Conciliatory Talk Doesn’t Mend Health Care Divisions : Reform: Clinton insists everyone should be covered. A fellow Democrat makes appeal to centrist group to repair the insurance system first.

President Clinton and his principal Democratic critics on health care reform tried to dampen the war of words but still reiterated their differences in appearances Friday before the Democratic Leadership Council.

Both Clinton and Rep. Jim Cooper (D-Tenn.), sponsor of a bipartisan health reform plan that Administration officials have sharply criticized, offered conciliatory remarks.

But both sides also reaffirmed their disagreement on what may be the principal question in the health care debate: whether and how to provide guaranteed insurance coverage for all Americans.

As in the past, Clinton stressed that providing coverage for the 37 million Americans without health insurance was the indispensable cornerstone of reform.

“Do not give up on universal coverage,” he urged the centrist organization.

But Cooper, whose legislation has attracted support from Democratic and Republican moderates, said Congress should not support universal coverage until reforms of the insurance system are given an opportunity to reduce the growth of health care costs.

In particular, Cooper opposed Clinton’s proposal that all employers be required to provide insurance for their employees.

“We have to clean up today’s rotten health care system before we consider forcing anybody to pay,” Cooper declared in his speech to the group. “Government coercion should always be a last resort.”

Later Friday, on a trip that will include appearances in Los Angeles today, Clinton toured a rural health clinic outside Albuquerque to dramatize what his health reform plan would do for New Mexico, which has more uninsured residents than any other.

After inspecting the El Pueblo Health Services Clinic in tiny Bernalillo, N. M., Clinton heard clinic director Dr. Alan Firestone explain that one-third of the area’s residents have no medical insurance, and many worry that they will be struck by serious illness.

“People worry about access to medical care,” said Firestone, who has treated patients in the narrow stucco clinic building for 17 years.

Seated beside a hay bale, Clinton listened to residents tell of traveling long distances for medical treatment, or searching to find treatment for unusual disorders, and struggling on small incomes to cope with medical bills.

He asserted that his plan “makes a real effort to increase people’s access to health care in rural areas.”

He said the plan would add enough physicians to give adequate care to “a couple million patients. . . . That would make a huge difference in the quality of care for rural people.”

Health care has emerged as a principal area of contention between Clinton and the Democratic Leadership Council, an organization of party centrists that the President chaired before his election. The disagreement has been awkward for both sides, which have tried to mute their differences in recent weeks.

Early in the Administration, many DLC members feared that Clinton was abandoning his “New Democrat” positions and shifting to the left on issues like the federal budget and allowing gays to serve in the military. But more recently, as the Administration has pressed its initiatives on crime and reinventing government, and passed the North American Free Trade Agreement, the group’s assessment of Clinton’s performance has brightened.

In his speech Friday, Clinton struck a generally amicable tone, crediting the group for generating many of the ideas that have marked his first year in office. But he also chided the organization for its occasional criticism of his record, asserting that “in a democratic society” he faced the responsibility of compromising with other interests that did not share their agenda.

“Our obligation is to do good things to move this country forward that embody our ideas and our philosophies,” he said. “That does not relieve us of the obligation to make the hard decisions; it imposes that obligation on us.”

But the differences between Clinton and the centrist Democrats over health care remained apparent. Many elected officials and policy analysts associated with the DLC believe Clinton’s health plan relies too heavily on government regulation.

Instead, many DLC officials back the Cooper plan, which represents a variant of the “market competition” concept on which Clinton’s plan also relies. Cooper’s bill would reform the health insurance system, create regional alliances to help small firms and individuals purchase insurance and provide government subsidies for low-income families to obtain coverage.

But, unlike Clinton’s plan, it would impose no mandate on employers or price controls on insurance premiums--thus avoiding the sharpest confrontations with the health care industry created by the Administration blueprint.

“Most DLC members lean toward the Cooper plan,” said Rep. Timothy J. Penny (D-Minn.).

Advocates of the Cooper plan maintain that the Administration ultimately must reach an accommodation with them, because their legislation is the only health care proposal that has attracted substantial bipartisan support: in the House, the bill has 31 Democratic and 26 Republican co-sponsors. A Senate version of Cooper’s plan sponsored by Sen. John B. Breaux (D-La.), the outgoing DLC chair, has also attracted some GOP support.

But Administration officials have derided the plan for failing to guarantee universal coverage. By Cooper’s own estimate, the bill would not cover about one-fifth of those currently lacking health insurance.

In November remarks to health care reporters, First Lady Hillary Rodham Clinton excoriated Cooper’s plan and indicated the Administration might seek to leapfrog the moderate Democrats to forge an alliance on health care with Sen. John H. Chafee (R-R.I.) and other moderate Republicans.

On Friday, though, Clinton expressed none of those criticisms. Instead, he suggested his plan followed the general principles for health care reform the DLC laid out last fall in its book “Mandate for Change.”

“We have to offer the American people a new choice that is guaranteed private insurance,” Clinton said.

Cooper was even more accommodating, lavishing praise on Clinton and the First Lady for elevating health care on the national agenda, and insisting that Clinton’s plan would form the basis for legislative action.

“None of us are obstructionists,” he said. “All of us know the status quo is dead . . . the only real question is how best to fine-tune the Administration’s policy.”

Times staff writer Paul Richter in Albuquerque also contributed to this story.

President’s Schedule

President Clinton’s schedule in Southern California today:

* 7 a.m.--Delivers radio address from Beverly Hilton Hotel.

* 10 a.m.--Meets with California business and political leaders at Rockwell International at 6633 Canoga Ave. in Canoga Park.

* Noon--Addresses Rockwell employees at Rockwell International.

* 6 p.m.--Addresses reception at Creative Artists Agency at 9830 Wilshire Blvd. in Beverly Hills.

* 7 p.m.--Attends private dinner in Beverly Hills.

* 9:30 p.m.--Departs Los Angeles International Airport for Washington.