwas on Chafee's. As governor, he worked\nplan \"Chafee minus.\" He says Chafee and\nin the 1960s to provide prenatal care for\n\"\nother moderate Republicans were pres-\nwomen who couldn't pay for it and to pro-\nsured by hard-line Republicans, including\nvide health insurance for the elderly be-\nfore Congress passed Medicare in 1965.\nThere is no point in coming out\nSenate Minority Leader Robert Dole, R-\nKan., not to come up with a workable plan.\nThree years ago, he began meeting with\nwith something no one is for.\n\"It is clearly a hard-line Republican par-\nGOP senators weekly to educate them\n\"\nty position to try to do what they can to dis-\nabout the nation's health-care problems.\nrupt and frustrate any attempt to get some-\nNow Chafee has pulled together a small\n- Sen. John Chafee, R-R.I.\nthing through,\" Pollack says.\nbipartisan group to stake out a centrist po-\nChafee is mindful that whatever bill\nsition on the finance panel.\npasses must have overwhelming support.\nThat's the committee responsible for de-\nance. But the individual mandate fell flat.\nOtherwise, it will be attacked, revised and\nciding how things will be paid for, and\n\"There was no constituency for it,\" Cha-\nweakened over time.\nmany believe it is where the health-care\nfee says. \"The right was against it. The left\n\"If you pass it 56-44, that means 44 sena-\nplan ultimately will be crafted, because it\nwas against it.\"\ntors are going to be going around the coun-\nreflects the makeup of the Senate.\nIn its place is a compromise designed to\ntry saying what a lousy bill it is,\" Chafee\nGone from Chafee's plan is any talk of a\nattract committee moderates like David\nwarns. \"It's not beyond the realm of possi-\nmandate. After Clinton proposed requiring\nBoren, D-Okla., who wouldn't go for a man-\nbility that the whole thing will collapse.\"\nemployers to pay at least 80% of workers'\ndate under any circumstances, and John\nChafee hopes there will be reform this\npremiums in order to achieve universal\nBreaux, D-La., who argues competition in\nyear, but says there are unrealistic expec-\ncoverage, Chafee had countered with a\nthe marketplace and insurance reforms\ntations about what Congress can do: \"I'm\nplan to require individuals to buy insur-\ncan be used to drive down prices without\nnot as optimistic as I was six months ago.\"\nClinton, Chafee\nplans compared\nMEDICAID\nUNIVERSAL COVERAGE\nBENEFITS\nChafee: Medicaid patients\nChafee: If 95% of all Ameri-\nChafee: National board\ncould be folded into private in-\ncans don't have insurance by\nwould establish two benefit\nsurance, but welfare recipients\n2002, national board would rec-\npackages: one based on Blue\nwould keep their extra health\nCross-Blue Shield standard op-\nbenefits.\nommend ways to achieve uni-\ntion under federal employees\nClinton: Same.\nversal coverage. Congress\nwould have to act on the recom-\nplan, and one lower-premium\nmendations but would not have\nplan with higher copayments\nMEDICARE\nto follow them.\nand deductibles, fewer benefits.\nChafee: Elderty could opt to\nClinton: Mandatory cover-\nCoverage would include doctor\nenroll in community plans to gain\nage of all Americans by 1998\nbills, hospital stays, emergen-\nprescription drug coverage, oth-\nthrough employer, individual and\ncies, mental illness, substance\ner benefits.\ngovernment payments.\nabuse, prescription drugs for\nClinton: States could opt to\nthose under 65.\nfold elderly into new system.\nMANDATES\nClinton: Congress would\nspecify minimum benefits avail-\nTAX DEDUCTIONS\nChafee: No mandate on em-\nable to all, including doctor bills,\nployer or individual to buy insur-\nhospital stays, emergencies,\nChafee: Expanded tax\nance. Vouchers to help low-in-\nmental illness and substance\nbreaks: All individuals could de-\ncome families buy insurance.\nabuse, prescription drugs for all,\nduct 100% of insurance costs.\nUSA MONDAY, JUNE 27, 1994\nVoluntary purchasing pools for\nsome long-term care at home\n(Currently, only self-employed\nindividuals and small business-\nand adult day-care.\nmay deduct only 25%.)\nes with 100 or fewer employees;\nClinton: Same.\ncommunitywide rates, adjusted\nFINANCING\nfor age. Insurance market re-\nforms to make coverage more\nChafee: Cigarette tax in-\nMoynihan plan\naffordable and available, includ-\ncrease from 24 cents to $1.24.\nExpected: Won't require individ-\ning guaranteed renewal and no\nSavings in Medicare, Medicaid.\nuals or employers to pay insur-\ndenial of coverage for existing\nNew tax on high-cost health\nance. Would rely on new insur-\nconditions.\nplans. All state and local govern-\nance rules: Renewal would be\nClinton: Employers must\nment workers would pay 1.45%\nrequired, denial of coverage for\npay 80% of workers' premiums.\nMedicare payroll tax.\nexisting conditions would be\nSubsidies for small, low-wage\nClinton: Cigarette tax in-\nbanned. If that doesn't result in\nfirms and low-income individ-\ncrease from 24 cents to 99\nuniversal coverage, a national\nuals. Insurance plans offered\ncents. Savings in Medicare, Me-\nboard would make recommen-\nthrough mandatory purchasing\ndicaid. 1% payroll tax on self-in-\ndations to take effect unless re-\npools. Companies with 5,000 or\nsured companies.\njected by Congress.\nmore workers could remain self-\ninsured, would still pay 80% or\nmore. Same insurance reforms.\n86\nModerate health plan may be placebo\nBid to please all,\nto find but have done little to reach\nplans - will continue to raise\nplan and remain unified behind it.\n- is in reality very small.\nstrenuous opposition from a ma-\nOther Republicans cited politi-\n\"Will the middle hold? That is\njority of Republicans.\nwon't fly on Hill\ncal problems they could have if a\nthe issue,\" said Rep. Rick Boucher\nBut Democrats will have the\nsmall group of their members\nof Virginia, a conservative Demo-\nmost problems with the proposal\nbroke ranks. \"Why should we\ncrat who differs with the majority\nbecause it fails to meet President\nshare the pain with the Democrats\nBy J. Jennings Moss\nof his party on health care.\nClinton's bottom line: It does not\nthat they will feel\" at the polls, said\nTHE WASHINGTON TIMES\nThat middle will be tested this\nguarantee that by a specific date\nRep. Dick Armey of Texas, chair-\nweek when the Finance Commit-\nevery American will have insur-\nThe compromise health plan\nman of the House Republican Con-\ntee takes up the proposal unveiled\nance coverage.\nference.\ncrafted by moderates on the Sen-\nFriday by four Democrats and\n\"You cannot pass through this\nate Finance Committee last week\nthree Republicans on the panel.\nHouse of Representatives an op-\nRep. Al Swift, Washington\nis a good example of what happens\nThe plan makes no guarantee\ntion [for Congress to do something\nDemocrat, agreed that Republi-\nwhen lawmakers from the politi-\nthat every American would have\nin the future]. We have to have uni-\ncans are better off politically by\ncal middle meet behind closed\nhealth insurance in the near fu-\nversal coverage by a date certain,\"\nsticking together. \"Whether or not\ndoors to develop policy.\n[the Senate Finance moderate\nture but sets a target to have 95\nsaid Rep. Mike Synar, Oklahoma\nThe plan borrows ideas from\nDemocrat and one of the presi-\nplan] creates any new problems\npercent covered by 2002 through\nDemocrats and Republicans. It\nthe use of insurance reforms and\ndent's health care cheerleaders.\nfor us, I don't know,\" Mr. Swift said.\npunts on the\nother measures. If the nation fails\n\"It leaves us pretty much with the\nRepublicans know any health\ncontentious is-\nsame splinters we've always had so\nNEWS\nto meet the goal, a commission will\nbill with a strictly GOP stamp has\nsue of insurance\nwe don't have any more political\nANALYSIS\nrecommend solutions to Congress,\nno chance of passage, but it could\nmandates. It\nand lawmakers will be forced to\nproblems, we've still got the old\nbe a good political document on\nwould protect\nconsider them but not bound to en-\nones. It's the Republicans with the\nwhich to challenge Democrats.\nAmericans from losing their in-\nact any changes.\n\"I'm not adverse to the notion\nnew problems.\"\nsurance. It would reach to cover 95\nLawmakers from both parties\nthat the election might tell us\nThe moderates who negotiated\npercent of the public.\nanticipated the proposal would\nsomething about what the Amer-\nthe compromise understand more\nBut it most likely would not pass\ncontain a mandate on individuals\nican people want.\" said Sen. Pete V.\nthan most the delicate nature from\nin Congress.\nto buy insurance if other reforms\nDomenici, New Mexico Republi-\nboth a political and policy view-\nLiberals will blast the plan be-\ndid not work in the future. The\ncan.\npoint of the tradeoffs involved.\ncause it does not have an automatic\nindividual mandate is not an ap-\nMr. Domenici said the feeling\n\"From the standpoint of myself\ndevice to force businesses to pro-\npealing concept for either side, al-\namong many Republicans was\nand, I think, probably other people\nvide insurance coverage. Conser-\nthough for different reasons.\nthat they would have preferred not\nas well, we're nervous\nnervous\nvatives will balk at the new taxes\nBy dropping mandates entirely,\nto see the moderate GOP members\nabout unintended results, nervous\nimposed and are likely to say it is\nthe moderate lawmakers made it\nnegotiating with like-minded\nthat in attempting to do something\nstill a big-government solution.\nmore attractive to conservatives,\nDemocrats. Instead, they wanted\ngood, we do something bad,\" said\nThe middle ground that place\nalthough other items - such as a\nto let Senate Minority Leader Bob\nSen. John C. Danforth, Missouri\nboth sides profess a sincere desire\ntax on the more expensive health\nDole work out a GOP concensus\nRepublican.\nAnd he is almost certain to be-\ncome the second president, after\nTroubled\nJimmy Carter, to visit black Af-\nrica. Speculation is centering\naround a trip early next year.\nIn his speech today, Mr. Clinton\nAfrica\nis expected to describe a new era\nof possibilities for U.S. policy on\nAfrica.\nGone is the Cold War in which\nfascinates\nAfrican states lined up on the U.S.\nor Soviet side. And gone is the\nhated apartheid system, now that\nSouth Africa has a multiracial\nClinton\nelected government.\nAlready, the administration has\nsponsored a conference - last\nmonth in Atlanta - on South Afri-\nca's political and economic devel-\nBy Julia Malone\nopment.\nMONDAY, JUNE 27, 1994 The Washington Times\nCOX NEWS SERVICE\nThis week's conference with\nIt's far more than a passing\nabout 150 academicians, relief\nfancy, say President Clinton's\nworkers, business leaders, and\naides.\nlawmakers is billed as an attempt\nThe president, who today will\nto gather fresh ideas on how to\naddress the unprecedented two-\nhelp Africa.\nday White House conference on\nThe United States \"has two\nAfrica that opened yesterday, has\nstark options,\" President Nelson\nMandela of South Africa said in a\nquite simply fallen in love with\nthat populous, troubled continent.\nvideotaped message on the confer-\nTo be sure, he has yet to overhaul\nence's opening day. \"On the one\nU.S. foreign policy toward Africa.\nhand, to succumb to the pessimism\nCritics score him for shortchang-\nof the false perception that Africa\ning the continent on aid, for bun-\nis on a permanent decline,\" or\ngling the Somalia aid mission and\n\"take the cudgels and become a\nfor indecisiveness on the Rwanda\nleading partner\" in the revival of\nmassacres.\nthe continent.\nThe White House conference it-\nMr. Clinton's focus on the sub-\nself almost became a public rela-\nject inspires both hope and skepti-\ntions calamity. White House aides\ncism.\nneglected to invite the Congres-\n\"I'm looking at previous admin-\nsional Black Caucus, long a\nistrations,\" said Melvin Foote, ex-\nstaunch defender of Africa aid, un-\necutive director of the advocacy\ntil the last minute.\ngroup Constituency for Africa, a\nNone of this could dampen Mr.\nparticipant in the conference. \"We\nClinton's abiding fascination with\ndidn't have this kind of opportu-\nAfrica, say aides. At the drop of\nnity to talk to the president about\nthe hat, he can tick off the names\nAfrica.\"\nof successive regimes in remote\nEven so, Mr. Foote has been dis-\nAfrican states.\nsatisfied with the Clinton adminis-\nWhen Atlantic Monthly pub-\ntration until now. \"He's been\nlished Robert D. Kaplan's article\ncaught up in his campaign prom-\n\"The Coming Anarchy\" in Febru-\nise to focus on the domestic\nary, Mr. Clinton pored over it,\nagenda,\" Mr. Foote said, adding\nscribbling furiously on the mar-\nthat there's \"a lack of talent\" on\ngins to rebut the bleak future it\nthe foreign policy team.\npredicted for Africa.\n115\nDear co eagt e' e ers wir VO\nBy Keith Glover\nEducation was the most popular\nof the Congress\" on issues impor-\nCONGRESSIONAL QUARTERLY\ntopic in the year ending June 2,\ntant to his constituents, and he\nwith letters about President Clin-\nsays he owes his success in two\nDozens of letters pour into con-\nton coming in a close second.\nhigh-profile victories in part to\ngressional offices each day, but\nOther popular topics included\nthat tool.\nlawmakers pay particular atten-\nhealth care, the environment, the\nMr. Mica distributed a series of\ntion to one stack of mail: letters\nmilitary and the North American\nletters when he and other junior\nfrom their colleagues.\nFree Trade Agreement.\nlawmakers sought to abolish four\nRep. Timothy Penny. Minnesota\nSome members compile their\nHouse committees just days after\nDemocrat, says he has found the\nown information for the letters.\nhe took office. The panels were\nletters to be even more effective\nOthers reprint news articles or\nabolished two months later.\nthan floor speeches that are often\neditorials that make their point.\nHe turned to the \"Dear Col-\ndelivered to a near-empty House\nRep. Bill Zeliff, New Hampshire\nleague\" strategy again when try-\nchamber. He has used them to\nRepublican, distributed a pointed\ning to head off a House vote on\nseek support for proposals to cut\n\"Dear Colleague\" letter June 14\nelevating the Environmental Pro-\nannual spending bills and for other\nthat was intended to garner sup-\ntection Agency to Cabinet level,\ndeficit-reduction measures.\nport for a special House session on\nand he succeeded again.\n\"Around here, you can go to the\nspending cuts.\n\"I actually had people sit me\nfloor and give a speech and maybe\nIn the letter, Mr. Zeliff, who is\ndown and say, 'Can you explain this\n20 members will hear the speech,\"\nsponsoring legislation to require\na little bit better? I got your let-\nhe says. \"A 'Dear Colleague' letter\nsuch a session, warns members of\nter,' \"Mr. Mica said of the response\nMONDAY, JUNE 27. The Washington Times\ngets you into 435 offices. And it's\nthe possible consequences of not\nto his EPA letters.\namazing how many members will\nsigning a petition to force a floor\n\"Dear Colleague\" letters are\ncome up and say, 'Hey, I got your\nvote on the bill: \"The people back\nalso popular among more senior\nletter.'\nhome will undoubtedly decide that\nmembers. \"I walk in here in the\nMarwan Burgan, president of a\nyou did not want to force the lead-\nmorning\nand the first thing I'll\ncomputer service called Congres-\nership to let Congress cut wasteful\ndo is grab the 'Dear Colleagues'\nsional Connection, has been track-\ngovernment spending now.\"\nand read them and see what the\ning the use of \"Dear Colleague\"\nRep. John Mica, a freshman Re-\nissues are,\" says Rep. Dick Armey.\nletters. More than 5,400 of the let-\npublican from Florida's 7th Dis-\nThe Texas Republican has sent 126\nters have been distributed in the\ntrict, is one of the most prolific\nsuch letters in the past year, put-\nlast year on topics ranging from\nwriters of \"Dear Colleague\" let-\nting him easily atop the list of\ntaxation and deficit reduction to\nters.\nthose who send the most.\nabortion and civil rights, accord-\nHe says he uses the letters as \"a\ning to Burgan.\ntool to try to tweak the conscience\nDistributed by Scripps Howard.\nIRS to hire 5,000\nin revenue push\nBy Ruth Larson\nIRS agents from the bill.\nTHE WASHINGTON TIMES\nSen. Richard C. Shelby, Ala-\nbama Democrat, supported Mr.\nTaxpayers beware: The Internal\nGrassley's amendment. \"I believe\nRevenue Service is about to put\nthis is a back-ended way of once\n5,000 more enforcement agents on\nagain putting it to the American\nthe beat to make sure you pay up.\ntaxpayer without any assurance\nThe Treasury Appropriations\nthat taxpayers will be protected\nbill passed by the Senate last week\nfrom undertrained or overzealous\nSen. Charles Grassley fears the\ngives $405 million each year to the\ntax collectors,\" he said during\nresults of hiring thousands of new\nIRS to beef up taxpayer compli-\nfloor debate.\nIRS agents to increase revenues.\nance, at a cost of $2.025 billion over\nMaureen Gilman, legislative di-\nfive years. The House passed a\nrector for the National Treasury\ngress gave the IRS $115 million to\nsimilar bill earlier this month.\nEmployees Union, said the bill in-\nincrease its compliance staff, but\nThis way, the IRS hopes to in-\ncluded a provision that the new\nit will actually spend only about\ncrease government revenues by\nIRS employees would be trained in\n$17 million of that on compliance.\nnearly $9.2 billion over the next\nprotecting taxpayers. \"We don't\nThe rest will help pay for a $219\nfive years - without a tax in-\nwant our employees out harassing\nmillion funding shortfall in labor\ncrease. It was unclear, though,\npeople, so we have no problem\ncosts.\nwhether the increased revenue\nwith them being properly trained,\"\nAnother criticism of the IRS en-\nprojections take into account the\nshe said.\nforcement strategy is that it\ncost of hiring the extra agents to\nAn IRS spokesman refused to\ncomes at a time when the rest of\ncrack down on unreported income,\ncomment on any of the provisions\nthe government is under orders to\nincrease the number of tax audits\ncontained in the legislation.\ntrim its ranks. \"The federal gov-\nand collect more delinquent taxes.\nAbout 900 of the positions will\nernment will never be reinvented\nOpponents of the plan, like Sen.\nbe filled by reassigning IRS staff\nwhen we allow agencies like the\nCharles E. Grassley, Iowa Repub-\nmembers from other tasks, ac-\nIRS to add massive numbers of\nlican, fear the \"tender mercies of\ncording to a General Accounting\nnew employees,\" Mr. Sepp said.\nthe IRS\" will get out of hand with\nOffice report in April that said the\nThe IRS maintains that the ex-\nso many agents bent on increasing\nremaining 4,100 agents would be\ntra agents do not represent a net\nrevenues.\nnew hires.\nincrease in its work force, because\nNational Taxpayers Union\nThe GAO appears to have\nit has already saved 3,612 full-time\nspokesman Pete Sepp agrees.\ndoubts about the wisdom of the\nequivalent positions by moderniz-\n\"The worst thing about this appro-\nmove. In response to questions\ning technology and improving ef-\npriation is that it puts the IRS un-\nfrom Mr. Grassley, the GAO said,\nficiency. Beyond that, the agency\nder enormous pressure to show in-\n\"There are steps IRS could take to\nplans to cut 2,544 additional posi-\ncreased revenues. That pressure\ngenerate additional revenues by\ntions, its share of the administra-\nwill inevitably lead to many unin-\nusing existing staff differently and\ntion's proposal to cut nearly\ntended but still very serious viola-\nmore efficiently,\" such as contact-\n273,000 federal workers.\ntions of taxpayers' rights.\"\ning delinquent taxpayers by tele-\nBut the IRS' own figures show\nEarlier this year, the Senate had\nphone earlier in the process.\nits staff grew by more than 30,000\nagreed to funding increases for\nThe GAO also noted that the IRS\nbetween 1983 and 1993 as the\nenforcement only if they were tied\nhad steadily cut its enforcement\nagency expanded to handle more\nto additional taxpayer safeguards.\nstaff since 1988, despite Congress'\nthan 200 million tax returns.\nBut the safeguards provision was\nrepeated funding increases for en-\n\"This is not reinventing govern-\nremoved during a conference\nforcement. The money was appar-\nment,\" Mr. Shelby said. \"This is\ncommittee with the House. Mr.