BOSTON — KICKING off the first of several regional forums around the country, Hillary Rodham Clinton, the first lady, outlined key problems in the nation's troubled health-care system and urged support of President Clinton's reform plan at a conference here Tuesday.
The skyrocketing costs and inefficiencies of the system make it imperative for the nation to act now, Mrs. Clinton said.
``This is an issue that all of us are working very hard on,'' she said. ``It is an opportunity to really achieve for the country the kind of historic breakthrough that only comes, if at all, once a generation.''
Thirteen Democratic and four Republican congressmen joined an audience of 2,000 at the ``New England Summit on Health Care Reform.'' The tightly orchestrated program, billed as a bipartisan forum, was hosted by United States Sen. Edward Kennedy (D) of Massachusetts.
Discussion focused on remarks by a group of ``citizen participants'' who shared their concerns with the first lady in a roundtable discussion.
Melanie Carmichael is a mother of three children who helps her husband operate a small dairy farm in Vermont. In the last 10 years, her premiums have doubled while prices for milk are as low as they were in 1979, she said. Her husband was forced to take a full-time job to receive health-insurance benefits, but since the job won't start for two months, her family is without coverage.
Meanwhile, in order to keep the farm going, her cows must continue to have monthly veterinarian checkups.
``I feel, Mrs. Clinton, that right now, in my situation that cattle on my dairy farm are receiving better health care than my children,'' she said.
Others were concerned about how the Clinton plan will drive up costs for small businesses. Carl Lindblade, general manager of seven Red Jacket Inns in New Hampshire and on Cape Cod, said the new mandates for health care would incur prohibitive costs on his hotel business.
``We have not been able to increase our rates in order to keep up with the mandates that keeping coming to us,'' he said.
Similarly, Maine lobsterman David Cousens said low lobster prices have made it difficult for him to pay health-insurance costs for his family. In trying to assuage concerns of small business owners, Clinton said the plan will result in reduced workers compensation rates.
Meanwhile, she said, the majority of Americans will face lower health insurance costs since everyone will be in the system together.
``The president would not be doing this if he didn't think it would be a big economic winner and a big job winner,'' she said.
Congressional participants acknowledged the need for reform, but some were more critical of the Clinton plan than others.
Some objected to the idea of mandating employers to cover 80 percent of employee health costs. Others said they preferred a Canadian-style ``single payer'' system.
Most, however, were cordial in their support of the Clinton effort and urged a bipartisan approach in shaping policy. But Sen. Christopher Bond (R) of Missouri, who offered the most critical remarks, said Clinton's plan needlessly hits employers with mandated costs.
``Reputable economists will not disagree that a mandate like this will cost jobs ... and I don't think it's necessary,'' Senator Bond said.