WHEN Hillary Rodham Clinton assumed her role as head of President Clinton's health-care task force last year, she spoke of a disgruntled middle class pressing for more accessible and affordable services.
But today, with the economy staging a strong recovery from recession and a marked slowdown in the rise of health-care costs, reform of the trillion-dollar industry has lost some of its urgency. Even Clinton officials concede that they can no longer count on a groundswell of support to enact legislation this year.
``It's easier to sell the negatives, including fear of diminished health-care quality and increased cost,'' says Democratic pollster Peter Hart. ``As that has happened, people have moved away from the health-care plan.'' While 70 percent of Americans want to change the system, ``better than 60 percent of the public says we can wait for reform,'' he says.
The president, who capitalized on a public perception of major problems with the financing of health care could find himself ``bankrupt'' in terms of popular support for overhauling health care this year, says Republican pollster Vince Breglio.
Mr. Breglio echoes a bipartisan comment that recession was the spur to reform. Great anxiety over the loss of jobs and employee benefits ``led to a lot of people focusing on health care.'' That, ``coupled with the fact that 3 out of 10 people in this country have long believed in a nationalized delivery system for health care'' created a springboard for Clinton and other reformers.
But the platform has weakened to the point where passage of major legislation this year is doubtful, Breglio asserts.
Congressional incumbents up for reelection this November, originally in support of revamping health care because they feared that a failure to do so would incur the wrath of voters, are now less intent on passing a major bill, he says.
``What they're finding when they return home to their districts is that 2 out of 3 Americans are saying it's OK to bag it for this year,'' Breglio says. A recent national study conducted by Princeton Survey Research found that 40 percent of Americans polled did not see any pressing need for reform, while 42 percent are reform-oriented.
THAT trend is also reflected in the latest surveys by the New York-based Conference Board polling firm. Of the 3,500 household residents it polled in July, roughly 15 percent (up from last year) expressed optimism about job opportunities in the next six months, 18 percent (down from last year) said they anticipate fewer jobs, and 68 percent expect the job outlook to remain the same.
Conference Board economist Jason Bram notes a ``dramatic improvement in people's view of their job prospects and a dramatic improvement in the unemployment rate,'' now at 6.1 percent; in 1991, it was 7 percent.
Mr. Bram recalls that the cost of medical care topped the list for 90 percent of those polled about their most serious concerns in 1991. But this year, crime surpassed it as the No. 1 concern, and 85 percent of those polled listed medical costs as a ``serious concern.''
The decrease in concern is largely based on a slower rate of inflation for medical-care costs. In 1990, the rate soared to 9.6 percent, but in the five years since then, it has fallen by half. Also, individual and corporate consumers are decreasing their health-care costs by moving from expensive conventional plans to less costly health-maintenance organizations (HMOs), Bram says, and ``complaints about costs and the current system are likely to be less prevalent.''
Mrs. Clinton charges that the health-care industry is fighting reform by holding down price increases and, once the threat of legislation is passed, will abandon efforts to restrain fees.
While that may be correct, says Alan Dobson, vice president of the Fairfax, Va.-based Lewin-VHI, a health-care-policy consulting firm, the most recent data show the rate of cost increases has slowed because of the business cycle and a one-time shift to cheaper HMOs and other managed care.
But he says, with the pressure to use expensive new technology and the next stages in the business cycle, ``there's a fair chance that costs will come back up.''
Given the confluence of economic and political factors, Dobson says, ``it's really hard to know if this is a start of a new era'' of lower health-care costs. But, he says with confidence, ``to the extent that the economy improves, people are less uncertain about the future,'' and less interested in agitating for change.