\nently used to pay for funding\nreinventing new ways to increase\nGrassley tried unsuccessfully last\nshortfalls in other programs.\nthe size and the cost of the federal\nweek to eliminate the additional\nThis year, for example, Con-\ngovernment.\"\nDropping GOP's pro-life plank means betraying its grass-roots activists\nIn a June 20 column (\"Should\nwrites Miss Charen, \"of squishiness\nwaivers on the right to life, will it\nRepublicans remain the right-to-\non the pro-life question.\"\nhasten the day when abortion is\nlife party?\"), Mona Charen writes,\nBut it's not absurd at all. They are\nbanished from our society or move\n\"Realists understand that battle\nsquishes.\nus closer to permanently tabling\n[over the right to life of unborn\nBill Kristol is sometimes\nthe issue in favor of the forces of\nbabies] has been lost. The election\ndescribed as a Republican strate-\ndeath?\nof Bill Clinton has postponed the\ngist. OK. What, then, is the strate-\nMr. Weigel, no doubt, has other\nday when the courts would reverse\ngic goal of his effort to play realpoli-\nthings to attend to as a \"renowned\nthemselves on Roe vs. Wade.\"\ntik with the lives of unborn babies?\nCatholic scholar,\" and neither Mona\n\"The Human Life Amendment\nWho is the target of Mr. Kristol's\nCharen nor Bill Kristol need to walk\nidea is dated,\" she adds.\noffensive? Whose influence is he\npoint for pro-life. If they find that\nTherefore, she endorses Bill\ntrying to curtail in GOP politics? Is\nthe Human Life Amendment is\nKristol's and George Weigel's effort\nhe trying to contain Massachusetts\nmorally indefensible, politically\nto trash the Reagan pro-life plank\nGov. Bill Weld and Ann Stone, pres-\nembarrassing or otherwise unwor-\nand move the party left on abortion\nident of Republicans for Choice, or\nthy of the Republican Party, they\n- while taking exception to Bay\nthe grass-roots activists, who won\ncan fall back into the ranks and let\nBuchanan's vigorous defense of the\ndemocratic election as delegates\nothers carry on the fight.\nGOP platform and criticism of Mr.\nto the 1992 convention and who\nKristol and Mr. Weigel.\nadopted the pro-life plank? Not SO\nTERENCE P. JEFFREY\n\"It is absurd to accuse Mr. Weigel,\nlong ago, both major parties in\nExecutive Director\na renowned Catholic scholar, and\nAmerica were pro-life. Now there\nThe American Cause\nMr. Kristol, a staunch pro-lifer,\"\nis one pro-life party. If that party\nMcLean\nRear-guard action on health care reform\nV\nA\n11 that opponents of massive government control\nbe harangued for killing \"reform\" just when it was\nin health care need to know about the work of\nin their very grasp.\nthe Senate Finance Committee \"rump group\"\nBut the work of the rump group is likely to be\nof moderates is that Hillary Rodham Clinton and\nsuperseded today as Finance chairman Moynihan\nSenate majority leader George Mitchell think it is\nintroduces to his committee a new version of his\npromising. This would be like hearing that Kim Il-\n\"mark\" - that is his basic version of a bill. Report-\nsung was perfectly happy with some new set of\ned to be similar in many respects to the rump group's\nnuclear monitoring requirements and eager to sign\nlegislation, the moderate Senators are already mak-\non the dotted line - one would have to assume that\ning noises about falling into line behind the chairman.\nsomething was very, very wrong with the deal.\nFrom the reports, however, Mr. Moynihan's mark\n\"Incredibly hopeful,\" says Mr. Mitchell of the\nis a particularly bad piece of legislation. The key pro-\nrumpsters, five Democrats and three Republicans\nvisions are said to be the creation of a National Health\nwho have cobbled together a health reform plan they\nCare Commission and a National Health Cost Com-\nhope will squeak through the Finance Committee.\nmission, each with broad near-legislative powers.\n\"I'm encouraged by what I hear is a very substan-\nMembers of each commission would be named by\ntive discussion,\" said Mrs. Rodham Clinton, before\nthe president and subject to Senate confirmation. The\nthe group presented their plan on Friday. Mrs. Clin-\nfirst commission would be charged with finding new\nton's comments are the most interesting, given that\nsolutions to the health care problem should, in the\nit was she who earlier this week forced her husband,\nyear 2000, less than 95 percent of the population have\nthe titular president, into an ironclad veto threat\nhealth coverage. The body would not get to propose\nMONDAY, JUNE 27, 1994 The Washington Times\nagainst any plan that didn't achieve universal health\nnew taxes and other mandates, but their \"recom-\ninsurance coverage. So it is hard to imagine that the\nmendations\" would automatically become law if\nrump group's version of reform can be seen as\nCongress did not vote the provisions down within a\nmuch of a threat to the first couple's more radical\nprescribed length of time.\nconcept of health legislation. For example, over the\nOnce again lawmakers look to winkle themselves\nweekend the president continued to rail against any\nout of a jam by tossing away their lawmaking\ncompromise plan that would fall short of his vision\nauthority. Last time we checked, the Constitution\nof insurance for all. \"Make no mistake: measures\nsaid that it was the job of Congress to levy all taxes.\nthat are half-hearted would, at best, guarantee that\nBut now Mr. Moynihan is going to propose that a\nthings stay only about as good as they are now,\" said\ncommission of unelected presidential appointees be\nthe president. \"The poor would get health care, the\ngiven that power. How convenient. And dangerous.\nwealthy would get health care, the middle class\nThe constitution provided that elected officials\nwould get it sometimes and not get it sometimes.\"\nwould be responsible for taxation for the explicit\nAfter the comments, Mr. Clinton's spokesman Dee\npurpose of making taxation difficult. Just wait and\nDee Myers assured one and all that the president\nsee what happens once that little difficulty has\nwas not referring to the work of the rump group.\nbeen removed.\nBut why not? The rump group doesn't mandate\nNot that we haven't already seen this scenario play\nuniversal coverage, so one would think it would be\nout thousands of times. The vast growth of the fed-\nthe object of the Clintons' ire. But they are letting it\neral government has been achieved in the last 50\nhave an uncontested run for now for two main rea-\nyears primarily by the transfer of legislative author-\nsons. The first is that the president needs to have an\nity from the Congress to the bureaucracy. We are gov-\nout, should the rump's compromise be the best he can\nerned now, not by laws made by our elected repre-\nget. If it is, he'll be able to sign the bill and claim he\nsentatives, but primarily by rules and regulations\nis fulfilling his promises - \"I always said that this\ndrawn up by the hundreds of thousands by an army\ncompromise met my goal of universal coverage,\" Mr.\nof unelected officials. When these rules ruin lives and\nClinton will be able to say, even though of course the\nlivelihoods, it isn't Congress that gets the blame, it is\nlegislation would do no such thing.\nthe bureaucrats, and our representatives get to enjoy\nThe second is that the rump group's action has\nthe non-controversial role of fix-it men, plastering\nhelped to break what was shaping up as a deadlock\nconstituent service band-aids on the wounded.\nin the Finance Committee. The Clintons and Mr.\nIt was just a matter of time before lawmakers\nMitchell know good and well that they just need to\nwould try to opt out of the tough choices demanded\nkeep the legislative process going, get a bill to the\nby health care legislation by handing the job over to\nfloor and play with it there. Even if the Senate pro-\nbureaucrats (whom Justice Scalia has devastating-\nduces a mild and somewhat conservative bill, the\nly taken to calling the \"junior varsity Congress\"). It\nHouse can be expected to have produced a liberal\nis hard to see why lawmakers want to be lawmakers\nbehemoth, chock full of mandates and price controls.\nif whenever it comes time to make law they ask some-\nTheir hope is that once in conference committee, the\none else to do it for them. One might get the impres-\nbig-government provisions will prevail. At that point,\nsion that our representatives want to enjoy the plea-\nthe only defense Senate moderates and conservatives\nsures and perks of power without enduring its\nwould have would be to vote down or filibuster the\nresponsibilities. King Lear tried to engineer for him-\nfinal bill. This could prove to be too much for many\nself just that sort of arrangement, /and it should be\nRepublicans and conservative Democrats who would\nremembered that it all ended rather badly.\n133\nfrom Boston GIODE rage 1\nR.I's Chafee\nmay rescue\nClinton's\ncommand a rifle company in Korea. A sense of\nhoblesse oblige 17116 t) retugh all of his political\nhealth plan\ndealings.\nHis ability to survive, however. is another matter.\nstate like Rhode Island. A political centr ist in a GOP\nBy Peter G. Gosselin\nthat has veered sharply rightward. he has been\nGlobe Staff\nejected from party leadership positions for his\nWASHINGTON - Sen. John H. Chafee makes a\nliberal apostasy.\nmost unlikely political infighter. He seems so\nThe combination of these political strands can\nfundamentally decent - as even his most vehement\nproduce dizzying results. During a recent visit home,\ncrities will admit - that it's hard to imagine he has\nChafee was cheered for defending a Medicaid\nmuch fight to him.\nprogram that provides money for Rhode Island's\nBut the Rhode Island Republican is in the\ndisabled against White House efforts to cut it. But\nbiggest battle of his political life, and that of\nless than a year earlier, he was assailed for helping\nDemocrat Bill Clinton's as well. With & key\nto kill the administration's economic scimulus plan\ncongressional committee on which Charge sits all but\nthat would have provided money for Rhode Island\nparalyzed by partisan divisions. the 71-year-old\ncommunities like Warwick, where his son, Lincoln. to\nformer Marine captain suddenly looks like the man\nmayor.\nto save at least a semblance of the 46-year-old\n\"Chafee was born into a difficult political habitat\npresident's biggest initiative - health reform.\nand has learned to thrive. He had to; I mean he grew\nLed by Chafee, a group of centrist lawmakers.\nup in a family that railed against Roosevelt in a state\nRepublicans and Democrats, have worked out a deal\nthat loved him,\" said John E. Mulligan, a reporter\nthat would salvage some elements of Clinton's health\nfor the Providence Journal-Buletin who has covered\nlive.\nthe lawmaker for almost two decades.\nIf it becomes the blueprint for compromise, the\nSome see signs of the instinet for political\nmeasure will represent a huge step back for both\nsurvival in Chafee's embrace of health reform.\nClinton and Chafee, who had proposed a much more\nAt the time he first became involved in the issue\nsweeping plan. But there was a growing sense over\nin the early 1990s. local polls showed his popularity\nthe weekend that only such a retreat can save the\nbeginning to slowly but steadily erode. And until\nhealth reform campaign, which otherwise seems\nClinton's presidential victory, many Chafee staffers\nheaded for a crackup in the Senate Finance\nthought that the lawmaker's 1994 Democratic Senate\nCommittee.\nchallenger might be Ira C. Magaziner. then a\n\"He's clearly the bridge if there's going to he any\nProvidence business consultant engaged in a highly\ncompromise on health in the Senate,\" said Robert\npublicized study of health care in the state and now\nBoston\nBlendon, chairman of the health policy and\nClinton's chief health policy adviser.\nreanagement department at the Harvard School of\nBut if politics played a role in his decision to get\nPublic School.\ninvolved. Chafee has since pursued the health 'ssue\nGlobe\n\"The Finance Committee can't get a health care\nwith a doggedness that has exhausted even bis\nbill without him,\" added Lawrence O'Donnell, chief\nclosest allies and an abandon that might cost him\naide to Democratic committee chairman Daniel\npolitically.\nPatrick Moynihan of New York. Moynihan aides\nAs chairman of a GOP task force. he has cajoled\nwere said to be working over the weekend on a plan\ncolleagues considerably more conservative than\nthat adopted many elements of the Chafee\nhimself into signing onto at least three different\ncompromise.\napproaches to reform in recent years: a 1991\nSuch a man-in-the-middle role did not come to\npackage of tax incentives, beefed-up preventive care\nChafee by happenstance. In some sense, he has\nand malpractice changes; a 1992 measure to set up\nspent his whole career preparing for it. by operating\ninsurance-buying cooperatives similar to those\njust as he is now doing - at the rocky margin\nsubsequently included in the Clinton plan: and, most\nbetween the two political parties.\nrecently. an elaborate proposal with the same end ad\nA pay-as-you-go Republican, he nonetheless\nthe president's - insurance coverage for all\nsupports the kind of big-government social programs\nAmericans - but different means.\nthat remain wildly popular in an old-line Democratic\nOriginally. Chafee won praise for his efforts from\nfellow Republicans. But Senate GOP leader Bob\nIn virtually every fight of his political career he has\nDole, Republican of Kansas, is now trying to\nbeen the beneficiary of a splintered opposition and a\nunderent him, apparently fearful a Chafee\ntough-minded campaign plan.\ncompromise could open the way for a Clinton victory\nRichard Licht, Chafee's 1988 Democratic vival,\non health, something Dole seems intent on blocking.\nsaid that the Republican lawmaker ran a clean but\nThe compromise illustrates the kind of political\nextremely aggressive race. Licht said that he had\nchances Chafee seems ready to take for reform. Like\nworried Chafee might use the fact Licht, like then-\nthe Clinton plan, the Chafee proposal would be\nVice President Dan Quavle, had spent the Vietnam\npartially financed by deep cuts in Medicare, the\nWar stateside in the National Guard, but be did not.\ngovernment health insurance progam for the elderly.\n\"He said. \"The National Guard is honorable service'\nBut unlike Clinton's, it wouldn't promise Medicare\nand left it at that.\" Licht remembered.\nrecipients any new benefits in return. That's quite a\nOf course, that didn't stop Chafee from attacking\nrisk for a politician from a state with the fourth-\nLicht at every turn. \"He put my record in absolutely\nhighest percentage of elderly people in the nation.\nthe most negative light,\" Licht said. The Republican\nChafee has turned such risk-taking into\nlawmaker's likely Democratic rival this year. Rhode\nsomething of a personal and political trademark. He\nIsland State Rep. Linda Kushner, got a taste of the\nis remembered in Rhode Island for calling for a state\nsame medicine last week when she attacked Chafee\nincome tax during his bid for a fourth term as\nfor owning drug stocks while engaged in the health\ngovernor in 1968. The idea lost him the election, but\ndebate only to find herself the target of a Chafee\nhis Democratic successor was forced to enact the\ncounterattack that she too owned drug stocks.\nvery same tax, earning Chafee the reputation as a\nChafee will almost certainly employ similar\ntruth-teller.\ntechniques in the health fight of the coming days and\nAt least in part, his ability to take such unpopular\nwill surely use the fact the battle has moved to the\nstands is the product of his Brahmin background; he\nfamiliar terrain at the margin between the parties.\nis a member of one of Rhode Island's Five Families,\nBut he may press with even greater-than-usual\na group of Yankee clans that exercise considerable\ntenacity, according to observers like Blendon, the\ninfluence over the small state. It was reinforced by\nHarvard professor. That's because what's at stake,\nmilitary service; he was a Marine at Guadacanal and\nsaid Blendon, is Chafee's \"legacy, the mark he leaves\nOkinawa and, as if that weren't enough, went back to\non America.\" It is a prize that can make a tough\ninfighter even tougher.\n138\n6/27/94\n^Abortion issue complicates efforts at health-care reform<\nIf Republicans opt out, Clinton will be depending\nBy Elaine S. Povich< Chicago Tribune<\non the 256 House Democrats to pass his plan. Since 218 votes\nWASHINGTON If the debate over health-care\nare required for a majority, the Democrats cannot afford to\nreform isn't emotional enough, just add the deeply divisive\nlose all of the 98 who voted to keep the Hyde amendment.<\nissue of abortion.<\n``It is a problem and one that could be a serious\nThree congressional committees last week either\nproblem for health-care reform,\" said Rep. Richard Durbin,\npassed health-care bills that provide a full range of\nD-III., one of the 98.<\n``reproductive services,\" including government-financed\nDurbin, who believes in access to abortion but is\nabortions, or voted on amendments to do so.<\ntroubled by having the federal government pay for it, says the\nThe Senate Finance Committee, which begins\nissue is more complex than has been articulated so far by\ndebating a health-care plan Monday, has yet to reach a\ncongressional committees.<\nconsensus. The committee's indecision is more representative\n\"I'm frustrated by the lack of options on this issue,\"\nof the Congress as a whole, since it is more moderate than any\nhe said.<\nof the other committees.<\nDurbin noted companies now providing insurance\nAbortion rights activists insist that abortion services\nthat covers abortion services get to deduct the cost of that\nbe covered in any national health-care program, because more\ninsurance from their taxes. That fact, he said, already\nthan two-thirds of private insurance policies and 80 percent of\nconstitutes an indirect government subsidy of abortion.<\nhealth maintenance organizations now cover the procedure.<\nWhile no compromise strategy has yet emerged,\nBut opponents balk at using any taxpayer money to\nand both sides are holding to their steadfast positions, it\ncover abortions, even if most Americans still would get their\nappears an accommodation will have to be made, especially to\ninsurance through private means. Many poorer and\nsatisfy Democrats like Durbin whose votes are crucial to\nmiddle-class Americans would have part of the insurance cost\npassage of health-care legislation.<\nsubsidized by the government, and that's where abortion foes\nConversely, Democratic leaders face a serious\ndraw the line.<\nproblem with abortion rights advocates if abortion services are\n\"Whatever emerges must provide immunization for\nremoved from the health-care bill. The question may come\nthe millions of pro-lifers who don't want their tax dollars\ndown to whether abortion rights supporters or abortion\npaying for abortions,\" said Rep. Henry Hyde, R-Ill., author of\nopponents hold more votes for a Democratic bill.<\nthe Hyde amendment, which prohibits federal funds going for\n\"There are those who are saying there is going to\nabortions.<\nbe a big fight if it's included,\" said Rep. Nita Lowey, D-N.Y.\nCurrently, the government will not pay for\n`What we are saying is that there's going to be a big fight if\nabortions for Medicaid recipients except in cases of rape and\nit's taken out.\"<\nincest or when the woman's life is at risk.<\n(EDITORS: STORY CAN TRIM HERE)<\nIn his health proposal, President Clinton calls for\nThe House Ways and Means Committee and the\ncoverage of abortion and other pregnancy-related services, and\nHouse Education and Labor Committee both voted last week\nso far, congressional committees have agreed to keep\nto preserve abortion services in their health bills, and the\n``reproductive services\" in plans moving through Congress. But\nSenate Labor and Human Resources Committee did likewise.<\nthe issue could tie up the House and Senate when the bills\nA group of Republicans and Democrats on the\nreach the floor next month.<\nSenate Finance Committee drew up yet another version of\nLabor Secretary Robert Reich said the\nhealth-care reform, but left the issue of abortion open.