Clinton To Move On Health In December?

A more modest, shrewder approach to health reform will be taken by the Clinton Administration next year, says Health and Human Services Secretary Donna Shalala. With Americans afraid the plan would have meant a government-run system, whatever is proposed next cannot have that handicap, she said. Change will likely come as part of the regulatory budget process next time around, with the President making the major decision by mid-December.

Expanding coverage and containing costs will still be key to any program, she said, and the administration will have to take note of the public's negative views on an employer mandate. One approach might be to regulate the health insurance market in a way similar to that by which the Securities and Exchange Commission oversees financial markets.

Congress "May Work Step By Step" On Reform if Americans want to expand health cover or slow medical inflation, something must be given up, said Congressional Budget Office head Robert Teischauer. Modest reforms are like "putting lipstick on a pig," and could raise both insurance costs and the numbers of uninsured, he said, but doubted if Congress will have the appetite for sweeping changes in 1995 after this year's debacle, or if the political climate will be conducive. He felt that this year Congress never got to some of the tough issues or resolved its differences via committee, as it usually does. Rather than trying for a "grand solution" next year it may try to work step by step, he felt; reform is a series of obstacles to be overcome, rather than a single problem.