Consumer, Labor Groups Tilt Toward Clinton Health Plan : Insurance: Support is expected from several organizations that have favored a system funded by the government. However, they are seeking other concessions.

Under pressure from the White House, some consumer and labor groups that were seeking a Canadian-style national health insurance system are now moving toward supporting the market-oriented health care reform plan being drafted by President Clinton.

If many of these groups with broad national memberships agree to support the President’s plan, as expected, they could provide Clinton with the strong constituency he needs to defend it against a likely assault from insurance companies, large employers, drug manufacturers and other opponents.

During the last year, a coalition of about 40 consumer, labor and public-interest organizations has been meeting regularly in Washington, hoping to persuade the government to enact a Canadian-style system. In political parlance, they are known as “single-payer” groups because they are seeking a health care system with just one source of funding: the government.

While the President never seriously considered proposing a single-payer system, his aides have worked aggressively to persuade these groups to support the Clinton plan on grounds that it will satisfy their desire for universal coverage, comprehensive care and cost containment.

As matters now stand, White House efforts to woo the single-payer groups are expected to yield a number of key endorsements of the Clinton plan after it is formally unveiled, possibly sometime next month.

“My assumption is that the vast majority of single-payer groups are going to be behind this,” said Ron Pollack, executive director of Families USA, a grass-roots consumer group that already has abandoned the single-payer approach.

To win the support of the single-payer groups, however, the President likely will be forced to embrace some ideas that would further alienate the insurance companies and the big employers. Given the current sentiment on both sides, it would be virtually impossible for him to please both the single-payer groups and big business.

Unlike the Canadian system, the President’s plan would continue to rely on private insurers to act as middlemen in the health care system. But at the same time, the Clinton plan also would establish new government entities known as health purchasing alliances to collect taxes and purchase insurance for most--if not all--Americans.

While the single-payer groups want to eliminate the role of insurance companies, some are inclined to support Clinton’s plan because it invests the government with a strong role in regulating the health care system and gives states the option of moving to a real single-payer plan.

Of course, some single-payer groups, such as Physicians for a National Health Program and Ralph Nader’s Public Citizen, as well as some unions, such as the Oil, Chemical and Atomic Workers Union, have indicated that they cannot support the President’s plan because it still depends on market forces.

But others, such as Consumers Union, Citizen Action, the National Assn. of Social Workers and a number of prominent labor unions, such as the Amalgamated Clothing and Textile Workers, have indicated that they are willing to consider supporting the Clinton plan, depending on the details.

“We’re willing to look at it,” said Ed Rothchild, spokesman for Citizen Action, whose board will review the Clinton plan after it is unveiled. Likewise, Gail Shearer, policy analyst for Consumers Union, said her organization “really wants to be able to support the President’s plan.”

No matter which side they are on, all of the single-payer groups said they have been lobbied heavily by Administration officials. In fact, Robert C. Dreyfuss, spokesman for 5,000-member Physicians for a National Health Program, said Clinton aides seemed “desperate” to win his group over because they need grass-roots support if they hope to persuade Congress to pass the President’s plan.

To woo the single-payer groups, the Administration has already made some concessions. Rep. Jim McDermott (D-Wash.), a single-payer advocate, often boasts that the President has borrowed several ideas from his proposal--including a health care card for every American, spending limits and an option for states to design their own plans.

But as White House advisers put the finishing touches on the Administration’s plan, the single-payer groups are demanding even more from the President in exchange for their support.

In a letter last week to the President’s chief health care adviser, First Lady Hillary Rodham Clinton, 22 single-payer organizations outlined several changes they are seeking in the Administration plan.

Among other things, the group pleaded with Clinton not to let big employers buy health insurance for their workers independently, instead of using the purchasing alliances.

In addition, the group demanded that the President’s plan require all insurers to offer health coverage to everyone at the same price, thus avoiding a two-tier system in which rich people could buy top-notch care and the poor would settle for a cheaper, second-rate health plan. Insurers want to be able to continue offering a wide variety of plans at different prices.

The single-payer groups portrayed these items as necessary for them to endorse the Clinton plan. As they reminded Hillary Clinton: “Our organizations have been at the forefront of the campaign for this type of health reform, and we have the capacity to mobilize millions of our members nationwide in support of health care reform.”

Yet while many single-payer groups may endorse the Clinton plan, some question whether they will be able to effectively rally their memberships.

“Each group will decide whether it’s prepared to take on the Clinton Administration or support it,” Dreyfuss said. “Many will not challenge the President because they have other issues they want the Administration to support. But I doubt you are not going to find any enthusiasm among them.”