<\nadministration is not worried about abortion becoming a\nRepublicans threaten to keep abortion provisions\ncrunch issue in health care because the \"basic package simply\nout of the panel's bill, but the committee is likely to follow the\ntracks the basic package in Fortune 500 (health insurance)\nlead of the House committees and preserve abortion rights.<\nplans.\"<\nHe acknowledged, however, that some members of\nthe House and Senate who are opposed to abortion ``want to\n^FBI director to travel to Europe to discuss wave of\ntalk about the question.\"<\norganized crime<\n(EDITORS: NEXT 2 GRAFS OPTIONAL)<\nBy Thom Shanker< Chicago Tribune<\nBut Reich could be showing the same kind of\nBERLIN Nuclear gangsters from the old U.S.S.R.\nnaivete that got abortion rights supporters in trouble in the\nNarco-conglomerates spanning Colombia, Italy and Russia.\nHouse last July 1. Then, those supporters failed to estimate the\nHate groups in Germany linked by computer to U.S. racists,\ndepth of the House's opposition to having federal money pay\nstarting a cyber-Nazi network.<\nfor abortions and lost 255-178 on a vote to scrap the Hyde\nThese 21st-century threats already are taken so\namendment.<\nseriously by American law enforcement that FBI Director\nBefore the vote, there was a shouting match\nLouis Freeh travels to Europe this week to discuss an\nbetween Hyde and Rep. Cardiss Collins, D-III., after he\norganized crime spree that he fears will ``threaten the integrity\ninsinuated that she was out of touch with the abortion views of\nof governments.\"<\nher own constituents, notably black ministers. The two patched\nFreeh warns that the `greatest national security\nthings up in a few days.<\nthreat\" to the United States comes from nuclear gangsters: The\n(END OPTIONAL TRIM)<\npossibility that working warheads or plutonium needed to\nThe top House Democratic leadership, which is\nmake them will be stolen amid the economic chaos that\nitself divided over abortion, didn't participate actively in the\nreplaced communism in the former Soviet republics.<\ndebate. Many newer House members of both parties simply\n\"There are several cases of highly enriched nuclear\nassumed that with 114 freshmen and a doubling of the number\nmaterials missing,\" Freeh said. ``We cannot take a chance that\nof women from previous years, the vote to allow federal\nterrorists might steal a nuclear weapon and then use it against\nfunding of abortions would be all but automatic.<\na nation, any nation.\"<\nOn that day, 98 Democrats voted to continue the\nA major goal of Freeh's nine-nation fact-finding\nprohibition against the government routinely paying for\nmission is sharing information on nuclear stockpiles. The FBI\nabortions. If all the House Republicans were to now spurn a\nalso will offer training for east European police battling\nhealth-care reform bill, which is now considered likely, some\ncriminals in a new, free-market environment.<\nof those 98 will be needed to pass Democratic-sponsored\nFreeh's 10-day tour, which begins Tuesday in\nhealth legislation.<\nBerlin, includes all the organized crime capitals of post-Cold\n148\n2nd victory for Clinton health plan\nBy Jessica Lee and Judi Hasson\ncare. Republicans will ensure the rich\nerage premiums. Another idea, to tax\nUSA TODAY\npackage gets more scrutiny.\nemployers who don't insure their\nThe House panel also defeated at-\nworkers, was taken off the agenda.\nThe House Education and Labor\ntempts to strip most abortion cover-\nStill, Sen. John Chafee, R-R.I, said\nCommittee approved a health bill\nage from the benefits. That issue, too,\nhe expects the group to present a fin-\npromising insurance for everyone\nwill remain contentious.\nished plan to Finance Committee\nThursday, becoming the second con-\nMeanwhile, four Democrats and\nleaders today.\ngressional panel to ratify President\nthree Republicans spent the day be-\nBut Senate Republican leader Rob-\nClinton's key health-care goal.\nhind closed doors trying to fashion a\nert Dole, R-Kan., planning to intro-\nClinton, noting that the Senate La-\nbill with enough coverage to be called\nduce his own bill, said the moderates'\nbor Committee had passed a similar\nuniversal without ordering employers\nplan apparently relies too heavily on\nbill, said, \"They have broken the\nor individuals to pay for it.\ntaxes to win many Republican votes.\nchokehold of special interests, and by\nSome points were in flux, but par-\nSen. David Durenberger, R-Minn.,\nchoosing to cover everyone, have\nticipants confirmed details: If 95% of\ncalled the Chafee group's bid the Sen-\nstood up instead for millions of hard-\nAmericans didn't have health insur-\nate's last shot at bipartisan reform.\nworking middle-class Americans.\"\nance by 2002, a commission would\nRepublicans' \"objective is health-\nKeeping options open, the House\nrecommend a plan for achieving uni-\ncare reform, and the president's is\npanel also narrowly approved a Cana-\nversal coverage. Congress would have\nuniversal coverage,\" he said. If Cha-\ndian-style bill that would replace pri-\nto approve It within six months.\nfee's bid fails, he predicted, Senate\nvate insurance premiums with payroll\nIf Congress failed to act, the bill\nDemocrats will try to pass a bill with\ntaxes to pay medical bills.\nwould require individuals to buy their\n51 votes, only one Republican. That\nThe panel's version of the Clinton\nown health insurance.\nwould let Democrats campaign as\nbill requires employers to pay for in-\nFinancing remains in dispute.\nhealth reformers but let Republicans\nsurance, has subsidies for small firms\nOne proposal is to tax top-dollar in-\nblame them for the taxes involved.\nand expands coverage for women's\nsurance policies at 25% to 35% of the\nBy Tim Dillon, USA TODAY\nhealth, mental illness and adult dental\ndifference between their cost and av-\nLOBBY: Hillary Rodham Clinton addresses\nToday's debate, 10A\nhealth-reform backers on Capitol Hill.\nUSA TODAY\n6-24-94\nPHOTOCOPY\nPRESERVATION\nLawmakers' Health Coverage Isn't So Generous\nBy Hilary Stout\nStaff Reporter of The Wall Street Journal\nWASHINGTON -- For President Clinton and his allies on health care, it has\nbecome the one sure-fire applause line: Give every American what Congress\ngets.\n\"You say it and the audience goes crazy,\" says Families USA foundation's\nArnold Bennett, a member of the team helping the administration craft its\nhealth-care message.\nHillary Rodham Clinton uses it in virtually every speech she gives. Just\nthis week a group of Democratic senators, including Labor and Human Resources\nCommittee Chairman Edward Kennedy of Massachusetts, called a news conference\nto demand that the general public get the coverage that \"members of Congress\nhave arranged for themselves.' Sen. Harris Wofford, the Pennsylvania Democrat\nwho won his seat in 1992 by stressing health care and faces a stiff\nre-election fight this year, is circulating a petition demanding a bill that\noffers \"every Pennsylvanian and every American the same kind of guaranteed\ncoverage and choice of private health plans that members of Congress get.\"\nBut while focusing on Congress's benefits may be a stroke of political\nbrilliance, the prospect of actually getting what Congress gets might not\nplease large numbers of Americans, including some of the most vigorous\nsupporters of the president's health-care bill.\nThe federal employees package isn't as generous as most union health plans,\nor the programs of many Fortune 500 companies. For example, many of the\npolicies available to federal employees don't include substance-abuse benefits\nor preventive dental care.\nHowever, Congress's benefits package would be an improvement for a vast\nnumber of Americans, particularly many employees of small and midsize\nbusinesses and, of course, the estimated 39 million people with no health\ninsurance. still, the federal government's share of the premium isn't as\ngenerous as most unions and many big employers -- or, for that matter, the\n80% share the White House would like employers to bear. And as far as the\nscope of the benefits and the patient cost-sharing requirements, Congress's\nplan isn't nearly as comprehensive as Medicaid, the federal-state health\nprogram for low-income people.\nWhat lawmakers -- and indeed all federal employees, including the president\n-- get is the opportunity to enroll in one of an array of health-care plans,\neach offering a comprehensive package of medical benefits, with the premium\npaid in part by their employer: the taxpayers.\nIn the Washington area, members of Congress can choose from among nearly 30\nhealth plans, including 14 health-maintenance organizations and seven\n\"fee-forservice\" plans, which pay at least part of the bill for visits to the\ndoctor or hospital of the patient's choice. The benefits in each plan vary,\nbut generally include hospital and emergency services, doctor visits, lab\ntests, prescription drugs and some dental care. Depending on the policy,\ncoverage may include children's immunizations and some nursing-home benefits.\nUnlike much of the general public, Congress is also free of some of the\nonerous insurance-industry practices that shut some people out of the market.\nUnder the Federal Employee Health Benefits Program, no health plan can drop or\nrefuse to enroll a government employee or dependent because of a medical\ncondition.\nBut as far as cost-sharing goes, Congress isn't getting quite the ride that\nmany working Americans do. According to the Office of Personnel Management,\nwhich runs the federal benefits program, the government pays on average 72% of\nemployee health premiums, and no more than 75%. But for some policies the\nshare is far less.\n(END) DOW JONES NEWS 06-24-94\n6 32 AM\n**** filed by: : TAPE (--) on 06/24/94 at 06:26EDT ****\n**** printed by : WHPR (JEL) on 06/24/94 at 08:01EDT ****\nBC-CLINTON-CRABFEAST\nCLINTONS HOST CRAB FEAST FOR CONGRESS\nWASHINGTON, June 23 (Reuter) - With the fate of their health care reform\nplan uncertain on Capitol Hill, President Clinton and first lady Hillary\nRodham Clinton hosted hundreds of members of Congress and their families and\naides at a crab feast Thursday night.\nThe president told the crowd of about 900 gathered under a huge white\ntent on the White House South Lawn that he wanted the second annual event to\nbe fun, relaxing, non-political, which is almost impossible in Washington.\nThe president, dressed in a green plaid shirt and tan pants, spoke\nbriefly but spent most of the evening posing for pictures with lawmakers and\ntheir friends and aides. The first lady wore\na casual, purple dress\nLawmakers and their families, many dressed casually in the muggy, rainy\nevening, dined on crab salad, marinated tomatoes, cole slaw, herbed potato\nsalad, hard-shell crabs, Rockfish with lump crab stuffing, barbecued chicken,\ncorn on the cob and baked beans.\nCountry music star Trisha Yearwood performed during the three-hour event,\nas did a Marine band called Country Currents.\nSeveral lawmakers laughed when asked if they thought the White House\nbelieves the way to their health care votes was through their stomachs.\nI think you should take a special note of all the fish and the salad\nand the chicken and the fruit, which clearly must be a good omen for health\ncare, because it's good for you, joked Representative Ron Wyden, an Oregon\nDemocrat and Clinton supporter.\nRepresentative Michael Bilirakis, a Florida Republican who is advancing a\nmarket-oriented plan that does not guarantee universal coverage, responded\nmore seriously, saying of lawmakers, I think they re more concerned with how\ntheir constituents are going to look at this in November\nBut Senator Donald Riegle, a Michigan Democrat, took a joking shot at the\nfeast, saying of lawmakers, There's going to be a lot of people that are\ngoing to need health care after they try to digest this dinner.\nREUTER\n****\nfiled by: RB\non 06/23/94 at 22:39EDT ****\n**** printed by: WHPR (JEL) on 06/24/94 at 08:04EDT ****\nBC-House-Panel-Passes-\nAUTOBREAK (2)\nIt has been deadlocked over how to pay for President Clinton's goal of\nguaranteeing health coverage to all Americans, with conservative Democrats\nand Republicans balking at the president's proposal to require business to\npay 80% of the cost of worker health coverage.\nChafee's group of moderates is floating a plan that would seek to expand\nhealth coverage by passing measures to make insurance more affordable. If that\nfailed to sufficiently reduce the number of uninsured over a specified period\nof time, individuals could be required to buy health insurance.\nDole, who sits on Finance, distanced himself from the group, saying he\nhopes to offer his own compromise package. I think we're closer together\nthan we think, Dole told reporters. I'm going to try to put something\ntogether that would attract most Republicans and some Democrats.\nAs you know, he said, everything around here is timing.\nBusiness Supporters\nMeanwhile today, representatives of about 50 major businesses, including\nChrysler, IBM and McDonnell Douglas, met with Democratic congressional\nleaders and Health and Human Services Secretary Donna Shalala to underscore\ntheir support for the president's plan, including the requirement to make\nemployers pay 80% of the cost of their workers' health-insurance costs.\nThese companies currently pay for their employees' health care and end up\nfooting part of the expense for those companies, big and small, which do not\noffer coverage.\nWe need health care reform now -- this year, said Walter Maher,\nChrysler's director of legislative affairs. The longer we wait, the worse\nthings will get.\nAnd Hillary Rodham Clinton attended a Capitol Hill rally in support of\nhealth-care reform hosted by Arthur Fleming, who served as secretary of\nHealth, Education and Welfare during the Eisenhower administration.\nFleming said, We are in the closing days of one of the greatest crusades\nthis nation has ever witnessed.\nClinton reaffirmed the administration's insistence on universal health\ninsurance, saying no other reform will work if we don't achieve universal\ncoverage. \" --Paul Heldman and Tom Ferraro in Washington 202\n434-1800/mk/ba/mfr/\n(For more information on health care; NI HCP, HEA; on insurance: NI INS;\non the Clinton administration: NI EXE; on Congress: NI CNG) -0- (BBN)\nJun/23/94 21:15 EOS (BBN) Jun/23/94 21:15 86\n**** filed by:BB-F(--) on 06/23/94 at 21:24EDT ****\n**** printed by:WHPR(JEL) on 06/24/94 at 08:05EDT ****\nABROAD AT HOME BY ANTHONY LEWIS: ISSUE OR SOLUTION?\n1994 N.Y. Times News Service\nBOSTON - Something strange is happening in Washington, something to\nconfound the skeptics and the cynics. Congress is showing signs that it may\nactually pass a meaningful form of compromise health-care legislation.\nI was a skeptic myself. Health care is so complicated a problem, involving\nSO many legitimate and powerful interests in this large and diverse country,\nthat getting anything serious past all the roadblocks in Congress seemed to me\nunlikely. Moreover, polls showed that the issue was way down on the list of\npublic concerns.\nPresident Clinton and Hillary Rodham Clinton deserve credit - much more\nthan they have been getting - for moving reform this far. They made some\nmistakes, notably the secrecy imposed on the early health meetings. But they\nhave educated the country on why we, like all other industrialized societies,\nneed national measures to assure us medical care.\nThe credit due is the greater because leading Republicans chose to make\nhealth care reform a partisan issue. They demonized the Clinton proposal as\nthey demonized the Clintons, saying falsely that the plan would mean more Big\nGovernment and bureaucracy. (Bureaucracy is what we increasingly have now,\nwith doctors having to get the approval of an insurance company clerk to give\na patient a test or refer her to a specialist.)\nNow some moderate Republicans in the Senate have broken with their\nbitter-end colleagues and joined centrist Democrats in trying to draft\ncompromise legislation. They have created a real possibility of getting a\nbill out of the crucial Senate Finance Committee.\nI like all of them, Bob Dole, the Senate minority leader, said of\nthose moderates. But we've got a party to think of In other words, better\nan issue than a solution.\nBut I doubt that all-out partisanship - the Newt Gingrich, Phil Gramm view\n- is going to prevail and prevent compromise on health reform. I doubt that\nBob Dole himself will take that position in the end.\nThe reason is simple. Too many American families know that they may be one\npaycheck away from no health insurance. They know that if they change jobs,\nthey may not be able to get new insurance because they have a prior medical\ncondition. or their insurance carrier may have terminated their policy because\nthey have been sick.\nSome far-right Republicans tried out the line that the country did not\nneed health care reform. That did not go down with the public. The experience\nmay suggest to Dole and others that blocking reform is not good politics.\nIf the compromise efforts finally succeed, the legislation will plainly\nremove some present evils. Insurance companies will have to offer standard\npolicies to all, at community rates, regardless of individuals' medical\ncondition. Those covered will be able to keep their insurance no matter how\nsick they get or how much they move. If they are poor, a subsidy will help\nthem pay for insurance.\nThe business world succeeded in making employer mandates'' sound bad, so\nthe bill will not require companies to pay for most of their workers'\ninsurance. That is a curious result, for it rejects the conservative approach\nof sticking with the way most Americans get their health insurance now. And\nmaking health care an aspect of employment would be a vital incentive to move\npeople out of welfare.\nWhether any compromise will work in practice without employer mandates and\nsome other features of the Clinton proposal will depend on the details.\nFor example, how will the legislation make sure that, in a voluntary''\nsystem, healthy young people do not go uninsured, thereby raising rates for\neveryone else? The universal coverage envisioned in the Clinton plan would\ndeal with that problem.\nThe ideas being discussed by such senators as Democrat Bill Bradley of New\nJersey and Republican John Chafee of Rhode Island would aim at covering 95\npercent of Americans by the year 2002, when individuals would be required to\nget insurance. A commission would monitor the plan and suggest other ways to\nincrease coverage.\nGradualism on an issue this complex is a good thing. If Congress faces the\nreality. real problems of health insurance, there will be time to adjust hopes to\n23:43 EDT JUNE 23, 1994\n**** filed by:NYT-(--) on 06/23/94 at 23:47EDT ****\n**** printed by:WHPR (JEL) on 06/24/94 at 08:03EDT ****\nHEALTH COALITION\nSTRONGLY OPPOSES\nCOMPROMISE PLAN\nContinued From Page Al\nplans.\nCapitol Hill today, Hillary Rodham\nSENATE MOVE UNDER FIRE\nThe Senate moderates are strug-\nClinton did not mention the Finance\ngling to broker a compromise that\nCommittee proposal. Instead, she\ncan budge a committee polarized for\nstuck to a broad thematic message:\nmonths over the so-called employer\nLabor and Civic Groups Vow\nwhat she described as a need for\nmandate: the requirement in the\nuniversal coverage.\nClinton bill that businesses pay most\nto Fight Any Bill That Puts\n\"No other reform in our health\nof the cost of their workers' insur-\ncare system will work if we do not\nance, a provision that is anathema to\nBurden on Individuals\nachieve guaranteed universal cover-\nRepublicans and many conservative\nDemocrats.\nage,\" she said.\nMrs. Clinton also reiterated the Ad-\nAt the same time, the moderates\nBy ROBIN TONER\nministration's argument that it is\nare trying to assure universal cover-\nmiddle-class Americans who are\nage, which is considered the bottom\nSpecial to The New York Times\nmost at risk if universal coverage is\nline for the Administration and most\nWASHINGTON, June 23 - A broad\ndropped from any health care bill.