Ready to Operate

(5 of 5)

Even so, there are reasons to believe that Congress will pass a plan like Clinton's within the next year or so. When voters are asked which issues concern them most, health care is right behind the economy and jobs. Even some conservative Republicans report that they are under pressure from constituents to "do something" about the price and security of health care, and some, notably Utah Senator Orrin Hatch, have submitted their own thoughtful, more market-oriented plans.

+ Part of the political problem is that there is little consensus either in Congress or among the public about the "something" that should be done with health care. Lawmakers are splintered among liberals who want a government- run, Canadian-style single-payer system; conservatives who prefer minimalist reforms to the insurance market; and those in the middle who support various versions of managed competition.

This leaves Clinton where he wants to be: somewhere near the political center with a plan that incorporates some market mechanisms and a lot of government regulation, cuts in some spending programs, and new health benefits in other areas. "The Clinton health-care bill," predicts Senator Tom Daschle of South Dakota, "will be the only vehicle in town with real credibility."

Robert Blendon, a Harvard expert on public opinion about health care, predicts that Clinton's plan will be popular because it offers "new benefits, no new taxes except for cigarettes," and control of the prices charged by doctors, hospitals and drug companies. Says he: "To be popular, the public has to think the money is coming from the provider community, which they think is doing too well anyway."

But Blendon's assessment will hold only after the tangled complexities of the Clinton plan begin to sink into public consciousness. "There has never been a national debate over health care, and these terms are all new to the American people," says Clinton pollster Stan Greenberg. "We're going to have an extraordinary period of public education."

That campaign will be dramatically joined next Wednesday night when Clinton delivers his televised address on the issue. An advocacy group has prepared a billboard near the Capitol that will light up that night and begin ticking off the number of Americans who have lost their health insurance: 50 every minute, or almost one a second. That should serve as a reminder of what Mrs. Clinton often calls "the cost of doing nothing" on this issue.