British Health Care Fight a Hornets’ Nest : Politics: Conservatives propose reforms that cut the costs of subsidized medical care.

Britain’s reformist Conservative government has stirred up an electoral hornets’ nest with a plan to revamp the hallowed Welfare State.

Better-off Britons often take out U.S.-style private health insurance, just as they send sons and daughters to “public” schools, which in Britain means fee-paying, private and elite.

And for a growing number, private health insurance comes with the job--a “perk” provided by their employer.

But a majority holds dear to its heart the free care by doctors and hospitals provided since World War II by the state’s taxation-financed National Health Service

Such is the passion it arouses that a battle over Conservative measures of reform has produced some of the worst parliamentary language heard in British politics for months.

Prime Minister John Major, in a rare show of fury, accused his Labor opponents of lying. Labor leader Neil Kinnock retorted that the Conservatives are “pompous whingers,” using an old English term for crybaby.

Kinnock, campaigning for a general election which Major must call by June, 1992, promises to levy higher taxes on the rich so as to spend more money on health care.

His party infuriates the Conservatives by saying that their reforms aimed at cutting costs in the health bureaucracy will in reality jeopardize patients.

The dispute mirrors a debate in many advanced industrial democracies: how to finance subsidized care in an era when people live longer and new drugs and surgical techniques are increasingly expensive?

It is a conundrum as old as the pioneering British National Health Service itself.

It was introduced in 1946 by Aneurin Bevan, a left-wing firebrand and Labor government health minister whose system has endured as the basis of British state medical care.

Bevan provided free treatment for everyone, from cradle to grave. Hospitals were government-funded. Family doctors were paid a fee by the state for each patient on their books.

The new service led to extraordinary public demand, says historian Henry Pelling in his book “Modern Britain.”

The Conservatives, reelected in 1951, vowed not to repeal Bevan’s legislation.

In the 1980s, however, Margaret Thatcher’s premiership brought an abrasive new right-wing approach in charting Conservative policies.

And although a rebellion by Conservative legislators forced her to resign last November, successor John Major inherited a project she launched to reform state medical care.

This allows hospitals, while remaining in the National Health Service, to become “Trust Hospitals” and opt out of its financing system. Those that decide to do this manage their own budgets as state trusts.

Family doctors may also take part. They still get state funds for each patient but can buy hospital care for those who need it at whatever hospital seems to offer the best deal.

The Conservatives say this hybrid--an evolving free market within a state service--will in time prove more efficient.

Labor--with backing from unionized health workers, its traditional supporters, and also from many doctors in the British Medical Assn.--disagrees.

Back in 1946, many doctors opposed Bevan’s new National Health Service, fearing that it threatened their professional freedom.

The fear now is that Conservative cost-cutting will create two-tier public health that would offer privileges for patients of doctors who play the new system.

The smoldering dispute blew up in mid-May when Labor won a parliamentary by-election in what had been a “safe” Conservative constituency at Monmouth in Wales. The Labor candidate alleged government pressure on a local hospital “to opt out of the National Health Service.”