\nDemocrats. As a result, they have\ncoalition of labor, civic and consumer\n\"If you are rich enough,\" she said,\nbeen discussing a complicated plan\ngroups mounted a counterattack to-\njabbing the air and leaning into her\nthat would set a goal of covering 95\nlectern, \"you will have health insur-\npercent of Americans by the year\nday against the compromise national\nance. If you are poor enough, you will\n2002. If the goal was not met, a com-\nhealth insurance plan emerging in\nhave health insurance. It's the people\nmission overseeing implementation\nthe Senate Finance Committee.\nin the middle, the vast majority, who\nof the plan would make a recommen-\nThe opponents announced that they\nare either losing it and are among the\ndation on how to achieve it.\nwould fight any bill that might ulti-\nnow 40 million uninsured or who are\nIn the absence of further action, a\nmately put a new requirement on\none job, one divorce, one accident, one\nso-called individual mandate would\nindividuals - rather than their em-\nillness away from losing their insur-\ngo into effect, requiring those individ-\nployers - to purchase health insur-\nance.\"\nuals who do not receive insurance\nance.\nthrough their employer to purchase\nTwo Bills Gain in House\ntheir own.\nSuch a requirement would neither\nachieve universal coverage nor pro-\nIn a day of frenetic activity on\nSenator Kent Conrad, a North Da-\nhealth care, another milestone was\nkota Democrat who is a member of\nvide adequate assistance to the unin-\nachieved for the cause, albeit one that\nthe moderate group, said, \"That\nsured middle-income people who, un-\nhad been widely expected. The quite\nwould be a very small slice of the\nder the plan, might eventually have\nliberal House Education and Labor\nAmerican population.\"\nto buy coverage, said the coalition,\nCommittee passed both a version of\nAnother Senator among the moder-\nknown as the Health Care Reform\n-Mr. Clinton's health plan and a bill\nates, John Breaux, Democrat of Loui-\nProject.\nthat would create a system of nation-\nsiana, said today that the plan under\nThat provision is believed to be a\nal health insurance financed entirely\ndiscussion would offer substantial\ncentral feature of the plan being de-\nby taxes.\nsubsidies to help people purchase\nveloped by seven moderate Republi-\nMr. Clinton said the House action\ntheir own insurance. Moreover, Mr.\ncans and Democrats on the Finance\n\"sends a clear signal to the American\nBreaux said, he does not believe that\npeople that Congress is well on its\nthe individual mandate would ever\nCommittee. The compromise plan is\n-way to making health care history\nkick in, since, he said, insurance and\nwidely viewed as the best chance of\nthis year\" and that Congress could\nmarket changes would bring about 95\nbreaking the committee's stalemate\n\"break the choke hold of special in-\npercent coverage. And one aide close'\nover health insurance. But one of the\nterests.\"\nto the talks said there would be no\nmoderates stressed tonight that it\nThe committee vote means that\nreal penalty on those who did not\nwas very much in a state of flux.\nhealth legislation has now made it\npurchase insurance.\nIn a letter to the Finance Commit-\nthrough two of the five major Con-\nStill, many groups long active in\ntee, the Health Care Reform Project\ngressional committees responsible\nthe health care struggle see the legis-\nsaid, \"We strongly urge you to reject\nfor acting on it: Labor and Human\nlative process taking an increasingly\nResources in the Senate, Education\nconservative turn in the Finance\nthis approach or any others that fail\nand Labor in the House.\nCommittee. And today, they chose to\nto meet the test of guaranteeing all\nBut in the Senate, the Finance Com-\ndraw their line in the sand.\nAmericans affordable, comprehen-\nmittee is embarking on formal ses-\nThe Health Care Reform Project\nsive coverage.\"\nsions of debate and voting next week\ndeclared firm opposition to any pro-\nThat was a formidable political\nwith results that are still very hard to\nposal that relies on an individual\nstatement to Democrats inasmuch as\npredict. And in the House, the Energy\nmandate, arguing that it would give\nthe coalition's 56 member organiza-\nand Commerce Committee is consid-\nmany profitable employers \"a free\ntions include important constituen-\nered hopelessly deadlocked.\nride,\" pose a heavy burden on middle-\ncies for health care restructuring,\nThe fifth committee, House Ways\nincome people and fail to guarantee\nincluding the American Association\nand Means, continued its painstaking\nuniversal coverage.\nof Retired Persons, the A.F.L.-C.I.O.\nway through a bill today, and its\nand the Catholic Health Association\nchairman, Representative Sam Gib-\nbons of Florida, said that if the work\nof the United States.\nwas not finished by the Fourth of July\n1994\nThe White House today tried to\nrecess, he would hold the committee\nmaintain official silence on the com-\nin session.\n24,\npromise proposal, which was worked\nIn a telling moment that under-\non into the evening behind closed\nscored the struggle on health care,\nMr. Gibbons said: \"I am constantly\nJUNE\ndoors. The Administration appears to\nbe trying to encourage movement in\nhaving to seek to hold together the 20\nthe Finance Committee, which has\nvotes I need for passage. Believe me,\nbeen deadlocked for months, but to\nthat is not a simple task.\"\nPRIDAY,\nmaintain distance from a plan vehe-\nFull Plan Due Today\nmently opposed by some traditional\nMuch of the attention, however,\nsupporters of the Democratic Party.\nwas focused on the rump group from\nthe Senate Finance Committee,\nTIMES,\nBehind this careful show of neutral-\nwhich is expected to present its plan\nity is the calculation of Administra-\nto the full committee on Friday. \"We\ntion allies that the plan can be fixed\nhaven't nailed it down,\" one member\nlater, as it moves to the full Senate,\nYORK\nof that group, Senator John C. Dan-\nwhere the leadership is expected to\nforth, said as a meeting of the com-\nproduce an amalgam of the Finance\nmittee broke up tonight. \"We're\nNEW\nbill and a more generous measure,\nsleeping on it.\"\ncloser to President Clinton's original\nIt is a measure of how volatile the\nproposal, which was passed earlier\nhealth care struggle is right now that\nTHE\nthis month by the Senate Labor and\nso much reaction was provoked by\nHuman Resources Committee.\nsketchy reports of the rump group's\nIn an appearance at a rally on\nPaul Hosefros/The New York Times\nSenator George Mitchell, left, and Hillary Rodham Clinton at a health care rally on Capitol Hill yesterday.\nAI\nHealthRIGHT\nPaul Hosefros/The New York Time\nSenator George Mitchell, left, and Hillary Rodham Clinton at a health care rally on Capitol Hill yesterday.\nNYT\nEmerging Plan Is Still Costly, Still Complex\nBy ROBERT PEAR\nwill have a strong incentive to say\nat the Brookings Institution, ex-\nSpecial to The New York Times\nthey have coverage even if they do\nplained: \"If subsidies are limited to\nWASHINGTON, June 23 - The\nnot.\nvery low-income people, you don't\nhealth care proposal being developed\nTAXES The proposal under discussion\nsolve the problem of the uninsured. If\nwithin the Senate Finance Committee\nin the Finance Committee would im-\nsubsidies are not so limited, they be-\nrelies on changes in insurance regula-\npose a new Federal tax on \"high-cost\ncome very expensive, and it will be\ntions, taxes on some businesses, sub-\nhealth insurance plans.\" But tax law-\nattractive for employers to drop cov-\nsidies to low-income people and a\nyers say it is very difficult to meas-\nerage. Employers will ask why they\nprovision that could require people to\nure the cost and value of health bene-\nshould pay for health insurance if the\nbuy insurance if they did not get it\nfits. Costs vary with the age of the\nGovernment will pay for it.\"\nthrough their employers. The pro-\nworker, family size, place of resi-\nThe proposal being developed in\nposal, like President Clinton's plan, is\ndence and other factors. Medical care\nthe Senate Finance Committee would\ntechnically complicated, difficult to\nfor older blue-collar workers in high-\nprovide subsidies to people with in-\nadminister and expensive, health pol-\nrisk industries like mining is more\ncomes 2.4 times the official poverty\nicy experts said today.\nexpensive than care for young white-\nlevel. For a family of four, the income\nThe new proposal, devised by con-\ncollar workers in safe, clean indus-\nceiling would be $35,433 a year.\nservative Democrats and moderate\ntries like data processing.\nRepublicans, calls for Federal regu-\nThe new taxes would almost surely\nA Touchy Trigger\nlation of health insurance practices\nbe passed on to consumers, econo-\nand other changes to make insurance\nmists say. Moreover, a tax on high-\nThe proposal to require people to\nmore available. If more than 5 per-\ncost plans would often be a tax on\nbuy health insurance if coverage does\ncent of Americans - about 12 million\ntraditional fee-for-service medicine,\nnot reach a specified goal is known as\npeople - still lacked coverage in the\nwhich tends to be more expensive\na trigger.\nyear 2002, an independent agency\nthan health maintenance organiza-\nRichard I. Smith, director of health\nwould recommend further steps that\ntions. Such organizations provide\nCongress could take to provide cover-\npolicy at the Association of Private\ncare for a fixed monthly premium but\nPension and Welfare Plans, a trade\nage for them.\noften limit the patients' choices of\nIf Congress did not act within six\ndoctors.\ngroup composed mainly of Fortune\n500 companies, said: \"In all likeli-\nmonths of receiving those recommen-\ndations, an \"individual mandate\"\nSUBSIDIES Insurance for a family\nhood, the triggers would be pulled.\nwould go into effect, requiring people\ncan cost $4,000 or $6,000 a year, and if\nVoluntary efforts are unlikely to get\nto buy insurance for themselves. The\nsubsidies were not large enough, peo-\ncoverage up to 95 percent, unless the\nGovernment would subsidize premi-\nple would be unable to afford it. How-\nsubsidies are extremely generous\nums for people with low and moder-\never, if the subsidies were generous,\nand hence expensive.\"\nate incomes. The subsidies would be\nthey would be expensive for the Gov-\nOne purpose of the changes in regu-\nfinanced, in part, by taxing the insur-\nernment. It is not clear that backers\nlations contained in the proposal is to\nance benefits offered by the most\nof the new proposal are willing to\nmake insurance more affordable for\ngenerous employers.\nspend the amounts needed.\nsmall businesses. But there is no\nConcerns about the proposal fall\nFurther, if the Government offers\nguarantee such a result would occur.\ninto several areas.\nsubstantial subsidies but does not\nMr. Wiener, a health policy specialist\nrequire employers to buy insurance\nCOUNTING THE UNINSURED No one\nat the Brookings Institution, said, \"If\nfor workers, it creates a strong incen-\nhas a reliable way of counting the\nyou reform the health insurance mar-\ntive for employers to drop coverage\npeople who have no health insurance.\nket so that everyone can get cover-\nThe Census Bureau does an annual\nthey now provide, specialists say.\nage, many sick and disabled people\nThat would raise the cost of the subsi-\nsurvey, but it is flawed because peo-\nwill come into the insurance pool,\ndies even further because more peo-\nple surveyed often do not distinguish\nraising the price.\" If premiums rise,\nple would need them.\nbetween being without coverage at a\nhealthy young people may drop their\nspecific time and being without it for\nHow Much Is Too Much?\ncoverage.\nan entire year.\nMarilyn Moon, a senior fellow at\nThe Cost for Small Business\nMoreover, health policy specialists\nthe Urban Institute, said, \"The suc-\nsay, if people are required to carry\ncess of this proposal will rise or fall\nhealth insurance and there are penal-\non the generosity of the subsidies.\"\nWilliam S. Custer, research direc-\nties to enforce that requirement, they\nJoshua M. Wiener, a senior fellow\ntor of the Employee Benefit Research\nInstitute, a nonpartisan organization\nwhose members include businesses\nand labor unions, said, \"Premiums\nmay go up for small employers who\nalready have insurance if you put\nthem in a pool with nonworkers and\nMedicaid recipients,\" who tend to\nhave higher health care costs.\nPresident Clinton's proposal would\nrequire employers to pay at least 80\npercent of the cost of health insur-\nance for their workers. Employees\nTHE NEW YORK TIMES, FRIDAY, JUNE 24, 1994\nwould pay a maximum of 20 percent.\nThe Finance Committee group would\nnot require employers to pay any-\nthing; the employees' share could be\nmuch more than 20 percent, and the\ncost of Government subsidies could\ngrow accordingly.\nSubsidies under the Clinton plan\nwould cost more than $100 billion a\nyear. Under the proposal emerging\nfrom the Finance Committee, the\nsubsidies would presumably be more\nexpensive because employers would\ncontribute less.\n8\nBlind Eye Now, Eyeing Victory Later\nDemocrats Tolerate Proposal Making Workers Pay Premiums\nBy ADAM CLYMER\nfrom their workers, pay for health\ning together\" and trying to pass what\nSpecial to The New York Times\ninsurance, than to leave it to the\nthey had put forward, he said.\nworkers alone.\nWASHINGTON, June 23 - The\nA Temporary Evil?\nsudden emergence of a health insur-\nBeyond the Committee\nBut the relatively restrained level\nance proposal that ultimately relies\nBut the Democratic hopes are not\nof criticism from Congressional\non making people pay for their own\nyet supported by any vote counts.\nDemocrats - unlike the angry and\npolicies has given the Administration\nNobody knows how the Senate would\nvocal attacks from outside organiza-\nand its allies a nasty choice between\nvote today, and of course it is even\ntions - shows that most of them\nprinciple and legislative\nharder to know how the Senate will\nbelieve the centrists' plan is little\nprogress.\nvote in a couple of months.\nmore than a necessary if ugly step\nNews\nThe idea of making\nAnd there is no reason to think it\ntoward making a law, and an idea\nAnalysis\nworking people, not their\nwill be easy for Mr. Mitchell, Mr.\nwith little staying power. \"Enough\nbosses, responsible for\nstaying power to get to the floor,\"\npaying for health insur-\nsaid Senator Max Baucus of Montana,\nance is an idea Democrats cannot\nwho dropped out of the centrist group\nembrace with any passion.\nwhich had once included eight sena-\nBut the still unfolding proposal, by\nTo get any health\ntors.\na seven-person group led by Senator\nIn the House, where fear of betray-\nJohn H. Chafee, Republican of Rhode\nbill out of the\nal by the Senate is endemic, there was\nIsland, seems to be the only hope of\nlittle grumbling. Highly placed Con-\ngetting any kind of bill at all out of the\nFinance Committee,\ngressional aides said their bosses\nsluggish Senate Finance Committee.\nwould worry if they thought the plan\nSo pragmatism dictates an Adminis-\ntration response of tolerance, or si-\nleaders swallow\nmight be adopted, but for now seemed\nwilling to rely on Mr. Mitchell to put a\nlence or, \"We haven't seen the details\ndifferent proposition before the Sen-\nso we can't comment.\"\nsome bile.\nate. The majority leader has said he\nMaintaining that noncommittal\nwould work with Mr. Kennedy and\nstance requires a restraint this White\nwith Senator Daniel Patrick Moyni-\nHouse has not always been able to\nhan of New York, chairman of the\nmaintain. But the pressure on the\nKennedy and Mr. Daschle to assem-\nFinance Committee, to decide just\nAdministration right now is not as\nble a Senate majority for making\nwhat combination of the bills backed\nintense as it is on the plan's advo-\nemployers pay for insurance. When\nby their committees should go before\ncates, especially Mr. Chafee and the\nJohn Breaux of Louisiana, one of the\nthe Senate.\nother two Republicans, Dave Duren-\nfour Democrats in the group of seven\nIn the Administration, while there\nberger of Minnesota and John C. Dan-\nbehind the new proposal, said Mr.\nwas plainly some anxiety about what\nforth of Missouri.\nKennedy could never get a Senate\nthe unfinished amendment would\nCriticizing Their Own\nmajority for the bill his committee\ncontain, the general view was that the\nSome of their fellow Republicans\nproduced, he was not boasting idly.\nsooner it could get through the Fi-\naccuse them of selling out by giving\nAnother of the group, Senator Kent\nnance Committee, the better.\nConrad of North Dakota, argued that\nThey argue that once the issue is\nthe Democrats a one-day excursion\nticket, valid only for one trip out of\ntheir proposal, while it may seem\ndebated on the floor of Congress, as it\nthe Finance Committee. They say\nawkward, is the only kind of measure\nnever has been before, then the\nthat on the Senate floor, Democrats\nthat the entire Senate, like its Fi-\nAmerican public will see the merits\nwill brush the plan aside and push for\nnance Committee, would be able to\nof their approach and persuade Con-\nmaking employers pay the bulk of\ngress to vote that way. However, this\nagree on.\nis about the fourth moment in the\ntheir workers' coverage, as other\nCongressional committees have done.\n\"Whatever we do, it cannot just be\nhistory of this legislation when the\na ticket out of the Finance Commit-\n\"They think they are above poli-\nAdministration anticipated a surge of\ntee,\" said Mr. Danforth. \"It would\ntics,\" another Republican said scorn-\npublic opinion on its side. It has been\nhave to be a group of senators stick-\ndisappointed the other times.\nfully.\nIn fact, the hostile Republicans are\nperfectly right about the hopes of the\nDemocrats backing proposals simi-\nlar to the Clinton plan, like Senators\nGeorge J. Mitchell of Maine, the ma-\nHawaii Governor Signs Gay Marriage Ban\njority leader; Edward M. Kennedy of\nMassachusetts, chairman of the La-\nbor and Human Resources Commit-\nHONOLULU, June 23 (AP) - The\nshow a \"compelling interest\" for re-\ntee, and Thomas F. Daschle of South\nGovernor of Hawaii has signed a bill\ntaining it, a very tough legal standard\nDakota, co-chairman of the Senate\nbanning same-sex marriages, a\nto meet.\nDemocratic Policy Committee.\nmeasure lawmakers approved after\nThe case, brought by three homo-\nMr. Daschle, a Finance Committee\nthe state Supreme Court ruled that\nsexuals who had been denied mar-\nmember, said he would be willing to\nexisting prohibitions on homosexual\nriage licenses, was sent back to a\nvote for for the emerging plan. \"I\nmatrimony may be unconstitutional.\nlower court for further consideration.\nmay not be excited about it,\" he said,\nThe bill signed by Gov. John Wai-\nA rehearing is scheduled for April\n\"but it's a meaningful contribution\nhee 3d on Wednesday says the ruling\n1995.\nand it keep the process going.\"\nencroached on the Legislature's law-\nThe new law, while denying mar-\nHe and the others want to see the\nmaking function and infringed on the\nriage for same-sex couples, also sets\nproposal emerge from the Finance\nseparation of powers of the respec-\nup a commission to examine extend-\nCommittee onto the Senate floor.\ntive branches of state government.\ning marriage benefits to them.\nClearly, they think that once the issue\nThe court ruled in May 1993 that\nis debated there that they can suc-\nthe ban was \"presumed to be uncon-\ncessfully argue that it is better policy\nstitutional\" because it was sexual dis-\nSHOW A CHILD THE STARS:\nto have employers, with some help\ncrimination, unless the state could\nSUPPORT THE FRESH AIR FUND\nTHE NEW YORK TIMES, FRIDAY, JUNE 24, 1994\nOn My Mind\nAbroad at Home\nA. M. ROSENTHAL\nANTHONY LEWIS\nJournalists\nThe\nIssue\nBut I doubt that all-out partisan-\nor peddlers?\nship - the Newt Gingrich, Phil\nGramm view - is going to prevail\nRemember Attica.\nland prevent compromise on health\nPress and\nH\nOr\nreform. I doubt that Bob Dole him If\nwill take that position in the end.\nThe reason is simple. Too many\nSimpson\nprinting damaging information that:-\nwe say we know, but really don't?\nSolution?\nAmerican families know that they\nmay be one paycheck away from no\nDon't we realize that police and\nhealth insurance. They know that if\nprosecutors often use the press 19,\nthey change jobs, they may not be\nAmong the scores of millions of\nmake a case against the accused?