Health-Care Debate Takes on Partisan Edge

An air of compromise in the US House has been replaced with the rough-and-tumble tone of TV lobbying campaigns and party discipline

HARRY and Louise are back on the air, talking up their consternation over health-insurance reform and determining to let Congress know about it.

The fictional but influential couple in television commercials funded by the health-insurance industry had taken a couple weeks off. Their return to the airwaves is part of a partisan deterioration in the political atmosphere of the health-care reform debate.

Several weeks ago, then-chairman Dan Rostenkowski (D) of Illinois of the House Ways and Means Committee struck an agreement with the Health Insurance Association of America (HIAA) to give Harry and Louise a vacation to lighten the atmosphere in his committee so that some bipartisan cooperation might emerge.

By the end of last week, Republicans and Democrats on the Ways and Means Committee - the main forum for forging a health-care bill in the House - had formed hard lines against each other. When House Republican Whip Newt Gingrich of Georgia advised Ways and Means Republicans on June 16 to vote against compromise amendments to the bill, his move drove the diverse Democrats at least temporarily together.

If confrontation across party lines spreads to the Senate, Sen. Dave Durenburger (R) of Minnesota told President Clinton last week, it will stop health reform in its tracks.

The main arena for health reform remains the Senate Finance Committee, where attention centers on the efforts of the Democrats, led by chairman Daniel Patrick Moynihan of New York, to find common ground with up to four moderate Republicans: Mr. Durenburger, John Chafee of Rhode Island, Bob Packwood of Oregon, and possibly John Danforth of Missouri.

But the Finance Committee is progressing at glacial speed. Mr. Moynihan no longer aspires even to begin markup - the first step toward a committee vote - before the July 4 recess. He told NBC on June 19 that it will be too late for a health bill this year if his committee is unable to find a compromise in the next two weeks.

Neither party wants to shoulder the blame for a failure to reform health care. The risk of failure is greater for the Democrats, who control both chambers of Congress and the White House - unless the Republicans are plainly in an obstructionist position.

But there is no great public call for the Clinton plan either. Recent polls show support for the plan at about 44 percent, according to Robert Blendon, a Harvard political scientist who studies health policy and public opinion.

The Clintons themselves and many of their allies have blamed some of the erosion of support for their plan on Harry and Louise. The HIAA has spent about $10 million since last fall to produce and air the ads, which have so far made the point in kitchen-table and family-room sofa conversations that the Clinton plan would create a complex government bureaucracy to run health care.

Targeted districts

The new ads will be targeted to 50 markets and aimed at reaching opinion leaders and key members of Congress. In one, Harry and Louise are commuting to work in their Ford Taurus car, discussing how price controls would lead to rationing of health care, long waits, and a government-controlled system. In another spot, Harry is shooting baskets in the driveway with his brother Pat, visiting from New York.

Since New York is the only state that requires community rating - meaning all insurance clients are charged the same whatever their health status or age - Pat warns of how his health insurance rates have nearly doubled and how many people are no longer insured at all.

Both price controls and community rating are key elements of the Clinton plan.

In surveys of views following up past Harry and Louise ads, some polls found that more viewers recalled the ad than should have been able to see it, based on the commercial time purchased, says Ben Goddard, president of Goddard-Claussen First Tuesday, the firm that produced the spots.

He attributes the disparity to news coverage of the advertisements, which also extend their reach considerably.

Dr. Blendon says publicly available data indicates that television commercials have only shifted public opinion about 5 percent in the negative direction. That is ``not insignificant,'' he says, and may be understated.

But he also believes that other critics of the Clinton plan have been far more influential in turning opinion against it.

Partisan edge

The more partisan edge to the debate in recent days is actually a healthy turn of events, says Robert Moffitt, a policy analyst at the conservative Heritage Foundation. ``The debate is maturing here. We're getting to basic philosophical distinctions,'' he says. ``At the end of the day, either you are or you are not in favor of the government making those decisions.''

``They're fundamental, unbridgeable, philosophical questions,'' says Joseph White of the more liberal Brookings Institution. ``And some of the Democrats may be on the wrong side.''

Partisan rhetoric from the GOP may drive the Demcorats together, as Gingrich managed to do last week, but that glue is not likely to hold in a floor vote, Mr. White says.

Members of Congress are hoping for a trigger mechanism that would put off some hard questions for a few years and give some of the consensus reforms a chance to work, but designing a trigger is ``fairly implausible,'' White says.

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