President Delivers Health Care Pep Talk : Legislation: The GOP opposition has stiffened. Clinton makes it clear to advisers that his reform proposal will be the top priority of 1994.

President Clinton called together his top health care advisers for a photo opportunity and pep talk Monday amid signs of stiffened Republican opposition to the Administration’s health care reform proposals.

The White House meeting, Clinton’s first public event of the new year, was designed largely as a showcase to demonstrate the President’s commitment to the issue. But it comes at a time when the health reform effort has been under increasingly sharp partisan attack--a marked contrast from the cautious approval with which Republicans greeted the plan’s unveiling last fall.

Clinton has made clear to his top aides that he intends health reform to be the overriding priority of the year and, in his remarks at the White House meeting, he likened the effort to two of the landmarks of Democratic social legislation in this century.

“We all look back now in American history (and) remember 1935 as the year that the American people adopted Social Security; 1965 is the year the American people adopted Medicare,” he said. “I believe that 1994 will go down in history as the year when, after decades and decades of false starts and lame excuses and being overcome by special interests, the American people finally--finally--had health care security for all.”

After several months in which his own plan has gone through extensive scrutiny that has generated doubts among many Americans about its financing and its costs, Clinton indicated that the White House will go more strongly on the attack against rival plans over the next several weeks.

“We are going to see a fleshing out of all the alternatives--something that hasn’t happened yet,” he said. “The burden has been borne almost entirely by our plan, which is something I was willing to do. But now we need to look at the cost of the status quo and the cost and the consequences of the other plans.”

Republicans, for their part, responded with sharp attacks. Rep. Dick Armey (R-Tex.), for example, called Clinton’s plan a “bureaucratic nightmare that will kill jobs.”

Sen. Phil Gramm (R-Tex.) declared, “I am not going to support the President’s effort to have the government take over and run the health care system.”

The two Texas conservatives have persistently been among Clinton’s sharpest critics. But this time, in marked contrast to the conciliatory tone of Republican statements in the fall, they were joined by senior Republicans, such as Senate Minority Leader Bob Dole of Kansas.

When Congress finishes work on health care, “there wouldn’t be much left of the Clinton bill,” Dole said in a television interview over the weekend in which he said that several key features of Clinton’s proposal would be unacceptable to Senate Republicans.

As the tone from both sides makes clear, after a few months of gingerly circling each other, the two sides have now joined the battle. Strategists on both sides believe that much of the outcome will depend on the steps they take in the next few weeks, in which supporters and opponents of the plan lay out their strategies.

Administration officials, who at times last fall seemed distracted among Clinton’s many priorities, have now clearly shoved other issues, such as welfare reform, aside in preparation for an all-out push for health reform.

Republican leaders, for their part, “have acknowledged certain mistakes in the way they handled it off the bat,” said William Kristol, the former George Bush Administration official who has urged Republicans to wage an uncompromising fight against Clinton’s plan. Now, he said, the party has begun to engage Clinton more directly.

“The first three months have been a draw,” Kristol argued, saying that Clinton has failed to “generate a sense of inevitability” about his plan but that Republicans “haven’t built any counter-momentum either.”

White House aides disputed that point only somewhat--arguing that Clinton has maintained the core of support he had when he unveiled his plan. But they conceded that many Americans who had been undecided have now moved into opposition.

Clinton hopes to begin turning the issue with his State of the Union speech on Jan. 25, which aides said probably will concentrate heavily on health care. He has also begun to focus his White House machinery on the topic--assigning his senior aide, George Stephanopoulos, to concentrate on health reform strategies.

Stephanopoulos will work with a longtime Clinton political associate, New York lawyer Harold Ickes, who has joined the White House as deputy chief of staff with a mandate to focus almost exclusively on health reform for the next several months.

Essentially, White House officials said, Ickes will function as a campaign manager, marshaling the forces for the “outside game”--everything from advertising to rallies to building coalitions with groups interested in the outcome.

Stephanopoulos will run the “inside game” of developing strategies to move the health reform proposals through Congress--handling negotiations and providing Clinton advice on the key deals he will have to cut in Congress.

Ira Magaziner, Clinton’s health care policy adviser, meanwhile, will continue as the “policy guru,” as a senior White House official put it--analyzing the impact of competing plans but spending relatively less time dealing directly with members of Congress, many of whom have called him abrasive and arrogant.

Congress will not begin serious work on health reform proposals until after the State of the Union speech. Administration officials hope to pass key House committee hurdles in mid-spring which then would put them on track for final action on the competing plans sometime in late summer or early fall.