\nable to get new insurance because\nBOSTON\nAmericans who watched the Simpson\nThey would not bother if they did not 1.\nthey have a prior medical condition.\nSomething strange is happening in\nOr their insurance carrier may have\nstory play out on TV and read about it\nbelieve that it would have impact in\nWashington, something to confound\nin the papers were every reporter,\nthe courtroom.\nterminated their policy because they\nIn 1971 New York State police gave\nthe skeptics and the cynics. Congress\nhave been sick.\ncommentator, editor and publisher in\nthe country.\na\nwildly\nexaggerated\nkill22\nis\nshowing\nsigns\nthat\nit\nof\nmay\nactually\naccount\nSome far-right Republicans tried\nings\nby\nrioting\nprisoners\nAttical\npass\na\nmeaningful\nform\nof\nat\ncompro-\nout the line that the country did not\nSince the first day, a sizable num-\nmise\nhealth-care\nber of them have been raising and\nThe New York Times bought it, and IW\nlegislation.\nneed health care reform. That did not\nwas an editor involved. \"Remember^\nI was a skeptic myself. Health care\ngo down with the public. The experi-\nanswering questions about the mean-\ning of the case - what we learned\nAttica\" became my annoying sloganU\nis so complicated a problem, involv-\nence may suggest to Senator Dole\naround the newsroom and is still table\ning so many legitimate and powerful\nabout our social, sexual and moral\nand others that blocking reform is not\ntooed on my mind.\ninterests in this large and diverse\ngood politics.\nmanners, beliefs and customs.\nOne part of the follow-up has been\nThis is written after hearing the 911,\ncountry, that getting anything serious\nIf the compromise efforts fi ly\ntruly important. Maybe wife-beaters\ntapes of 0. Simpson's rage and\npast all the roadblocks in Congress\nsucceed, the legislation will plainly\nNicole Simpson's terror. Those tapes\nseemed to me unlikely. Moreover,\nwill never again feel quite so secure.\nremove some present evils. Insur-\nMaybe judges will not be as quick to\nare fact, not rumor. A jury will decide,\npolls showed that the issue was way\nance companies will have to offer\nwhether this wife-beater became that\ndown on the list of public concerns.\ngive them a \"sentence\" that amounts\nstandard policies to all, at community\nkiller.\nPresident Clinton and Hillary Rod-\nto a knowing wink.\nrates, regardless of individuals'\nMost of the rest has been the usual\nI am sick of cotton-candy justice\nham Clinton deserve credit - much\nical condition. Those covered will be\nas in the case of the two louts in\nmore than they have been getting -\nsocioblather - journalists interview-\nable to keep their insurance no mat-\nCalifornia who killed their parents\nfor moving reform this far. They\ning other journalists or reaching out\nter how sick they get or how much\nfor a specialist to say something, any-\nand have managed to escape convic-\nmade some mistakes, notably the se-\nthey move. If they are poor, a subsidy\nthing, preferably about the discovery\ntion. What's more, it was the report-\ncrecy imposed on the early health\nwill help them pay for insurance.\ning of Dominick Dunne that con-\nmeetings. But they have educated the\nThe business world succeeded m\nthat not all athletes may be heroes.\nvinced me of their viciousness and\ncountry on why we, like all other\nPopcorn - no harm done unless you\nmaking \"employer mandates\" sound\nmistake it for real food for the mind.\nguilt - reporting, long, painstaking\nindustrialized societies, need national\nbad, so the bill will not require com-\nBut as we while away our time\nreporting, not pickup garbage-ped-\nmeasures to assure us medical care.\npanies to pay for most of their work-\ndling.\nThe credit due is the greater be-\ners' insurance. That is a curious re-\nwaiting for the trial, the press might\nask what questions the case raises\nMy concern in the Simpson case is\ncause leading Republicans chose to\nsult, for it rejects the conservative\nabout ourselves.\nnot just for the accused's rights but\nmake health care reform a partisan\napproach of sticking with the way\nAre we journalists or garbage col-\nfor journalism, whose cleanliness and\nissue. They demonized the Clinton\nmost Americans get their health in-\nlectors?\néthics are important to the country.\nproposal as they demonized the Clin-\nsurance now. And making health care\nIf some other journal or broadcast\nIn this, TV has a tougher job than\ntons, saying falsely that the plan\nan aspect of employment would be a\ndistributes unverified rumors - the\npress. In the Simpson case, TV was at\nwould mean more Big Government\nvital incentive to move people out of\nits best and worst. The much-mocked\nwelfare.\nequivalent of journalistic garbage\ndo we just pick it up and peddle it\nlong coverage of the \"chase\" was\nWhether any compromise will\nexactly what TV should do - show\nourselves?\nwork in practice without employer\nlife live.\nDo we care anymore about sourc-\nRepublicans\nmandates and some other features of\nTV could not do much to prevent\ning and double-checking, and that\nthe Clinton proposal will depend on\njust passing on the biased out-of-court\nstuff? If so, why was so much of the\ndemonize\nthe details.\ntrial put on by police and prosecutor.\nmaterial aired and printed simply\nFor example, how will the legisla-\nThat was part of live coverage. But\npicked up from some other station or\nhealth-care\ntion make sure that, in a \"voluntary\"\nTV allowed flocks of reporters and\npaper, which itself had shown no\nsystem, healthy young people do not\nstringers to regurgitate, unchecked\nproof?\nreform.\ngo uninsured, thereby raising rates\nand unevaluated, rumors shoveled up\nIs it excuse enough that somebody\nfor everyone else? The universal cov-\nhot off the street.\nelse did it first and competition is\nerage envisioned in the Clinton plan\nPrint journalism had more think-\ncompetition? Is that all we believe, or\nwould deal with that problem.\ning time. But the thinking has to start\nwere taught, or remember about\nand bureaucracy. (Bureaucracy is\nThe ideas being discussed by such\nlong before a big story breaks\njournalism? Or is competition raised\nwhat we increasingly have now, with\nsenators as Democrat Bill Bradley of\ndeveloping a set of beliefs and prac-\nto a religion simply as excuse for our\ndoctors having to get the approval of\nNew Jersey and Republican John\ntices within the staff about sourcing,\nown lust or advancement?\nchecking, deciding about responsibil-\nan insurance company clerk to give a\nChafee of Rhode Island would aim at\nDo we still recognize any ethical\nity to the accused and the craft.\npatient a test or refer her to a special-\ncovering 95 percent of Americans by\npress obligation not to imply guilt\nist.)\nthe year 2002, when individuals would\nThat is the payback the press can\nbefore the accused is convicted?\nNow some moderate Republicans\nbe required to get insurance. A com-\ngive to the Constitution and country\nIn the courtroom during a trial that\nin the Senate have broken with their\nmission would monitor the plan and\nfor the First Amendment not-im-\nbecomes a legal mandate for judge\nbitter-end colleagues and joined cen-:\nsuggest other ways to increase cover-\nposed by law, but due and decent.\nand jury. Outside, anybody else has a\nWe should stop asking what the\ntrist Democrats in trying to draft\nright to make up his own mind. But\npublic thinks of us and worry about\ncompromise legislation. They have\nGradualism on an issue this com-\njournalists - as people who have\ncreated a real possibility of getting a\nNex is a good thing. If Congress faces\nwhat we think of ourselves. Remem-\nbill out of the crucial Senate Finance\nthe\nreal\nprotected nationwide megaphone put\nproblems\nof\nhealth\ninsur-\nber\nAttica,\ninto our hands by the Constitution\nCommittee.\nance, there will be time to adjust\naren't we obliged to exercise some\n\"I like all of them,\" Bob Dole, the\nhopes to reality.\nrestraint, forgive the word, before\nSenate minority leader, said of those\nmoderates. \"But we've got a party to\nthink of.\" In other words, better an\nissue than a solution.\nTHE NEW YORK TIMES, FRIDAY, JUNE 24, 1994\n7,7\nHealth Bill\nCleared for\n\"Don't force us to pay for abortion if we don't\nHEALTH, From A1\nwant it,\" Klink said. But Marge Roukema (R-N.J.),\nFloor Votes\nPatsy Mink (D-Hawaii) and others said 65 percent\nany plan, and some Democrats on the House Ways\nof women are now covered for abortion in their\nand Means Committee began to complain yesterday\nthat their panel was producing a bill that would be\nexisting health plans and the Klink amendment\ntoo radical to pass the House.\nwould wipe out that coverage.\nBut Many Disputes\nThe House Education and Labor Committee bill\nKlink, Roemer, Dale E. Kildee (Mich.), Austin\nprovides health insurance to all Americans to pay\nJ. Murphy (Pa.) and Scotty Baeslar (Kentucky)\nRemain, Clouding\nfor doctor and hospital bills, prescription drugs,\nwere the only Democrats to vote for the Klink\nmental health and substance abuse coverage and\namendment. Roukema, Susan Molinari (N.Y.) and\nProspects This Year\nsome dental benefits. About 80 percent of the\nMichael N. Castle (Del.) were the only Republi-\nAI\ncost would be paid for by employers, 20 percent\ncans opposing Klink.\nby workers. The poor and small businesses would\nOn the final vote on the modified Clinton bill, all\nBy Spencer Rich and Dana Priest\nreceive government subsidies to help pay their\nDemocrats backed the bill except Baeslar and Rob-\nWashington Post Staff Writers\ncosts.\nert E. Andrews (N.J.). On the \"single-payer\" bill, 22\nThe committee \"has brought us one step closer\nIn a victory for the president, the\nDemocrats voted in favor, while Democrats Baeslar,\nto achieving our goal of universal coverage-\nHouse Education and Labor Com-\nAndrews, Roemer, Kildee, Karan English (Ariz.) and\nguaranteed private insurance for every American\nmittee approved a modified Clinton\nthat can never be taken away,\" Clinton said.\nTed Strickland (Ohio) joined the 15 Republicans in\nhealth bill yesterday that provides\nBut the committee's senior Republican, William\nopposition.\nhealth insurance for all Americans\nF. Goodling (Pa.), said the bill adds burdensome\nIn the Senate, the \"rump group\" of three Republi-\nand compels employers to pay 80\ngovernment mandates, more bureaucracy and will\ncans and five Democrats attempting to write a com-\npercent of the premiums for their\nincrease the federal deficit $120 billion over five\npromise plan that could pass the Finance Committee\nworkers.\nyears, about $50 billion more than the original\nmade a pact to stick together during the public com-\n\"Today\nfor the first time ever,\nClinton bill.\nmittee deliberations next week. They also are work-\na committee in each house of Con-\nThere isn't a chance in Hell that this plan can\ning on a contingency plan they could offer en bloc if\ngress has reported a bill that guaran-\npass the Congress of the United States,\" Rep.\none or more of them feel they are under unbearable\ntees universal coverage,\" President\nSteve Gunderson (R-Wis.) said recently.\npressure to break from the group, members said.\nClinton said, referring to a similar\nAfter approving the modified Clinton bill, the\nThe group, led by Sens. John H. Chafee (R-R.I.)\nbill passed by the Senate Labor and\nEducation and Labor Committee also reported to\nand John Breaux (D-La.), has become the best hope\nHuman Resources Committee three\nthe floor \"without recommendation\" a Canadian-\nfor finding a middle ground in the panel, which is\nweeks ago.\nstyle government-run health insurance plan fi-\nstuck on the issue of how or whether to finance uni-\nThe president said the House Ed-\nnanced by taxes. The vote was 22 to 21, with six\nversal coverage, the bottom-line goal for Clinton.\nucation and Labor Committee had\nDemocrats joining 15 Republicans in opposition.\nBut already Minority Leader Robert J. Dole (R-\nbroken the \"chokehold\" of special in-\nBackers of the so-called \"single-payer\" bill had\nKan.) has promised to come up with a more conser-\nterests, but deadlocks in two other\nthreatened to oppose the Clinton measure unless\nvative alternative. The Chafee group's plan is con-\ncommittees, and increasing difficul-\ntheir plan was also reported and given a chance\nsiderably scaled-down from a bill Chafee proposed\nties in a third, suggested that health\nfor an airing and vote on the floor.\nlast year, and which Dole co-sponsored.\ncare reform this year is far from a\nWhile reporting a bill without recommendation\nThe Finance Committee's counterpart in the\nsure thing.\ndoes not carry the weight of a full committee en-\nHouse, the Ways and Means panel, began to show\nThe Education and Labor Com-\ndorsement, Rep. George Miller (D-Calif.) said,\nstress yesterday. Some members said the acting\nmittee, one of the most liberal com-\n\"The important thing is that it qualifies it to go be-\nchairman, Sam Gibbons (D-Fla), was trying to craft a\nmittees in Congress, approved its\nfore the full House where it will be one of only\nbill that too closely mirrors the liberal Ways and\ncomprehensive bill, 26 to 17, with-\nthree\" major health bills under consideration. \"It\nMeans subcommittee bill passed several months ago.\nout Republican support and with the\nwillkeep it in the mix,\" said Sara Nichols of Public\n\"He's too much in control,\" said Rep. Barbara\ndefection of two Democrats.\nCitizen, a supporter of the,single-payer measure.\nB. Kennelly (D-Conn.) who said she was frustrat-\nThe victory guaranteed that Dem-\nBefore approving the modified Clinton bill, the\ned that one of her amendments to exempt large\nocratic leaders in both chambers can\ncommittee defeated, 25 to 16, an effort by Rep.\ncompanies from government cost control meas-\nbring the president's bill to the floor.\nRon Klink (D-Pa.) to forbid health insurance poli-\nures did not get a full airing. \"Every time you try\nBut the Senate Finance Committee\ncies from paying for abortion, except where the\nto do an amendment that makes the private mar-\nis deadlocked as a \"rump group\" of\npregnancy resulted from rape or incest or endan-\nket work, it gets shot down,\" she said.\nmoderate Republicans and Democrats\ngered the life of the mother. The vote was 25 to\nIn the private caucus meetings, Gibbons is try-\nstruggles to craft a centrist plan they\n16. Klink, Timothy J. Roemer (D-Ind.) and others\ning to get a 20-vote majority on each amendment\nhope could pass the panel. The House\nargued that since all Americans would be required\nbefore going into public session.\nEnergy and Commerce Committee al-\nto buy the health policies provided by the bill,\nGibbons recognized the difficulty he is having\nso is stymied, lacking a majority for\nmandatory inclusion of coverage for abortion\nwith such paper-thin margins for the major parts\nwould require people to finance a procedure they\nof the bill when he took the dais at 4:30 p.m. and\nfind morally repugnant.\nexplained why the committee was beginning its\npublic work so late in the day.\n\"I'm constantly trying to hold together 20 votes,\"\nhe said. \"When you only have two votes to spare, it\ntakes a long time to reach a consensus.\"\nThat was all the sign of vulnerability the Republi-\ncans needed. \"And if you can't get 20 votes for your\nFRIDAY. JUNE 24. 1994 THE WASHINGTON POST\nbill,\" said Rep. Bill Thomas (R-Calif.). Republicans\nstand ready to vote\nfor a reasonable bill.\"\n30\nHealth Form and Re-Form\nO\nN ALTERNATE days for the next few\nneeds in the Senate, he weakens his position-\nweeks-sometimes the same day-you're\ncosts himself votes that he also badly needs-in\ngoing to read that health care reform is\nthe House. He's stuck with repeating the mantra,\nhopelessly bogged down or finally making some\nthat he will only accept a plan that leads to\nprogress; that the Democrats-or was it the\nuniversal coverage. It's a strong enough position\nRepublicans?-are newly united/in disarray; that\nif he sticks to it, but not very lively.\nthe president or chairman of the Senate Finance\nCommittee or Bob Dole, or someone, is getting\nIn the Senate, it appears that the most serious\neither, good or bad marks, most likely for exer-\nwork is now being done by a group of middle-road-\ncising or failing to exercise the proper leadership;\ners on the Finance Committee, members of both\nand that the elderly are (a) off the reservation.\nparties. They're trying to produce a compromise\n(b) back on or (c) split right down the middle\nthat the president will accept or, at any rate, not\nbecause of the latest change in the terms of a\ndenounce and that can still pass the Senate. Atten-\ndrug benefit that will or won't be phased in by the\ntion has mostly centered on the benefits package. In\nyear 2010.\nthe name of increasing coverage, who would get\nIt will all be true, if not on the day you read it\nwhat and how would it be financed?\nthen likely as not within a day or two thereafter;\nWe say again that, hard as this may seem, it's\njust wait. It's not the fault of the journalism but in\nthe easy part. Congress knows all too well how to\nthe nature of the process, now reaching a partic-\nularly complicated stage, that the journalism now\nconstruct new benefit programs. The hard thing\nseeks to record. You need to read, but you also\nto achieve is cost containment. It's also the more\nneed to preserve a sense of detachment for a\nimportant of the two great goals of reform: it's\nwhile. Give them a couple of weeks; then the\nabove all the rising cost of care that is driving\nalternatives may be much clearer.\npeople out of the system in the first place-cost-\nFor better or worse, the administration has\ning them coverage. The measure of these bills\ngotten- itself into a position where, while it is\nhas to be much more than just the percentage of\nobviously a major player, it can't play. If the\nthe population they would likely cover and what\npresident tries to work out the compromise he\nfurther steps would be triggered if they failed.\nMetro's Platform Dispute\nM\nETRO OFFICIALS are in a dispute with\nofficials are requesting more time to test the\nthe federal government involving the\nmaterials. But federal officials respond that it's a\nedges of the rapid rail system's plat-\nmatter of complying-as other urban transit\nforms. To the outrage of some organizations\nsystems are-with the Americans with Disabili-\nrepresenting visually impaired riders. Metro is\nties Act regulation.\nfighting a federal order to install new warning\nedges. Transportation Secretary Federico Pena\nWe don't know who's right about the best\nhas told Metro to remove the white granite\nedges, but the concerns of Metro general manag-\nplatform edges in use for 18 years and to replace\ner Lawrence G. Reuter do not strike us as either\nthem with wider strips of brightly colored rubber\ncallous or stubborn. Mr. Reuter notes that Metro\nwith raised bumps. Metro officials argue that the\nhas the best safety record of any transit property\nnew edges create new problems-people could\nin the country. Even at that, he says, Metro is\ntrip on them. They have proposed a widening and\nwilling to consider any changes \"as long as\nretexturing of the existing granite to make it\nimprovement for one group does not result in a\nmore easily detected by disabled riders.\nreduction of safety for others.\" Before spending\nStill other organizations representing the visu-\nlarge amounts of precious federal, state, District\nally impaired share Metro's concerns about the\nand regional money to make a change. why not\nsafety of the bumpy strips. The transit system\nallow closer study?\nFRIDAY. JUNE 24. 1994 THE WASHINGTON POST\nPanel in House\nFrustrated by Business\nContinued From Page A2\nscribed state reimbursement schedule for\nStiff opposition from business remains\na major problem for the administration.\nproviders, but they would be permitted to\nDespite appeals from the president this\nmaintain their own health-care delivery\nApproves a Bill\nweek, Democrats are frustrated by their\nsystem as many do today.\ninability to win more support or weaken\nCommittee debate this week over the\nOn Health Care\nbusiness's grip on the GOP.