Health Plan Is ‘Superior’ to Alternatives, First Lady Says : Medicine: During Midwest speech, she notes failings of rival ideas but signals that President is willing to negotiate. She is cheered by GOP senators.

Conceding that there is “no perfect approach” to health care reform, First Lady Hillary Rodham Clinton offered a spirited defense of the Clinton Administration’s plan Friday while highlighting its differences with competing proposals.

The President’s plan is “far superior” to any of the Democratic or Republican alternatives, she told a Midwest Summit on Health Care attended by seven Republican senators as well as 2,400 business and health care leaders from Kansas and Missouri.

For the most part, the First Lady, who headed the Administration’s health care task force, continued arguing for a bipartisan solution to health care reform and signaling the Administration’s willingness to negotiate.

Her remarks drew much applause from the audience, including a standing ovation at the end led by Senate Minority Leader Bob Dole (R-Kan.).

But just two days after she and President Clinton delivered the 1,342-page prescription for change to Congress, she also embarked on a new tack: going after the perceived shortcomings of the half-dozen competing plans.

At one point, for instance, she noted that none of them have offered a credible, detailed accounting of how to achieve savings in the $900-billion health care system.

“We have serious differences,” she said.

Despite her occasionally combative tone, the First Lady’s remarks nevertheless were hailed by many of the GOP senators present.

“She left room for a lot of flexibility,” Dole said. “We want to be players . . . and establish that the Republicans are for real and want to help find a solution.”

Earlier in the day, however, two Republican senators leveled harsh criticisms of the Clinton plan. Sen. Don Nickles of Oklahoma said the proposal would lead to a massive new government bureaucracy and cause the quality of medical care to “come tumbling down.”

And Sen. John McCain of Arizona called the plan “an enormous social-engineering experiment,” suggesting sardonically that it should be tried first in Arkansas, the President’s home state.

Nickles and McCain left the conference before the First Lady arrived. Among those who stayed on were GOP Sens. Nancy Landon Kassebaum of Kansas and John C. Danforth of Missouri.

Clinton’s proposal would create hundreds of regional “health alliances” that would shop for the best insurance plans on the basis of price and quality. Consumers would then choose from among those plans.

The proposal would require all businesses to pay at least 80% of every worker’s insurance premiums, with workers picking up the rest. No firm would have to pay more than 7.9% of its payroll, and small businesses with 75 or fewer low-wage earners would receive government subsidies on a sliding scale while having their premiums capped at as low as 3.5% of payroll.

“One of the critical differences” between the Clinton plan and most of the others, the First Lady said, is that under the Administration bill “everybody has to pay something for their health care.”

She also reiterated the Administration’s commitment to provide a government-designed standard benefits package to all Americans. “If we do not have universal coverage, we do not have health care reform,” she said.

Among the other speakers were Sen. John H. Chafee of Rhode Island, author of a plan with 23 Senate Republican co-sponsors that also seeks to achieve universal coverage. It would require individuals--but not employers--to buy insurance.

Signaling the Administration’s interest in compromise, the First Lady specifically excluded the Chafee plan from criticism, noting that it has much in common with the Administration’s proposal.

Chafee later predicted that a reform plan combining the competing proposals will be enacted in 1994. He joined several other Senate GOP colleagues, including Danforth and Christopher S. Bond of Missouri, in praising the President and the First Lady for their commitment to enact reform.