NEWS ANALYSIS : Nation Braces for Another Big Leap Into Future

Every so often, usually under the compulsion of crisis, the government collectively braces itself, takes a deep breath and leaps into a largely unknown future.

During the late 1930s, the nation took such a leap, agreeing to give the federal government a whole new set of responsibilities--from providing social security for the elderly to establishing a new system of national regulatory agencies to monitor the economy. In the 1960s, the nation took another such leap, adopting a new code of civil rights laws to change fundamentally the relationship of black and white Americans.

Now, another new President has proposed a sweeping plan and the sounds echoing from the White House and the Capitol for the last few weeks have been the noises of a political system warming up once again for the big jump.

There is, of course, no guarantee that the leap will be taken. Clinton’s plan, having been put forward, will now be taken apart in a dozen or more congressional panels. Before a final decision can be made, all of them will debate whether to jump--and if so, how high, in what direction and with which foot leading.

If, however, Congress and the people opt for rebuilding the nation’s health care system, they will do so after facing one of the fundamental facts about all such leaps into the future: There is no ultimate certainty.

As even the President has conceded, the “extent you can predict” is limited. “Do we know that every last dollar is accurate, or that there will be no unintended consequences? Or that the timetable is precisely right? No, we don’t know that,” Clinton said this week.

“Nobody can know that exactly.”

“It’s a gamble, a really big gamble,” said one White House official. “Everyone acknowledges that.”

As that debate proceeds, Americans will be deluged with wildly divergent claims, all focused on one basic question: Will it work?

The President, the First Lady and their aides insist that the answer is yes. Health care reform as they propose it, Administration officials say, will cost some Americans more. But overall, they say, it will provide security to everyone, improve the nation’s economic competitiveness and control the steadily rising spiral of health care costs.

To back up their claim, the Administration has teams of experts, reams of computer printouts and piles of projections all designed to ensure Americans that this time the government has gotten the thing right. Or, as Clinton said Tuesday in a discussion with radio talk show hosts: “I want you to understand that we really have killed ourselves at least to get the arithmetic right.”

Clinton’s opponents have marshaled their own experts, complete with their own charts, graphs and projections, all designed to bolster their claims that universal health care coverage will cost too much, force companies to lay off workers and generally wreak havoc on the economy.

If the Clinton plan passes, Americans will be so upset by the problems it causes that “they’ll be hunting Democrats with dogs” by the end of the century, predicts one leading opponent, Sen. Phil Gramm (R-Tex.).

Already, the argument has taken on some of the overtones of a schoolyard standoff: “Can’t,” say the opponents. “Can, too,” respond the President’s men and women.

Opponents can--and do--point to the experience of Medicare, which has provided health care to the nation’s elderly but also has cost far more than predicted at the time it passed Congress in 1965. Clinton’s supporters, for their part, point to the experience of states such as Minnesota and Hawaii and cities such as Rochester, N.Y., which have succeeded in holding down health care costs and expanding coverage using systems similar to those Clinton now proposes to adopt nationwide.

“It is a misperception that this is a blind leap of faith,” said one senior Clinton aide. “A lot of this is based on experience. There are state experiments upon which a lot of this is modeled. It is not purely theoretical. To the extent you can predict with any kind of certitude, we have tried to make sure we have not left anything untried or unverified.”

For the country as a whole, as for its representatives in Congress, the ultimate issue will probably come down to two questions: Whom do you believe? Is the risk of standing still greater than the risk of jumping?

On both of those questions, Clinton, at least for now, appears to have a substantial advantage.

Six years ago, as then-Vice President George Bush prepared his campaign for the presidency, Republican strategists urged him to avoid talking about health care. The subject, they said, was a “Democratic issue” on which the GOP had little credibility. The more important the issue became, Bush strategists warned, the more the Republicans would be in trouble.

Two presidential elections later, that credibility gap has only widened. By large margins--sometimes as much as 40 points or more--Americans tell pollsters that they trust Democrats more than Republicans to handle health care issues. The fact that Clinton’s principle adviser on the issue is his wife, Hillary Rodham Clinton, has accentuated that gap even more, given that many Americans see health care as a family issue and believe, whether rightly or not, that women are more likely than men to handle such issues with fairness.

The best testimony for Clinton’s advantage on the issue has been the behavior of his likely opponents. In sharp contrast to the battle earlier this year over the budget and taxes, Republicans have been quick to pledge bipartisan cooperation with Clinton on the health care issue.

Ross Perot has been conspicuously silent. And while some Republicans, like Gramm and Rep. Newt Gingrich of Georgia have taken stands in sharp opposition to much of what Clinton proposes, others, led by Rhode Island Sen. John H. Chafee, have proposed plans that embrace many key elements of Clinton’s proposal--elements that only a few years ago most Republicans would have rejected out of hand.