\nstandard health benefits package some-\nAt a Capitol breakfast yesterday de-\ntimes has had the atmosphere of an auc-\nsigned to energize business support,\ntion, with the Congressional Budget Office\nHealth and Human Services Secretary\ncalling in estimates of the cost of bids\nDonna Shalala emphasized the need to\nto add such items as chiropractic services\nAmbitious Measure Faces\ncurb rising health expenditures and the\nor hearing aids for young children. The\nshifting of costs from people who don't\nnew prescription-drug benefit set off skir-\nPressures to Cut Back,\nhave insurance to those with insurance,\nmishes pitting such large companies as\nBig Opposition on Floor\nwhich imposes a burden on many em-\nPfizer Inc. and Merck & Co. against\nployers. But when she appeared later at a\neach other and bringing former Demo-\nnews conference with South Dakota Sen.\ncratic aides and members of the committee\nBy DAVID ROGERS\nThomas Daschle, a member of the Demo-\ntolobby on each side. The retail druggists,\nStaff Reporter of THE WALL STREET JOURNAL\ncratic leadership, the two were joined\nwith grass-roots membership in law-\nlargely by familiar faces from older, heavy\nmakers' districts, proved one of the most\nWASHINGTON-Th House Education\nindustries-like auto and steel-and other\npowerful lobbies, even though its lead\nand Labor Committee approved an ambi-\nchampion, Rep. Bill Brewster (D., Okla), a\ntious health-care reform bill that would\ninterests that have won concessions from\nrequire employers to help pay for their\nthe administration.\nformer pharmacist, is almost certain to\nworkers' insurance, and would expand on\nSpeaking on behalf of small business,\nvote against the underlying bill.\nbenefit levels promised by the Clinton\nfor example, was the National Association\nWays and Means Democrats have filed\nof Retail Druggists, which has won a series\nat least two dozen potential amendments to\nadministration.\nThe 26-17 vote represents a liberal\nof victories this week in the House Ways\nthe revenue section of the bill, which may\nhigh-water mark in the prolonged health-\nand Means Committee regarding the pric-\ncome up for debate this weekend. Some\ning of drugs under a new federal prescrip-\namendments would add to taxes on tobacco\ntion-drug benefit. And the list of \"compa-\nand ammunition, but others seek conces-\nWhat Congress Receives\nnies\" at the breakfast included Amtrak,\nsions in the form of expanded tax credits or\nFor President Clinton, it has become the\nthe passenger rail system that depends on\nexemptions for segments of the health-\none surefire applause line: Give every\nAmerican the kind of health coverage\nfederal subsidies, and an array of Wash-\ncare industry.\nthat Congress gets. But the prospect of\nington lobbying firms with political ties to\nNo less than Geraldine Ferraro, the\nactually getting what Congress gets\nDemocrats.\nformer congresswoman and Democratic\nmight not please large numbers of\nFormer Ways and Means Committee\nvice presidential nominee, has made calls\nAmericans. Article on page A12.\nChairman Dan Rostenkowski (D., III.) of-\non behalf of a group health insurance firm\nten spoke of the need to find \"some\ncare debate. But the bill faces major\nin New York. And Hank Gutman, who was\ncheerleaders\" from business while he was\nopposition on the House floor, and is sure\nstaff director of the Joint Committee on\ncrafting his early version of a health-care\nto be overtaken by pressures to cut back on\nTaxation until early this year, is represent-\nbill. And Rep. Sam Gibbons (D., Fla.), who\nthe administration's reform agenda.\ning Par Pharmaceutical Inc., a New York-\ntook over the chair after Mr. Rosten-\nEven as the House committee acted,\nbased generic-drug company. The generic-\nkowski's indictment on corruption charges\nmoderates on the Senate Finance Commit-\ndrug industry is seeking to reverse an\nlast month, has followed much the same\ntee struggled to complete negotiations on a\nInternal Revenue Service ruling that would\npath with concessions to tobacco and\ncompromise plan that anticipates provid-\ncurb their ability to benefit from the\ninsurance interests.\ning much lower benefits in order to\nresearch and development tax credit.\nIn action yesterday, Rep. Jim McDer-\nstretch funds available to subsidize cover-\nmott (D., Wash.), a strong advocate of a\nPressed by Rep. Gibbons to complete\nage for lower-income families.\ngovernment-run, single-payer health sys-\naction by the July Fourth congressional\nEasier on Employers\ntem, conceded he lacked the votes to\nrecession, the Ways and Means Committee\nSen. John Chafee (R., R.I.), who has\noverturn a partial exemption backed by the\nworked into the night yesterday. The panel\ntaken a lead role for the Finance Commit-\ncommittee leadership for multistate corpo-\nnarrowly approved an amendment that\ntee moderates, said the group hopes to\nrations with more than 5,000 workers. If a\nwould force most health plans to accept\npresent the outlines of its plan to the\nstate should adopt a single-payer system in\nany doctor, hospital or other provider who\ncommittee leadership as early as today.\nthe future, the bill would require these\nagrees to the plans' rates and other operat-\nUnlike the Education and Labor bill, the\nlarge corporations to conform to the pre-\ning terms. The committee also approved\ncompromise avoids the most burdensome\nPlease Turn to Page A12, Column 5\non a voice vote another amendment aimed\nrequirements the Clinton plan would im-\nat widening patient choice. It would re-\nquire all managed-care networks to allow\npose on employers, and instead relies on a\nmore voluntary system of market reforms\npatients to go to doctors outside of the\nand subsidies to be financed by added\nnetwork provided they pay a slightly\nhigher fee.\ntaxes and savings from the Medicare and\nMedicaid programs.\n-Mary Agnes Carey and Hilary Stout\ncontributed to this article.\nThe goal would be to provide about 95%\nof Americans some insurance by the year\n2002. Although this stops short of the White\nHouse's standard of universal coverage,\nthe moderate bloc is seen as the adminis-\ntration's best hope of breaking the current\nstalemate in the Finance panel.\n\"The idea is to move, not stand pat,\"\nsaid Finance Committee Chairman Daniel\nPatrick Moynihan (D., N.Y.), who ex-\npressed encouragement last night. While\ndivisions remain, the moderates- by their\nnumbers and ideas - have already helped\ndefine the political framework for the\ncommittee debate. And rather than being a\nTHE WALL STREET JOURNAL FRIDAY, JUNE 24, 1994\n\"rump\" group, the bloc of seven or eight\nRepublican and Democratic senators is\ncloser to a majority than any of the rival\ncamps on the left or right.\nTo maximize the number of people who\nwould have insurance, while operating\nwith limited funds, senators are discussing\na set of benefits packages that would be\nmore modest than proposed by the presi-\ndent. One would be about 25% below the\nstandard level, and would serve chiefly to\nprotect families against large out-of-pocket\nexpenditures or catastrophic costs.\nThe plan also would delay and phase in\nRepublican-backed proposals to expand\ncertain tax deductions for health expendi-\ntures by individuals. But small-business\ninterests have lobbied successfully against\na Democratic-backed proposed \"free-\nrider\" assessment on employers who fail,\neven in the future, to make any contribu-\ntion to their workers' insurance.\n70\nTHE WALL STREET JOURNAL FRIDAY, JUNE 24, 1994\nPOLITICS & POLICY\nA Look at Lawmakers' Medical Plans Suggests\nCongress's Health Coverage Isn't So Generous\nBy HILARY STOUT\n75%. But for some policies the share\nStaff Reporter of THE WALL STREET JOURNAL\nWhat Congress Gets\nis far less.\nWASHINGTON- President Clinton\nFor example, the government's share\nand his allies on health care, it has become\nHighlights of the Blue Cross/Blue Shield\nof a family policy for a Blue Cross/Blue\nthe one sure-fire applause line: Give every\nStandard Option Plan, one popular health plan\nShield \"high option\" fee-for-service plan is\nAmerican what Congress gets.\nin the Federal Employee Health Benefits\n$306.41 a month, or less than half; the\n\"You say it and the audience goes\nProgram\nemployee pays $343.24. For a Blue Cross\ncrazy,\" says Families USA foundation's\n$200\nstandard option plan - which has higher\nAnnual deductible\nArnold Bennett, a member of the team\ndeductibles and generally pays 75% of\nhelping the administration craft its health-\nAnnual Inpatient\n$250\nmost doctor bills instead of 80% - the\ncare message.\nhospital deductible\ngovernment pays $303.77 for a family\nHillary Rodham Clinton uses it in\nOut-of-pocket limit\n$3,250\nplan and the employee pays $101.25.\nvirtually every speech she gives. Just\nLawmakers Are Flustered\nthis week a group of Democratic senators,\nInpatient hospitalization\n100% coverage\nincluding Labor and Human Resources\nThe political thrust and parry over\nDoctor services\n75%\nCommittee Chairman Edward Kennedy of\nthe \"what Congress gets\" argument flus-\nMassachusetts, called a news conference\nOutpatient hospital\n75%\nters some Republicans. For instance,\nto demand that the general public get the\nservices\nHouse Minority Whip Newt Gingrich, a\ncoverage that \"members of Congress have\nstaunch foe of the president's health-care\nPrescription drugs\n$50 deductible,\narranged for themselves.\" Sen. Harris\nproposals, was taken aback on NBC's\nthen 60% coverage\nWofford, the Pennsylvania Democrat who\n\"Meet the Press\" Sunday when a reporter\nwon his seat in 1992 by stressing health\nTotal premium\n$405.02 per month\nasked him, \"Why can't the average citizen\ncare and faces a stiff re-election fight this\nhave the same health-care plan that Con-\nMember's share\n$101.25\nyear, is circulating a petition demanding a\ngressman Gingrich has?\" The Georgia\nbill that offers \"every Pennsylvanian and\nGovernment share\n$303.77\nRepublican replied, \"I have a Blue Cross\nevery American the same kind of guaran-\nplan that I pay for every month.\nI\nthink it's about $400.\"\nteed coverage and choice of private health\nplans that members of Congress get.'\nget is the opportunity to enroll in one of an\nNot exactly. The total monthly pre-\nPackage Isn't That Great\narray of health-care plans, each offering a\nmium for the standard-option Blue Cross\nBut while focusing on Congress's bene-\ncomprehensive package of medical bene-\nplan Mr. Gingrich and his family are\nenrolled in is just over $400. But on Monday\nfits may be a stroke of political brilliance,\nfits, with the premium paid in part by\nthe prospect of actually getting what Con-\ntheir employer: the taxpayers.\na spokesman for Mr. Gingrich said the\ncongressman only pays about $100 a\ngress gets might not please large numbers\nChoice of 30 Plans\nmonth. The government picks up the re-\nof Americans, including some of the most\nIn the Washington area, members\nmaining $300.\nvigorous supporters of the president's\nof Congress can choose from among nearly\nAmong other things, Republicans are\nhealth-care bill.\n30 health plans, including 14 health-main-\nespecially irked that Democrats seldom\nThe federal employees package isn't as\ntenance organizations and seven \"fee-for-\nmention that the president gets the same\ngenerous as most union health plans, or\nservice\" plans, which pay at least part of\nbenefits as lawmakers. (The Clintons have\nthe programs of many Fortune 500 compa-\nthe bill for visits to the doctor or hospital of\nthe same plan Rep. Gingrich has.) Senate\nnies. For example, many of the policies\nthe patient's choice. The benefits in each\nMinority Leader Robert Dole of Kansas\navailable to federal employees don't in-\nplan vary, but generally include hos-\nthis week denounced the argument as a\nclude substance-abuse benefits or preven-\npital and emergency services, doctor\n\"cheap shot,\" and said he plans to propose\ntive dental care.\nvisits, lab tests, prescription drugs and\nthat the president and members of Con-\nHowever, Congress's benefits package\nsome dental care. Depending on the policy,\ngress pay their entire premium costs them-\nwould be an improvement for a vast\ncoverage may include children's immuni-\nselves. Democratic Sen. Wofford, though,\nnumber of Americans, particularly many\nzations and some nursing-home benefits.\nhas already gone him one-up: He says he =\nemployees of small and midsize businesses\nUnlike much of the general public,\npay the full cost of his health insurance\nand, of course, the estimated 39 million\nCongress is also free of some of the\nuntil Congress passes coverage for all, and\npeople with no health insurance. Still, the\nonerous insurance-industry practices that\nis challenging his GOP opponent. Pennsyl-\nfederal government's share of the pre-\nshut some people out of the market. Under\nvania Rep. Rick Santorum, to do the\nmium isn't as generous as most unions and\nthe Federal Employee Health Benefits Pro\nsame.\nmany big employers - or, for that matter,\ngram, no health plan can drop or refuse to\nIn addition, the president's allies are\nthe 80% share the White House would like\nenroll a government employee or depen-\nalready planning a sequel to the \"what\nemployers to bear. And as far as the scope\ndent because of a medical condition.\nCongress gets\" line, says Mr. Bennett of\nof the benefits and the patient cost-sharing\nBut as far as cost-sharing goes, Con-\nFamilies USA. If moderate and conserva-\nrequirements, Congress's plan isn't nearly\ngress isn't getting quite the ride that many\ntive lawmakers continue to tout a bill that\nas comprehensive as Medicaid, the fed-\nworking Americans do. According to the\nwould cover 91% of the American popula-\neral-state health program for low-income\nOffice of Personnel Management, which\ntion as a worthy achievement, he says, the\npeople.\nruns the federal benefits program. the\nretort will be: \"Which nine senators\nWhat lawmakers - and indeed all fed-\ngovernment pays on average 72% of em-\nintend to give up their health insur-\neral employees, including the president-\nployee health premiums, and no more than\nance?\"\n71\n2nd victory for Clinton health plan\nBy Jessica Lee and Judi Hasson\ncare. Republicans will ensure the rich\nerage premiums. Another idea, to tax\nUSA TODAY\npackage gets more scrutiny.\nemployers who don't insure their\nThe House panel also defeated at-\nworkers, was taken off the agenda.\nThe House Education and Labor\ntempts to strip most abortion cover-\nStill, Sen. John Chafee, R-R.I., said\nCommittee approved a health bill\nage from the benefits. That issue, too,\nhe expects the group to present a fin-\npromising insurance for everyone\nwill remain contentious.\nIshed plan to Finance Committee\nThursday, becoming the second con-\nMeanwhile, four Democrats and\nleaders today.\ngressional panel to ratify President\nthree Republicans spent the day be-\nBut Senate Republican leader Rob-\nClinton's key health-care goal.\nhind closed doors trying to fashion a\nert Dole, R-Kan., planning to intro-\nClinton, noting that the Senate La-\nbill with enough coverage to be called\nduce his own bill, said the moderates'\nbor Committee had passed a similar\nuniversal without ordering employers\nplan apparently relies too heavily on\nbill, said, \"They have broken the\nor individuals to pay for IL\ntaxes to win many Republican votes.\nchokehold of special interests, and by\nDetails were in flux, but partici-\nSen. David Durenberger, R-Minn.,\nchoosing to cover everyone, have\npants confirmed key details: If 95% of\ncalled the Chafee group's bid the Sen-\nstood up instead for millions of hard-\nAmericans didn't have health Insur-\nate's last shot at bipartisan reform.\nworking middle-class Americans.\"\nance by 2002, a commission would\nRepublicans' \"objective is health-\nKeeping options open, the House\nrecommend a plan for achieving uni-\ncare reform, and the president's is\npanel also narrowly approved a Cana-\nversal coverage, and Congress would\nuniversal coverage,\" he said. If Cha-\ndian-style bill that would replace pri-\nhave to act within six months.\nfee's bid falls, he predicted. Senate\nvate Insurance premiums with payroll\nIf Congress failed to act, the bill\nDemocrats will try to pass a bill with\ntaxes to pay medical bills.\nwould require individuals to buy their\n51 votes, only one Republican. That\nThe panel's version of the Clinton\nown health insurance.\nwould let Democrats campaign as\nbill requires employers to pay for In-\nFinancing remains in dispute.\nhealth reformers but let Republicans\nsurance, has subsidies for small firms\nOne proposal is to tax top-dollar in-\nblame them for the taxes involved.\nand expands coverage for women's\nsurance policies at 25% to 35% of the\nhealth, mental Illness and adult dental\ndifference between their cost and av-\nToday's debate, 10A\nBirths-welfare link is disputed\nBy Margaret L Usdansky\nhave looked into whether out-of-wedlock child-\nUSA TODAY\nMany on welfare\nbearing is higher in states with generous welfare\nbenefits than in those with smaller payments.\nWelfare benefits aren't the main reason out-of-\nstarted families early\nHigher payments had no effect on whether black\nwedlock births are rising, 76 leading poverty ex-\nwomen have children outside of marriage, the\nperts argued Thursday, as the controversy over\nChildren on welfare, Ald to Families with\nstudies found. and the effect on white unmarried\nwelfare reform and illegitimacy heated up.\nDependent Children, are more likely to have\nwomen was small or non-existent\n\"Welfare may be on the list of explanations, but\nyoung mothers, who are more likely to be\nWelfare can't be the main factor in rising out-of-\nit's way down the list,\" social psychologist Kristin\nunmarried than older women. Mothers'\nwedlock births, said Northwestern University\nMoore said at a press conference.\nages, when they first gave birth:\neconomist Rebecca Blank, because illegitimacy\nThe statement came as the Clinton administra-\nAFDC recipients\nAll mothers\nhas risen while the real value of welfare benefits\ntion defended its welfare plan, sent to Congress\n9.1%\nhas dropped, from $900 in AFDC payments and\nthis week, against conservatives who want a plan\nUnder 16\n2.9%\nfood stamps for the average woman with three\nthat cuts off all welfare benefits to young. unmar-\n23.0%\nchildren in 1970 to $700 in 1990.\nried mothers.\n16-17\n10.3%\nMore relaxed attitudes towards sex, poor job op-\nOne conservative group, Empower America,\n26.2%\nportunities and increasing acceptance of single\nbegan running radio ads this week attacking Clin-\n18-19\n18.7%\nparenthood had more effect on the rise of illegiti-\nton's plan as \"cynical and deceptive.\" Thursday,\nmacy, the academics said. Out-of-wedlock birth\n33.7%\nHealth Secretary Donna Shalala fired back, saying\n20-24\nare rising among middle-class women, too.\n43.6%\nthe conservative's proposals were \"un-American\"\nThe researchers said they support welfare re-\nand would \"create a generation of children who\n25-29\n6.7%\nform. but they sharply criticized cutting off wel-\n19.6%\nwill grow up on the streets.\"\nfare benefits for young. unmarried mothers.\n30+\n1.3%\nSuch plans would cut off a lifeline to very poor\nThe Clinton plan would limit women born after\n0.5%\nchildren and amount to \"a drastic social experi-\n1971 to just two years of benefits, then require\nthem to find a job. Although states could deny ad-\nSource: Census Bureau\nTODAY\nment,\" said University of Michigan economist\nSheldon Danziger.\nditional benefits to women who have more chil-\nthree out of 10 births today. About half of women\nBut American Enterprise Institute lawyer Doug\niren while on welfare. unmarried mothers\nreceiving Aid to Families with Dependent Chil-\nBesharov attacked the researcher's conclusions.\nwouldn't automatically lose aid.\ndren are unmarried; a majority were teen-agers at\n\"The research is quite ambiguous,\" Besharov said.\nOut-of-wedlock births have soared in recent\nthe time of their first birth.\n\"Whether or not welfare causes illegitimacy, it\nyears, rising from 10.7% of all births in 1970 to\nThursday, the researchers said many studies\ndoes nothing do discourage it.\"\nFRIDAY.\n24.