Clinton, Aides Hit the Road to Push Health Care Plan

His health care reform agenda on the table at last, an energized President Clinton and top Administration officials fanned out across the nation Thursday to promote a plan he said would generate “hundreds of thousands” of jobs and put raises in workers’ pockets.

Extending his promises for the plan at a televised “town hall” gathering in Tampa, Fla., Clinton said the measure would spur a boom in the hiring of home-health and preventive-medicine workers. Other jobs would be indirectly created, he said, as companies paid their workers wages that otherwise would have gone toward meeting the spiraling cost of health care.

“You’re either going to have more folks hired, or pay increases going back to employees for the first time,” Clinton told an audience gathered at Tampa’s Performing Arts Center for a meeting organized by ABC-TV’s “Nightline” program.

The President’s comments came a day after he unveiled his health plan in an impassioned speech to a joint session of Congress, and as he and his Cabinet began trying to solidify public support before the plan comes under the critical scrutiny of congressional committees next week.

On Thursday afternoon, the President and First Lady Hillary Rodham Clinton, who was in charge of the Administration’s health care reform task force, led a pep rally on the White House South Lawn for 1,100 supporters and longtime health reformers.

But in Tampa, as he sketched out the plan’s benefits for the economy and the nation, Clinton also acknowledged that the billions of dollars that the plan envisions in savings may not materialize exactly as planned.

“All of us have to prepare to face the consequences if the cost savings don’t materialize,” he said in response to a question from John P. White, the former budget adviser to 1992 independent presidential candidate Ross Perot. “Then we’re going to have to slow down the benefits or raise more money.”

Referring to the planned phase-in of some benefits between 1996 and 2000, Clinton added: “That’s why we’ve got to phase these things in carefully so it doesn’t get away from us.”

The Tampa audience included physicians, business people and average users of the health care system who had been chosen by “Nightline” producers for their interest in the subject.

Though Clinton’s speech on Wednesday was highly general, he was forced to become specific as he answered queries from the Tampa audience.

To a woman who opposed abortion, he acknowledged that under his reforms, tax money would be used to pay for the abortions of poor women. But he said that by bringing the poor into mainstream health coverage, the plan would eliminate a harmful two-tier system.

He also promised that the proposal’s new emphasis on preventive services would prevent other abortions.

“That will be a big political minefield” as the plan moves through Congress, Clinton acknowledged.

He told a woman caring for two Alzheimer’s patients that the plan would give them care that is at least as good as they receive now, and would, after a phase-in period, begin reimbursing her for the cost of in-home care.

And he told a Tampa cigar-maker that tobacco would be singled out for new tax levies because he believes that it is unfair to impose a new broad-based tax, and because tobacco use leads to heavy costs for the health care system.

Clinton was questioned by White on why the plan would phase in some added benefits--for prescription drugs and a range of preventive services--before it was proved that the system’s “managed competition” arrangement could produce huge savings.

“We have a very poor record in this country of getting savings out of the health care system,” White said.

But Clinton defended the phased-in preventive services, saying that by avoiding more expensive care later “those achieve net savings pretty quickly.”

Clinton predicted that once Congress passes the initial health care plan and Americans had their “health security cards,” the country would be irrevocably behind the new system.

“The feeling for this will sweep across America,” Clinton said, and the program will become “a tide that no one can turn back--that no one will want to turn back.”

Amid the hoopla at the White House on Thursday, there were signs that some congressional Republicans were becoming bolder in attacking the President’s plan.

Senate Minority Leader Bob Dole of Kansas went so far as to suggest that the program might have to be dramatically pared back because of cost considerations.

Vice President Al Gore, however, strongly defended the plan against criticism that the Administration has underestimated its expense and overstated its anticipated savings.

Aside from $105 billion in new revenue--largely through the tobacco tax--Clinton’s reforms would be paid for largely through $700 billion in projected savings over seven years.

“The numbers in our plan have been submitted to rigorous examination and cross-checking by all of the experts in the various government agencies,” Gore said in an interview. “They also have been submitted to analysis by private actuaries and accounting experts, companies around the nation. And they stand up very well.”

Gore also said the Administration intends to continue consulting with members of Congress--on both sides of the aisle--between now and October, when Clinton officially submits his health care reform legislation.

“We are emphasizing bipartisanship,” Gore said.

Such consultation was strongly encouraged by Sen. John H. Chafee (R-R.I.), author of what is considered the leading alternative to Clinton’s plan.

Chafee called on the President to meet with Senate Republicans in an effort to work out their differences before the bills are introduced.

He noted that the two proposals have “very significant similarities,” and added: “It’s certainly possible that serious discussions could bring us closer to agreement on those issues that we have in common.”

Chafee also suggested that the debate be put on an “informal timetable” in which the plan would face its first round of congressional hearings by Thanksgiving, be reported out of committees by spring and put to a final vote by August.

Gore said the Administration expects enactment of comprehensive health care reform before the current Congress adjourns, about a year from now.

The Clinton plan, meanwhile, also came under some fire from the left, as about 20 proponents of a government-financed system known as “single-payer” said the Clinton proposal would not achieve its goals.

Almost 90 members of the House have endorsed a single-payer measure sponsored by Rep. Jim McDermott (D-Wash.). Although congressional strategists say they believe that the single-payer adherents can be persuaded to vote for the Clinton plan, McDermott cautioned: “I think it’s always a mistake to take for granted the vote of any member of Congress.”

Conservative Democrats are seeking to put together their own alternative. Two of their leaders, Sen. John B. Breaux of Louisiana and Rep. Jim Cooper of Tennessee, met Thursday with Hillary Clinton.

With the President’s address, the Administration launched a concentrated series of promotional events aimed at winning broad public backing for the plan before it comes under intense scrutiny--and inevitable second-guessing and criticism--from various congressional committees.

Hillary Clinton gave an interview to CNN, repeating the Administration’s position that most of the “details” of the health care proposal are open to compromise but that the “principles are not negotiable.”

In California, Health and Human Services Director Donna Shalala visited with senior citizens in the San Fernando Valley on Thursday to “try to overcome some of the nervousness out there” about Clinton’s plan to extract savings from Medicare.

In a meeting with editors and reporters at The Times, Shalala said the proposed Medicare savings of $124 billion over seven years would still only “slow down the rate of growth (in the program) from three times the rate of inflation to just under two times the rate of inflation.”

Times staff writer Karen Tumulty contributed to this story.