After Perfect Launch, Clinton Health Plan Hits Rougher Waters

Momentum lags as foreign crises dominate US agenda

THE slight chill coming over the popular reception to President Clin-ton's health-care plan in the past week may owe as much to events in the horn of Africa as to merits of the plan itself.

Public confidence in the health-care proposal was moderately high and holding steady until American troops suffered losses in Somalia last week. Mr. Clinton slipped a few percentage points in approval, and his plan did, too. (Health care and illegal aliens, Page 3.)

This is one twist in the long, winding road ahead as Americans come to judgment over health-care reform. Most have more questions than hard opinions about the makeover envisioned by the Clintons.

``I really don't know what he's doing,'' says one young Florida woman with health insurance. ``I don't know much about it.''

A woman who was uninsured for part of last year has the impression that the plan is good for those less well-off, like her family. ``It's supposed to be good, I don't know,'' she says.

Most Americans appear willing to give the plan the benefit of the doubt, but their questions are very personal and specific about how they would be affected by a plan not drafted into specific legislation yet.

As the public gradually fills in the blanks, most analysts - including those who have spent time probing public views recently -

believe that Clinton can hold onto majority support for taking significant action to change the health-care system.

But not necessarily for his own plan. Instead, the changes that emerge are likely to fall to the right of Clinton's proposal, perhaps toward a bipartisan plan proposed last week by conservative Democratic Rep. Jim Cooper of Tennessee that spurns government price controls.

After a nearly perfect launch of the plan onto the seas of public opinion, beginning with the president's speech to Congress Sept. 22, public doubts are beginning to make waves. But much of what one Republican calls ``a little queasiness'' growing around the plan is due less to the plan than to events in Somalia, according to some pollsters.

A Washington Post poll published Wednesday showed that support for the Clinton plan had dropped from 56 percent to 51 percent, while disapproval had risen from 24 percent to 39 percent since Clinton's speech.

But the survey was taken in the days following bad news in Somalia, where an American soldier was taken hostage and more than a dozen killed.

Bill McInturff, a Republican pollster, was doing daily tracking polls of the health-care issue through the middle of this week. He says the Clintons did a superb job of sustaining the initial approval of the plan until the Somalia news hit.

Since people know relatively little about the plan, they were taking its virtues largely on faith from the general statements the Clintons made about it. Events in Somalia seemed to erode a bit of that faith.

Many people know so little about the status of the plan that they consider criticism unfairly premature, Mr. McInturff says.

The Post poll found that 79 percent of voters believed that Clinton had not yet developed a complete plan. The White House has not made final decisions on some important details, but a 239-page draft of the plan has been widely distributed and heavily covered in the press.

Robert Blendon, who studies the politics of health care as a Harvard University professor, says that the public's concerns are very practical. ``It's very clear that people are judging this on a personal level - how this will affect myself and my family.''

If the Clintons pitch the plan well, Dr. Blendon foresees the potential for about 55 percent popular support, one-third in opposition, and the rest unsure. This is strong enough support to spur Congress to some kind of action, he adds, but not necessarily to follow Clinton's agenda.

The two leading doubts about the plan are whether it will cost more in taxes or out-of-pocket health-care expenses and whether quality will suffer. Both Republican and Democratic strategists key on these vulnerabilities.

``Quality is the dirty little secret of health-care reform,'' says Democratic campaign consultant Greg Schneiders, who figures that any plan, including Clinton's, cuts health-care costs by ultimately giving Americans less health care. ``When the public figures that out, they'll be mad.''

Reaction among larger businesses, where the most well-informed audience lies, remains mixed. Larry Tucker, a Hewitt Associates consultant who has briefed business clients on the proposals, sees a general concern about the heavy government hand Clinton proposes in the health-care market.

``If you're a [chief financial officer] and you just look at the page that says your health costs won't go up more than inflation, it looks great,'' Mr. Tucker says. ``But the other side of that is what happens to the quality.''

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