\n1994\nUSA\nTODAY\nJUNE\n2nd victory for Clinton health plan\nBy Jessica Lee and Judi Hasson\ncare. Republicans will ensure the rich\nerage premiums. Another Idea, to tax\nUSA TODAY\npackage gets more scrutiny.\nemployers who don't insure their\nThe House panel also defeated at-\nworkers, was taken off the agenda.\nThe House Education and Labor\ntempts to strip most abortion cover-\nStill, Sen. John Chafee, R-R.I., said\nCommittee approved a health bill\nage from the benefits. That issue, too,\nhe expects the group to present a fin-\npromising insurance for everyone\nwill remain contentious.\nished plan to Finance Committee\nThursday, becoming the second con-\nMeanwhile, four Democrats and\nleaders today.\ngressional panel to ratify President\nthree Republicans spent the day be-\nBut Senate Republican leader Rob-\nClinton's key health-care goal.\nhind closed doors trying to fashion a\nert Dole, R-Kan, planning to intro-\nClinton, noting that the Senate La-\nbill with enough coverage to be called\nduce his own bill, said the moderates'\nbor Committee had passed a similar\nuniversal without ordering employers\nplan apparently relies too heavily on\nbill, said, \"They have broken the\nor individuals to pay for it.\ntaxes to win many Republican votes.\nchokehold of special interests, and by\nSome points were in flux, but par-\nSen. David Durenberger, R-Minn.,\nchoosing to cover everyone, have\nticipants confirmed details: If 95% of\ncalled the Chafee group's bid the Sen-\nstood up instead for millions of hard-\nAmericans didn't have health Insur-\nate's last shot at bipartisan reform.\nworking middle-class Americans.\"\nance by 2002, a commission would\nRepublicans' \"objective is health-\nKeeping options open, the House\nrecommend a plan for achieving uni-\ncare reform, and the president's is\npanel also narrowly approved a Cana-\nversal coverage. Congress would have\nuniversal coverage,\" he said. If Cha-\ndian-style bill that would replace pri-\nto approve it within six months.\nfee's bid fails, he predicted, Senate\nvate insurance premiums with payroll\nIf Congress failed to act, the bill\nDemocrats will try to pass a bill with\ntaxes to pay medical bills.\nwould require individuals to buy their\n51 votes, only one Republican. That\nThe panel's version of the Clinton\nown health insurance.\nwould let Democrats campaign as\nbill requires employers to pay for in-\nFinancing remains in dispute.\nhealth reformers but let Republicans\nsurance, has subsidies for small firms\nOne proposal is to tax top-dollar in-\nblame them for the taxes involved.\nBy Tim Dillon, USA TODAY\nand expands coverage for women's\nsurance policies at 25% to 35% of the\nLOBBY: Hillary Rodham Clinton addresses\nhealth, mental illness and adult dental\ndifference between their cost and av-\nToday's debate, 10A\nhealth-reform backers on Capitol Hill.\nUSA TODAY\n6-24-94\nToday's debate: HEALTH\nKeep up the push for\nreal health-care reform\nMillions of Ameri-\nOUR VIEW\ncould choose to ignore the mandate, or it\ncans are denied ba-\ncould simply fail to fund the subsidies. It\nsic primary care. That's\nhas done that before.\nIf so, the reform would fail to attain the\nIntolerable.\ngoals that have put it at the top of the na-\ntion's political agenda.\nSomewhere toward the misty-murky\nStill, the deal has undeniable political\nmiddle of the health-care debate stands -\nmerit. As a bipartisan proposal from the in-\nor, more aptly, sits - the Rump Group.\nfluential Finance Committee, it may well\nIt is a coalition of moderate senators, all\nmove the debate to the full Senate.\nmembers of the powerful Senate Finance\nThat's a crucial service, for even if in-\nCommittee, and their\ncomplete, some type of reform that moves\nwork on a health-care-\nus toward health care for all is needed.\nreform compromise\nMore than 38 million Americans still lack\nmay well offer the best\nhealth insurance at any moment.\nhope for meaningful\nReform\nSuch high levels of uninsurance are un-\naction on health reform\nFRIDAY, JUNE 24, 1994 USA TODAY\nacceptable twice over. In this nation, no\nthis year.\nTheir plan is simple.\n$\none should be denied basic health care.\nS\nM\nAnd no one should pay outrageous prices\nEnact market reforms\nin order to cover the cost of somebody\nto make insurance\nelsc's unreimbursed care.\nmore available. Then,\nThat is, in part, why President Clinton\nif fewer than 95% of all Americans remain\nintroduced his health-reform legislation\nuninsured by 2002, impose an \"individual\nlast fall. His plan, however, requires em-\nmandate\" requiring all consumers to buy\nployers to provide insurance for their work-\ninsurance. Subsidies for the near-poor -\ners, a strategy that is bitterly opposed by\nthose earning up to 240% of poverty level\nconscrvatives. They are wrong, but they\n- would be financed by taxing those who\nhave neverthcless managed to force the re-\nget better-than-basic insurance benefits.\nform process to a grinding near-stop.\nThe compromise is useful but risky.\nTime is running out for this year, and the\nFor the first eight years, it won't provide\nnext Congress may be even more ambiva-\nuniversal coverage, and thus it cannot as-\nlent. So even if the latest compromise plan\nsure health-care costs will be brought under\nis incomplete, its bipartisan character\ncontrol. During that time, if private sector\npromises to help drive the debatc forward.\npressures fail, national health spending\nOther proposals lack that quality, and\ncould double, exceeding $2 trillion. And\nwithout it, you can kiss real health reform's\nmillions would remain uncovered.\nRump\ngoodbye.\nMoreover, there's no guarantee Congress\nwill obey its own 2002 deadline. Congress\nCongress & health care, 8A\nNo need for this 'reform'\nImpact of\nthey got there. President Clinton is asking\nOPPOSING VIEW\nmany of\nlegislators and the American people to trust\nhim on this one.\nthese proposed cures would be\nThough the people seeking to foist a\nfar worse than the disease.\nmassive federal intrusion into the U.S.\neconomy clearly have no idea what they\nBy Armstrong Williams\nare about, it is at least clear that any rushed\nHealth care is showing some vital signs\noverhaul of this magnitude could be a ca-\nas Congress rushes to pass legislation be-\ntastrophe that we can never unmake.\nIt would institute a national health board\nfore the fall elections. Before inflicting\nthat would make medical decisions for in-\nwidespread damage for political gains,\nCongress should remember the principal\ndividual Americans and their doctors, and\naxiom of medicine: first, do no harm.\nit would devastate a struggling economy.\nPassage of a rushed package this summer\nBusinesses will cut jobs, wages or both to\nout of the current chaos on Capitol Hill\ncompensate for the increased expenses they\nwould be an unmitigated disaster for our\nwill incur under almost any form of federal\nhealth care.\neconomy and our medicine.\nThink you're confused about health\nA study by the state of California esti-\ncare? Members of Congress and their staffs\nmates job losses due to employer mandates\ndon't know any more than you do. There is\nalone at up to 3.8 million jobs. Wage earn-\ners and small businesses will be hardest hit.\nno plan.\nThe federal Office of Technology Assess-\nThe rest of the costs will be borne by con-\nment has determined that it is impossible\nsumers who will no longer be assured a\nchoice of doctor or even treatment.\nto even make a \"reasonable guess\" about\nthe costs of the various loose concepts\nThe medical system does not need a\nfloating around.\nhasty and radical overhaul. Public support\nThe Clinton administration's advocates\nfor the \"Hillary plan\" has dwindled to 33%.\nof change have never presented anything\nLet the monstrous plans percolating in the\nlike a detailed implementation program or\nlegislative committees die there, for the\nhealth of all Americans.\nspecific cost estimates for their plan. Nor\nhave they detailed how they plan to cover\nArmstrong Williams is a Washington busi-\nthe costs. They have offered only a bottom-\nnessman, writer, radio talk-show host and edi-\nline net figure with no evidence for how\ntor of The Right Side newsletter.\n98\n6/24/94\nLos Angeles Times first-edition\nHouse Panel Approves Health Care Plan Similiar to\nPage 1 for Friday, June 24, 1994:\nClinton's (Washn) By Karen Tumulty and William J.\nEaton= (c) 1994, Los Angeles Times=\nTop of page:\nWASHINGTON President Clinton's beleaguered effort to\noverhaul the nation's health care system took a step\nCol 1: La Mamma is the same dominant figure in Italy\nforward in Congress Thursday, when the House Education and\ntoday that she was in Caesar's time, but she is raising\nLabor Committee became the first committee in the House to\nfewer \"bambini\" than ever, and her changing role is\napprove a health plan that closely resembles the\nforcing a social revolution in a country that is running\nadministration's.\nout of children. (ITALY-BIRTHRATE, will move overnight).\nElsewhere on Capitol Hill, however, the fate of health\nlegislation remained in question. In the Senate, a\nCols 2-4: Photo of developments in Rwanda. (refers to\nbipartisan group of moderate Finance Committee members\nstory inside).\nencountered stiff resistance from both the left and the\nright as they attempted to fashion a bill that carries the\nCols 5-6: Giving President Clinton's health care plan a\nthreat of imposing a government requirement that uninsured\nneeded boost, the House Education and Labor Committee\nindividuals buy health coverage.\nbecomes the first committee in the House to approve a\nPassage of a bill similar to Clinton's was never in\nhealth reform plan that closely resembles the\nquestion in the Education and Labor Committee, the most\nadministration's. (HEALTH-TIMES, moved).\nliberal of the three House panels considering health\nlegislation. Indeed, it also narrowly approved Thursday\nAbove fold:\nthe most radical of the health care options before\nCongress: a Canadian-style, government-financed health\nCols 2-3: Top law enforcement officials huddle in the\ncare system known as ``single payer.\"\nDistrict Attorney's office as a grand jury convenes for a\nBut the committee's 27-17 vote in favor of a plan that\nfifth day to hear witnesses in the murder case against\nhews to Clinton's goal of guaranteeing coverage for every\nO.J. Simpson. (SIMPSON-TIMES, moved).\nAmerican nonetheless marked a milestone and assured that\nhealth legislation can reach the House floor. The vote,\nCol 4: Both men and women are flooding domestic\ngenerally along party lines with two Democrats defecting,\nviolence hotlines as a result of news coverage surrounding\nfollowed similar action earlier this month by the Senate\nthe O.J. Simpson case. (SIMPSON-HOTLINE, moved).\nLabor and Human Resources Committee.\nCol 6: A top cigarette company executive rejects\n(Begin optional trim)\nallegations by Food and Drug Administration Commissioner\nDavid A. Kessler that the company concealed efforts to\n\"With today's action, for the first time ever, a\ndevelop a high-nicotine form of tobacco. (TOBACCO-TIMES,\ncommittee in each house of Congress has reported a bill\nmoved).\nthat guarantees universal coverage,\" Clinton said in a\nstatement issued by the White House after the vote. ``They\nBelow fold:\nhave broken the chokehold of special interests, and, by\nchoosing to cover everyone, have stood up instead for\nCol 3: Senior officials at the Treasury Department and\nmillions of hard-working middle class Americans.\"\nthe White House have been told by their attorneys that\nAdded Chairman William Ford, D-Mich.: \"It's going to\nthey do not expect special counsel Robert B. Fiske Jr. to\nbe on the floor in a matter of weeks. Everyone's going\nseek any criminal indictments against them for their\nto get the chance to put up or shut up.\"\ncontroversial meetings linked to the Whitewater scandal.\nThe Education and Labor Committee bill is significantly\n(WHITEWATER-TIMES, moved).\nmore generous than Clinton's. Over five years, it would\nadd an extra $30 billion in health benefits and subsidies\nCols 5-6: Los Angeles Raiders agree to reamin in the\nfor the poor and small businesses.\nColiseum for the 1994 season.\n(End optional trim)\nBottom of page:\nMeanwhile, the Ways and Means Committee plodded\nCols 1-2: With no warning and after claiming that\nthrough\nactress Faye Dunaway would be an apt fit to replace Glenn\na series of minor amendments to its health bill, but\nClose as the star of the Andrew Lloyd Webber musical\nacting Chairman Sam Gibbons, D-Fla., called the lawmakers\nSunset Boulevard,\" the composer's Really Useful Company\ninto unusual weekend sessions in a drive to finish work by\nannounces that the show will close in Los Angeles this\nnext Tuesday.\nSunday because Dunaway cannot meet the musical demands of\nSo far, with a single exception, the Ways and Means\nthe role. (with art). (SUNSET, moved).\npanel has kept to its chairman's call to match spending on\nbenefits with new revenues to pay for them. The biggest\nCols 5-6: Feature on permits to carry a concealed\nchallenge ahead appears to be the financing provisions,\nweapon in Los Angeles County.\ncoming up for votes early next week.\nThe third House committee considering health\nSent: 10:25 p.m. EDT. For questions, call (800)\nlegislation Energy and Commerce appears hopelessly\n283-NEWS, ext. 77832.\ndeadlocked, and unable to even begin producing\nlegislation.\nLos Angeles Times-Washington Post News Service=\nUltimately, House leaders will have the task of melding\nthe committee bills into a single piece of legislation\nthat they hope to bring to a vote this summer.\nMany in the House are watching the Senate and\nspecifically its Finance Committee with a wary eye. They\nare reluctant to take a dangerous political stand on\nhealth care until they are confident that the Senate will\n99\n6/24/94\nnot undercut them by insisting on something more\nResolution Trust Corp. to the Justice Department that\nconservative.\nnamed President Clinton's 1984 gubernatorial campaign as a\nHopes for a compromise in the Finance Committee are\npossible beneficiary of criminal acts at a failed Arkansas\nriding on the group of moderates, who say they are close\nthrift.\nto agreement. Their plan would first put into place a set\nBut administration sources say they are increasingly\nof changes in insurance practices that are aimed at making\nconfident that Fiske will conclude that portion of his\nhealth coverage more affordable.\ninvestigation without seeking any criminal charges against\nPresumably, those measures alone would expand the\ncurrent or former officials of the Clinton administration.\nnumber of people who have health coverage now roughly 85\nAlthough administration sources stress that they have not\npercent of all Americans. But if 95 percent of the public\nbeen given any information by Fiske's office on the status\ndid not have coverage by the year 2002, a so-called\nof his investigation, they say that attorneys hired by\n``individual mandate\" would kick in, forcing people to\nadministration officials who have been subpoened and\nbuy health coverage, just as state law now requires them\ninvestigated by Fiske are now certain that Fiske will not\nto buy insurance for their cars.\nmove against them.\nThe moderates' approach is an effort to reach Clinton's\n\"Based upon my understanding and assessment of what is\ngoal of universal coverage without his proposal to require\ngoing on, I don't see the basis for any criminal\nbusinesses to pay for 80 percent of their workers'\nindictments,\" said Steven Tabackman, an attorney who\ninsurance. That has proven the single most controversial\nrepresents Jack Devore, the former chief spokesman for the\nprovision of the Clinton plan, with business groups\nTreasury Department who testified about his involvement\nwarning that the additional cost would force many small\nbefore the Whitewater grand jury earlier this year.\nfirms to lay off workers or shut down entirely.\nThe Treasury Department became embroiled in the\nHowever, it is far from certain that there would be any\nWhitewater controversy because of the administration's\nmore support for a bill that could force middle-class\ninability to name someone to run the RTC on a permanent\nfamilies to spend thousands of dollars a year on health\nbasis. In the interim, deputy Treasury Secretary Roger\ncoverage. Moreover, it is unclear whether such a\nAltman became acting RTC chairman last year, and other\nrequirement could be enforced.\nsenior Treasury aides helped him work on RTC issues on an\nad-hoc basis. The duality of their roles as Clinton\n(Optional add end)\npolitical appointees and running an independent regulatory\nagency raised questions about their actions after they\nPoor and low-income people would receive government\nheld a series of meetings with White House officials to\nsubsidies to help them afford the coverage. However,\ndiscuss the Whitewater case.\npaying for those subsidies could mean hundreds of billions\nin new taxes.\n(Begin optional trim)\nConservatives already had expressed opposition to the\nindividual mandate. On Thursday, liberal groups chimed in\nFiske has been moving to conclude the Washington\nas well.\nportion of his investigation first in order to allow\nThe Senate Finance Committee is moving toward\nCongress to begin hearings this summer on the controversy.\nabandoning millions of American health care consumers,\"\nThe Arkansas portion of his probe covering the origins of\nsaid Robert Carolla, legislative counsel to the Consumers\nthe controversy including the Clintons' investment in the\nUnion.\nWhitewater real estate development and the failure of a\nIn a letter to each member of the Finance Committee,\nLittle Rock, Ark., thrift owned by their Whitewater\nthe Health Care Reform Project a coalition of 56\npartner is likely to take much longer.\norganizations that support the president's plan also said\nSeparately, the White House said it would comply with a\nthat it opposes the alternative being crafted by the\nrequest by the Senate Banking Committee for\nmoderates.\nWhitewater-related documents, which the committee wants in\nWe strongly urge you to reject this approach or any\npreparation for the start of Whitewater hearings, probably\nothers that fail to meet the test of guaranteeing all\nin late July. Presidential spokeswoman Dee Dee Myers said\nAmericans affordable comprehensive coverage,\" the groups\nthe White House received a letter Wednesday night from\nwrote.\nSenate Banking Committee Chairman Donald Riegle, D-Mich.,\nand Sen. Alfonse D'Amato, R-N.Y., the ranking Republican\non the panel, asking for documents already turned over by\nthe White House to Fiske. The committee said in a statement\nthat it wants documents from current and former officials\nAdministration Officials Not Expecting Whitewater\nat the White House and other agencies, who may have had\nIndictments(Washn) By James Risen= (c) 1994, Los\nsome involvement in the Washington aspects of the\nAngeles Times=\nWhitewater case.\nWASHINGTON Senior officials at the Treasury Department\n``It was not a subpoena. Just a letter,\" said Myers.\nand the White House have been told by their personal\n`We will cooperate.\"\nattorneys that they do not expect special counsel Robert\nFiske to seek any criminal indictments against them for\n(End optional trim)\ntheir controversial meetings linked to the Whitewater\nscandal.\nThe growing sense that no indictments will be\nFiske is said to be close to completing the first phase\nforthcoming from Fiske has had a positive effect both at\nof his Whitewater investigation, focusing both on the\nthe White House and the Treasury Department, and has\nsuicide of White House deputy counsel Vincent Foster Jr.\nhelped heal wounds between officials in the two buildings\nand the way in which administration officials responded to\nthe news of a Whitewater-related criminal referral by\nIndeed, the pressure from the scandal this spring had\nfederal regulators.\nled to a quiet round of finger-pointing about news leaks\nThat aspect of the probe will focus in part on a series\namong White House aides and Treasury staffers. And it\nof meetings between Treasury and White House officials in\nseemed to make officials on both sides wary of informal\nthe fall of 1993 and early in 1994 to discuss how to\nconversations and spur-of-the-moment meetings.