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White House Panel to Seek Public’s Views on Health Care Reform Ideas : Policy: Hillary Clinton’s task force will begin the hearings next week. Officials reject AMA’s request to join in group’s deliberations.

TIMES STAFF WRITER

Hillary Rodham Clinton plans to begin public hearings on the nation’s health care problems next week, the White House announced Thursday, as Administration officials rebuffed a request by the American Medical Assn. to participate in the First Lady’s health care task force.

The hearings will be the second stage of the panel’s work. After weeks of analyzing health policy issues and gathering hundreds of ideas, the task force and its 30 working groups are supposed to begin winnowing the list of options soon.

The goal is to narrow the choices enough so that the Administration can send a final legislative proposal to Congress in May.

President Clinton, who met for the first time with top White House health policy aides last week, has said repeatedly that he wants Congress to pass a health care reform bill by the end of the year.

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Although congressional leaders have cast doubt on the feasibility of that timetable, the White House hopes to stick to it, Communications Director George Stephanopoulos said.

“As the President said repeatedly, he hopes we can get it done this year,” Stephanopoulos said. “We continue to hold that hope out.”

A spokesman for House Ways and Means Committee Chairman Dan Rostenkowski (D-Ill.) said earlier this week that completing a comprehensive health care bill this year would be “extremely unlikely.” Rostenkowski’s panel would have jurisdiction--or at least a share of it--over almost any health care plan put before Congress.

According to a task force schedule drawn up when the President established the panel, the working groups are to begin narrowing options by the middle of this month. Simultaneously, officials hope to use the public hearings, which will be conducted by the task force and the private Robert Wood Johnson Foundation, to highlight some of the major problems that health care reform should address and to begin building public support for the approach the Administration will take.

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“We need to go out and listen more, and Mrs. Clinton and I are going to do that in these public hearings,” Health and Human Services Secretary Donna Shalala, a member of the task force, told reporters.

In the last few weeks, Hillary Clinton has made a number of public appearances in connection with the work of the task force, but those appearances, such as a visit to a small steel company in New Orleans on Thursday, have been relatively low-key affairs.

Touring the Glazer Steel & Aluminum Co. plant, she talked with workers who had been unable to obtain health insurance and repeated the Administration’s pledge that its health plan will end the insurance industry practice of denying coverage to people with existing medical problems.

“There will be no more of that, no matter what plan is introduced,” she said.

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The public hearings are expected to be much more substantive and will focus largely on flaws in the existing system rather than on specific ideas for reforming it.

The first of the sessions will take place in Tampa, Fla., on March 12 to look at health care for elderly Americans. A second session in Des Moines, Iowa, on March 15 will focus on rural health issues, while a third in the Detroit area on March 22 will examine how health costs affect business competition. Organizations representing doctors, hospitals, insurance companies and other parts of the health care industry will be invited to testify at a final session in Washington on March 26-27.

At least some of those organizations already have begun pressing for a larger role in the process.

Earlier this week, AMA officials wrote Ira Magaziner, the White House aide who serves as the chief executive of the task force, asking for a more formal role in the group’s deliberations. The letter also indicated that the organization would consider backing away from its long-held opposition to a broader federal role in regulating medical practices.

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But the White House rejected the request.

“It would be a conflict of interest, we believe, to have representatives of various interest groups, regardless of their positions, as official members of the working group,” White House Press Secretary Dee Dee Myers said.

“No official representatives of any interest groups have a seat” on the task force, Myers added.

Dr. James S. Todd, the AMA’s executive vice president, said the group’s objectives had been “misunderstood.”

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“Clearly, we are not entitled to, nor do we seek a seat--what we are asking for is input into the working group. We’re going to be the group that will have to implement whatever reform comes along. We do have a lot of data and hands-on experience in the delivery of health care, and we think that ought to be valuable as these groups are developing their options,” he said.

White House officials insisted that the task force and its working groups have sought out information and ideas from all segments of the health care industry. But at the same time, they have tried to keep organized interest groups at arms length, fearing that too close an involvement with them would taint the final proposal in the public’s eye and could limit the Administration’s flexibility.

As a result, the AMA and other major health industry groups have been complaining loudly that they have been left outside Administration deliberations. The consultations with medical groups so far have been “predominantly token contact,” Todd complained.

“We have met with Mr. Magaziner. He had a group of the specialty societies in, including the AMA, and it was ‘show and tell.’ I’ve met with Shalala, and it was cordial--but there wasn’t any opportunity for real give-and-take,” he said.

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Over the past half century, starting with its opposition to a plan put forward by President Harry S. Truman, the AMA repeatedly has helped block health reform proposals. But the organization has substantially moderated its positions, Todd told Magaziner in his letter. “We know that the status quo must go,” he wrote.

Times staff writer Marlene Cimons contributed to this story.


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