Brokering Votes for Health Reform Begins in Earnest : Politics: Special interests--oil and tobacco--step up lobbying. Deal making may be only way to get bill passed.

Hey, it’s just a thought, Mr. President. Just an offhand suggestion on how to get around a sticky little legislative technicality--and one that might make it a bit easier for you to get that health bill through Congress.

Maybe all the health bill needs is, say, a tax break or two for the oil industry.

Upon hearing that idea, offered Thursday when President Clinton met with about 60 oil-patch lawmakers, Treasury Secretary Lloyd Bentsen “just kind of put his head in his hands,” said Sen. John B. Breaux (D-La.), who had broached the proposal.

Capitol Hill hand that he is, Bentsen knew that--as surely as the National Anthem is followed by the words “Play ball”--he was hearing the opening pitch in a time-honored game. And the playing field in this case--health care reform--is bigger and richer than anything Congress has seen for a long, long time.

Nothing is as high a priority for the President--and, therefore, no bill is likely to involve more incongruous trades to get it passed. The nation has heard two years of soaring rhetoric invoking high moral principle, a generation’s duty to its sick and vulnerable. But in the end, it is likely to take scores of far-flung breaks for special constituencies to make the legislation happen.

It might seem odd, for instance, that a congressional committee working to improve health care would vote to lower a proposed tax on such a notorious carcinogen as tobacco. But that is precisely what the House Ways and Means Committee did Thursday.

By a 24-14 vote, the committee scaled back Clinton’s proposed 75-cent-a-pack cigarette tax increase in favor of a 45-cent increase, because that was the most that Democratic Rep. Lewis F. Payne Jr. of a tobacco-growing Virginia district said he would support. And the committee needs his vote, if it is to get any bill at all.

Lawmakers are getting plenty of advice on what they should ask for. Last weekend, while the rest of the Capitol was dark, no fewer than 70 lobbyists could be seen going in and out of the Ways and Means Committee chamber with other proposed amendments to be considered by overworked Republican staff members, according to a Washington Post report.

In the largest sense, the crafting of the health care bill will be an example of politics as the art of the possible--and of the cynical.

Asked about lawmakers brokering health reform votes in exchange for oil concessions, Senate Finance Committee Chairman Daniel Patrick Moynihan (D-N.Y.) deadpanned: “Grazing fees come first with me.”

Moynihan can afford to scoff at those who must get their breaks by begging for them. As chairman of a pivotal committee, he can write his in himself--as he did when he included $40 billion in aid to academic medical centers (of which New York has many) in the legislation that will serve as his panel’s first draft of health care legislation.

Breaux said that Clinton was noncommittal about his proposal to add oil-industry tax breaks to the health care bill.

He and other oil-staters also vehemently deny any suggestion that their health care votes might be tied to any special deals for the industry.

“I would not think there would be that much direct linkage. Health care is too important,” said Sen. J. Bennett Johnston (D-La.), chairman of the Senate Energy and Natural Resources Committee and one of those who met with Clinton. “It may sweeten the pot a little bit for some marginal voter who is right on the fence but I just don’t see the linkage.”

However, the oil-patch legislators also point out that the oil business is hurting and that it would take a tax bill to ease its financial problems. By happy coincidence, the only tax bill on the horizon is the health legislation.

“It’s been done before,” Breaux said, when it was suggested that the health bill could be loaded down with unrelated goodies.

The industry and its allies are seeking a series of breaks, including tax credits to encourage production from new and marginal wells, reductions of penalties for pollution and measures that would reduce imports of refined products.

On the oil industry’s side is one of the most formidable and savvy allies any interest group could have: Rep. John D. Dingell (D-Mich.), chairman of the House Energy and Commerce Committee and one of the chief architects of the health reform effort in the House.

Last April, Dingell co-signed a letter to Clinton that implicitly linked the issues of energy and health as “two very important domestic policy concerns.”

“In particular, two vitally important issues must be resolved this year, both of which affect the long-term economic security of this nation and its citizens,” the letter said. “Specifically, we are concerned with the economic devastation occurring in the energy industry and we believe that comprehensive health care reform must be adopted during this Congress.”

Few in Congress are as skilled as Dingell in figuring out where the votes are on a bill, and what it takes to get them. The version that he is drafting is laden with breaks for such important groups as small business and agriculture.

He also made a high-profile concession that would weaken Clinton’s proposal to give the government significant leverage over the prices of breakthrough drugs--a move that allowed two freshmen on his committee, Reps. Lynn Schenk (D-San Diego) and Marjorie Margolies-Mezvinsky (D-Pa.), to claim a significant victory for the biotechnology firms of their districts.

Both are facing difficult battles for reelection, and won wide praise from the businesses in their districts for winning the biotechnology breaks.

But for all his maneuvering, Dingell still finds himself several votes short of a majority. Which means that the dealing is not over.