\nrespond to a criminal referral from investigators at the\nNow, Treasury Secretary Lloyd Bentsen believes that his\n$100\nHawaii\nMassachusetts\nOregon\nWashington\nUnder a 1974\nemployers\nIn 1\nbecame the first state\nEnacted its own \"play or\nIn 1\nenacted guaranteed\nmust pay at\n50 percent\nto enact a\nor\nman\nin 1\nIn\n1\nI,\nthe\nuniversal\ncoverage,\nof their employees health\nmandate requiring employers\neffective date was delayed\nrequiring all employers to\ninsurance premium. The\nto either provide private\nuntil 1995, and in 1993 it was\ncontribute at least 50 percent\nrequirement doesn't include\ncoverage directly to their\ndelayed again to March 1997\nof the premium charged by\ndependents or part-time\nemployees or make payments\nfor firms with 26 or more\nthe lowest-price health plan in\nworkers.\nto a public fund. In 1991, the\nworkers and to January 1998\nan area beginning in 1997.\nimplementation date was put\nfor firms with 25 workers or\noff to 1995 due to concerns\nless.\nabout the economy and a\nchanged political\nclimate. Gov. William\nWeld will propose repeal\nof the mandate later\nthis year.\nEmployers block efforts by states\nto mandate health care payments\nBy Karen Riley\nTHE WASHINGTON TIMES\nSTATES\nMassachusetts Gov.\nThey call themselves the States That\nFrom page B8\nWilliam Weld has\nCouldn't Wait - states that have en-\nacted some form of health care reform\nsaid he will propose a\nthese state examples show how\nahead of any federal action.\nhard it will be to get a federal em-\nrepeal of the mandate\nA few officials from some of these\nployer mandate.\nstates recently came to Capitol Hill to\n\"It's extremely difficult, no\nthis year.\ngive a pep talk to Democratic law-\ndoubt about it,\" he said.\nmakers who have been frustrated by\nBut observers point out that\nthe lack of progress on a federal health\nthere are special problems at the\nmandate, seems even further from\nbill.\nstate level that don't exist nation-\nuniversal coverage.\nIn separate meetings with House\nally.\nIts play-or-pay mandate cleared\nand Senate members, the state offi-\nStates are skittish about passing\nthe legislature in 1988 with little\ncials told them not to yield to intense\nlaws viewed as contributing to a\nscrutiny because lawmakers\nbusiness opposition to achieving uni-\nbad business climate; critics insist\nwanted to give Gov. Michael Du-\nversal health care coverage by requir-\nemployer-mandated programs\nkakis, the Democratic candidate\ning employers to pay their workers'\nwould create such problems.\nfor president, an issue to run on.\nhealth insurance premiums.\nAnd a federal law bars states\nMs. Buell, who is co-chairman\nVoting for employer-mandated in-\nfrom regulating self-funded\nof the Massachusetts legislature's\nsurance, in which employers are the\nhealth plans, which are carried by\nJoint Standing Committee on\npayers of health insurance premiums,\na majority of companies. Thus, for\nHealth Care, said the potential\nis not tantamount to political suicide,\nstate mandates to be effective,\nramifications weren't immedi-\nthe officials said.\nstates must get a waiver from fed-\nately apparent. Moreover, the plan\n\"We got re-elected anyway,\" state\neral law; such legislation is on hold\nwas backed by major employers\nRep. Carmen Buell, Massachusetts\npending national reform.\nbecause they believed it would re-\nDemocrat, recalled saying in meetings\nHistory suggests that \"passing\nduce their own health care costs\nwith the House Democratic Caucus\na bill doesn't guarantee that debate\nby shifting the coverage of some\nand the Senate Democratic Policy\nis over,\" said Jim Weidman, a\ndependents.\nCommittee, congressional Democrats'\nspokesman for the National Feder-\nBut in the next few years the\ntwo chief policy-making arms.\nation of Independent Business\nstate's economy soured rapidly,\nBut as enthusiatic as the state of-\n(NFIB), the main organized oppo-\nand legislators decided that it\nficials are, the realitv is that none of\nnent of the mandate at the state\nwasn't the time to push ahead with\nthe states has implemented laws that\nlevel.\nthe mandate, she said. And big\nwould force employers to foot much of\nConsider the case of Oregon.\nbusiness decided to oppose the\nthe bill for health insurance.\nThe Oregon legislature enacted\nmandate, fearing it would discour-\nIn the past eight years, the employer\na plan in 1989 for achieving univer-\nage business formation and eco-\nmandate has been enacted in three tra-\nsal coverage based on \"play or\nnomic growth.\nditionally liberal states: Massachu-\npay\" rules for employers. Compa-\nThe reform law had set 1992 as\nsetts, Oregon and Washington.\nnies were required to play along\nthe effective date for the mandate.\nA glance at those three shows how\nand pay their workers' premiums\nIn 1991, Massachusetts law-\ndifficult it is to achieve reforms that\nor pay into a public fund that\nmakers voted to postpone the im-\ninclude the mandate.\nwould finance coverage for their\nplementation until 1995 after re-\nOregon has twice delayed the date\nemployees.\njecting a repeal of the reform.\nwhen employers must begin insuring\nWhen the bill passed, Demo-\nMassachusetts Gov. William\ntheir workers.\ncrats controlled the government,\nWeld has said he will propose a\nMassachusetts has never imple-\nand business was devoting most\nrepeal of the mandate this year,\nmented its health reform plan and is\nits attention to a fight over a pro-\nand that proposal may prevail.\nlikely to kill it this year.\nposal to raise the minimum wage.\nThe history of the employer\nIn Washington state, reform based\n\"It was a mistake,\" said Fred\nmandate in Washington state has\non an employer mandate passed last\nVan Natta, a lobbyist with the Or-\nbeen shorter.\nyear largely because Democrats had\negon State Homebuilders Associ-\nRep. Dennis Dellwo, a Demo-\ntaken control of the Statehouse.\nation.\ncrat who heads the House Health\nHealth reform measures have been\nBut Republicans took over the\nCare Committee, said the state's\nintroduced in nearly every other state\nstate House of Representatives in\ncomprehensive proposal for guar-\nin the past few years but have not been\n1991, and business focused on the\nanteeing universal health cover-\naccepted.\nmandate. Business interests tried\nage was approved last year largely\nHawaii has had an employer man-\nto repeal the mandate but settled\nbecause of Democratic control of\ndate since 1974. But health reform ob-\nfor a postponement of the effective\nboth houses and the governor's of-\nservers say that happened too long ago\ndate from 1992 to 1995. Last year,\nfice.\nin a state isolated from the mainland to\nthey won a delay until March 1997\nEven then, intense business lob-\noffer much of a lesson for the current\nfor companies with 26 or more\nbying forced lawmakers to scale\nnational debate.\nworkers and to January 1998 for\nback the benefit package and re-\nDick Merritt, the director of George\nfirms with fewer employees.\nduce the amount companies would\nWashington University's intergovern-\n\"It's been as volatile out here\nhave to pay, he said. The proposal\nmental health policy project, said\npolitically as it has been in Wash-\nwent from requiring companies to\nington, D.C.,\" said Barney Speith,\npay 80 percent of their employees'\nsee STATES, page B9\nexecutive vice president of Blue\npremiums to 50 percent.\nCross and Blue Shield of Oregon.\nThis year, as the possible effects\nA factor in the delay was that\nof the law have seeped in, business\nsome specifics of the plan had not\nopposition to the mandate has\nbeen worked out by a health care\nrisen, said Carolyn Logue, direc-\ncommission. These included such\nFRIDAY,\ntor of the Washington state office\nthings as what would be in the\nof the National Federation of Inde-\nbenefit package and what relief\npendent Business.\nwould be available for small, mar-\n\"We've got a lot of scared people\nTimes\nginal companies.\nright now,\" she said, adding that\nPublic sentiment on the man-\nsome lawmakers are rethinking\ndate may be tested in Oregon this\ntheir votes. \"We're talking to legis-\nfall because the architect of Or-\nlators who are going, 'Oh, my gosh,\negon's health plan, Dr. John Kitz-\nwhat did I vote for?'\nhaber, former president of the\nMr. Dellwo disagrees about the\nSenate, is the Democratic candi-\npolitical impact. \"People almost\ndate for governor.\nunanimously believe there's need\nMassachusetts, which once\nThe\nfor a change in health care. It's not\nclaimed bragging rights as the\ndeveloping into a campaign\ne,\"\nfirst $ : to e reform with a\nhe\n\"I have no oppo\nyet.\"\nHillary\nIn what was described as a\nstant kowtowing to accommodate\nhappens. \"Eventually, there will\nrhetorical removal of the gloves,\npolitical and personal needs.\nbe enough of us that we'll just\nFoley: 'No vacancy\n\"Evenings are a treadmill of\nBob Dole slammed Hillary\nsay, 'Enough of this stuff.' But it'll\nreceptions and fund-raising\nRoll Call reports that House\nRodham Clinton for taking a\ntake a while,\" said Rep. Patricia\nevents. The leader's personal po-\n\"C\nshot\" at Congress to win\nSchroeder, Colorado Democrat.\nSpeaker Thomas S. Foley is at-\nlitical agenda must usually\ntempting in a series of intimate\nsupport for the Clinton health\nmarch in lockstep with the party\ndinners to squash rumors he will\ncare plan.\nThe Los Angeles Times said\nline, however ill-plotted and tortu-\nThe Carter mission\nnot be a candidate for party\nthat in a closed session of the Fi-\nous it may be\nIn contrast to other former\nleader in the next Congress.\nnance Committee on Wednesday,\n\"The vote for majority leader,\npresidents, Jimmy Carter's ef-\nAs he dines with small groups\nthe angry Senate minority leader\nset for next January, is a pitiless\nforts as a troubleshooter seem\nof House Democrats, however,\nand public judgment of each can-\n: so far as to ask the panel to\n\"particularly selfless,\" wrote col-\ntwo potential successors - Ma-\ntake the extraordinary step of\ndidate's worth by his peers. It is\numnists Jack Germond and Jules\njority Leader Richard A. Gep-\nnot a race for the weak-kneed.\"\npublicly criticizing the first lady.\"\nWitcover.\nhardt and Rep. Charlie Rose of\nHis North Korean visit may\nNorth Carolina - are seeking fa-\nMrs. Clinton had said on a tele-\nvision program Tuesday night\nLimits loves Rosty\nhave moved everyone back a bit\nvor with a new crop of freshman\nfrom military confrontation. \"If\nmembers.\nthat it is \"only fair\" that Amer-\nU.S. Term Limits is so happy\n8 should have health care\nso, he will have demonstrated\nBoth men are contacting\nabout the indictment of Rep. Dan\nbe\nts \"as good as those en-\nonce again why he may\nbe\nDemocratic candidates in open-\nRostenkowski that it issued a\nbetter remembered for his time\nseat races or likely-pickup dis-\njoyed by members of Congress.\"\nRosty poster, the National Jour-\nThe Kansas Republican was\nafter leaving the White House\ntricts. In keeping with tradition,\nnal reported.\n\"incensed\" because he felt Mrs.\nthan for his time in it.\"\nthey do not mention the\nThe former head of the Ways\nClinton was trying to exploit pub-\nMeanwhile, the administra-\nspeakership. Instead, each offers\nand Means Committee is \"our\nlic dissatisfaction with Congress\ntion's shift from chagrin to cau-\nhelp with fund-raising and re-\n1994 poster child for term limits,\"\ntious optimism over the talks\nsearch.\nand because the congressional\nsaid Ronald Nehring, the group's\nIn his dinners Mr. Foley quells\nplan is the same one that covers\nonly underscores a public per-\ndirector of congressional affairs.\nception of drift in the Clinton\ntalk he will become secretary of\nPresident and Mrs. Clinton and\nU.S. Term Limits will distribute\nall other federal employees.\nconduct of foreign policy gener-\nstate or an ambassador, Roll Call\nsome 100,000 copies of the poster,\nally, the two men wrote.\nsaid. Some observers think Mr.\nThe Times' Karen Tumulty\nwhich features \"Rosty, the Post-\nRose is angling to replace GOP\nsaid, \"The new, more personal\nman\" on a mock postage stamp.\nSen. Jesse Helms, who is not ex-\ntone in the health care debate re-\nThe National Journal adds that\nFutures\npected to run in 1996.\nflects the make-or-break point\nthe organization's efforts are at-\nthat the deliberations have\nIn Missouri, state Rep. Steve\ntracting attention.\nreached, as well as lawmakers'\nCarroll, considered among the\nPundit Leno\nIt so vigorously supported win-\nfront-runners in the crowded\nsensitivity to the low regard the\nning Republicans in special elec-\npublic now has for Congress.\"\nfield seeking the Democratic\nNBC's Jay Leno on \"the big\ntions in Oklahoma and Kentucky\nSenate nomination, dropped out\nstory\" in Washington: \"We've fi-\nthat the Democratic Congres-\nminutes before deadline and filed\nnally got a president with a for-\nToday's quote\nsional Campaign Committee has\nfor a state Senate seat.\neign policy, willing to stand up on\n\"I don't know what would have\ncomplained to the FEC.\nprinciple and confront the North\nKoreans, I think it's great\nhappened had I not met with Kim\nHollywood\n\"But enough about Jimmy\nIl-sung,\" Jimmy Carter said in a\nToday's quote II\nCNN interview.\nOne of the insights from the\nCarter.\"\n\"Everybody in town is trying to\nCommon Cause report on Presi-\nOf course there are extremely\nFeel your pain?\nfigure out where Bob Dole is [on\ndent Clinton's raising of \"soft\nconservative candidates this year,\nhealth care],\" Sen. Dave Duren-\nmoney\" despite pledges of re-\nbut their agendas seem more\nSingapore may yet pay dearly\nberger, Minnesota Republican\nform was the degree to which the\neconomic than social, he said. \"To\nfor rapping Michael Fay - the\nand health care moderate, told\nWhite House has tapped the en-\nthe extent that the religious right\ncost of feeding President Clinton.\nthe Wall Street Journal.\ntertainment industry.\nis having a dramatic impact on\nWord from the White House is\n\"Just because it's good for Re-\nShow biz trails only the finan-\nthe political scene, my impres-\nthat he will visit the caning capi-\npublicans doesn't mean it's good\ncial industry and organized labor\nsion is that it is on intraparty\ntal in November\nlegislation\nBut if we had\nas a soft-money contributor to\nmatters and in local elections.\nThe honor of a presidential\nBob Dole [on our side], we'd add\nDemocrats, said the Los Angeles\n\"Many Democratic attacks\nvisit - in conjunction with his\n12 people.\"\nTimes. Over a 21-month period, it\ndo come awfully close to reli-\ntrip to Indonesia and Australia\ngave more than $2.6 million.\ngious intolerance, however.\"\nmay seem at odds with threats\nAcquittal\nAmong the contributors: Time\nof diplomatic retribution for the\nWarner Inc., $508,333; Walt Dis-\nLoves veggies\nFay caning, but there's prece-\nA former Pennsylvania state\nney Co., $250,000; recording pro-\nsenator was acquitted of charges\nducer David Geffen, $220,000;\nHillary Rodham Clinton said\nPresident Bush went there\nhe illegally opened voting ma-\nSony Corp., $175,000; director\nher husband gets \"a bad rap\"\nwith smiles on despite\nchines and absentee ballots.\nSeven Spielberg, $100,000; actor\nwhen it comes to food: Sure, he\nSingapore's refusal to abide by\nWilliam G. Stinson, 50, had\nChevy Chase, $35,000.\nlikes to eat, but it's not just junk\nhis administration's intercession\nbeen stripped of his office be-\nThe law permits corporations,\nfood.\nto lift censorship sanctions on the\ncause of fraud by his campaign\nlabor unions and individuals to\n\"My husband has good eating\nAsian Wall Street Journal and\nin the Nov. 2 special election.\nmake unlimited \"soft\" donations\nhabits,\" the first lady said as she\nother U.S.-related publications.\nThis week he was cleared of re-\nto the national parties for \"party\nparticipated in front of the White\nlated charges by a judge who\nbuilding\" while limiting direct\nHouse in a ceremony denoting\nClinton zaps GOP\nheard the case without a jury.\ncontributions to candidates for\nFruit and Vegetable Month.\nA former Stinson aide pleaded\nfederal office.\n\"He really does love fresh\nPresident Clinton has accused\nguilty Monday to absentee-ballot\nfruits and vegetables\nHe's not\nRepublicans of trying to divide\nfraud, and a second aide awaits\ntrial on election violations. Re-\nThe Christian right\na big sweet eater or any of that,\"\nthe American people with a \"cul-\nshe said in a tone that was de-\ntural war\" over moral, racial and\npublican Bruce Marks sued after\nIn Roll Call, analyst Charles E.\nscribed as playfully defensive.\nethnic issues.\nelection results showed him los-\nCook says the \"validity\" of the\n\"He got a little bit of a bad rap, I\nThe president sounded the\ning to Mr. Stinson by 461 votes.\nDemocratic attack on the reli-\nthink.\"\n1\ne in partisan speeches at\nA federal judge said the Stin-\ngious political activists may be a\n\"He's got good [eating] habits,\ntwo Democratic fund-raisers that\nson campaign had coerced, in-\n\"little dubious\":\nand they include fresh fruit and\nnetted $3.5 million for party ac-\ntimidated and deceived voters\n\"I've met with plenty of\nvegatables - and broccoli,\" she\ntivities - and drew criticism\ninto casting absentee ballots, an\ncandidates from both parties over\nsaid in a swipe at former Presi-\nfrom campaign finance reform\noption restricted by law to voters\nthe last 18 months, and I've seen\ndent Bush, who banned the vege-\ngroups.\nunable to make it to the polls.\nvery few that I would describe as\ntable from his White House.\nHe said Republicans believe\nvery closely associated with the\nShe was asked to say what food\nthey can pick up seats in Con-\nin the fall elections by pro-\nPotty parity redux\n'religious right' - even though a\nMr. Clinton likes best. \"Well,\ng\nlarge number of conservative\neverything,\" she said, smiling\nmoting cynicism, bombarding\nMark Z. Barabak of Copley\ncandidates will receive support\nbroadly.\nAmericans with negativism and\nNews Service noted in his report\nfrom such forces.\"\nfocusing on \"process and conflict\non the gains women have made in\nins\nof substantive product.\"\nCongress that bathroom avail-\nWatch out, Rush\nKennedy organizes\nHe also seemed to be lashing\nability remains a point of consid-\nerable annoyance.\nThe Chicago Sun-Times re-\nFacing his toughest re-election\nout at conservative Republican\never, Sen. Edward M. Kennedy is\ntalk radio shows like that of con-\nMen's facilities are just off the\nports that Ross Perot is\nlaunching a new career as a talk-\norganizing an early attack on his\nvative Rush Limbaugh for\nHouse floor. Female members\nbi\nng divisiveness.\nmust leave the chamber, cross a\nshow host and commentator for\nlikely GOP opponent, Mitt Rom-\nTribune Radio Networks. Starting\nney.\nhallway and hike into the re-\nOct. 1, the Texas billionaire will\nThe Boston Globe reports that\nThe leaders'job\ncesses of the speaker's office, a\nhost a live, weekly call-in show.\ncampaign insiders say the strat-\njourney that takes several min-\nIn its account of the \"subterra-\nutes, Mr. Barabak reported.\nThe deal also calls for Perot to\negy is dictated by a flurry of ag-\nThis inequity is a matter of\ndeliver commentary pieces five\ngressive reporting and the antici-\n\" struggle between Sen. Tom\nDaschle and Sen. Jim Sasser to\nor six days a week.\npation of being the target of a $1\npersistent grumbling, but nothing\nbecome the next Senate majority\nDan Fabian, general manager\nmillion advertising campaign.\nof WGN radio in Chicago, said:\nThe Globe added: \"At 62, Ken-\nleader, the New York Times re-\n\"If it is purely issues and politi-\nnedy must also allay concerns\nported \"the ugly truth\": The job\nis anything but pleasant.\ncally oriented, there will be those\nthat he's no longer up to the job\nhe has held since 1963. A cam-\n\"The chamber's 99 other sen-\nwho polarize. But if the format\nators, any of whom can bring\nallows his wit, charm and insight\npaign scrap with Romney is one\nway to show he is still vigorous\nlawmaking to a halt, demand con-\nto come through, it's impossible\nand engaged, said one source.\"\nnot to be ingratiated by him.\"\nThe Washing\nCi\n00 FRIDAY. JUNE 24, 1994\n124"
}