A Medicine Show A Minute In Washington

Sit-ins in the House cafeteria. An 800-pound "Trojan horse" loaded with "hidden taxes" circling the Capitol. Paid two-minute speeches by President Clinton on Cable News Network. Newspaper ads linking outspoken Surgeon General M. Joycelyn Elders to "big government" control of medicine.

It must be time for Congress to vote on health-care reform.

In a capital burned out by a year and a half of fierce debate, in a month when most people would rather be anywhere but Miasma-on-the-Potomac, interest groups are flooding into Washington with pleas for action--or inaction--on remaking the American way of health. Lawmakers are trapped in a Capitol besieged by employers, labor unions, and consumer groups--and the $1 trillion medical industry--as they begin floor debate on competing reform bills. "The action is white-hot now, but it's only going to get hotter," predicts Alan M. Kranowitz, chief lobbyist for the National Association of Wholesaler-Distributors.

The White House is counting on a blast of public outrage against the current health-care system to melt opposition to reform. To boost that response, the President starred in a $1 million, weeklong series of nightly ads on CNN, beginning on Aug. 4, in which he responded to critics' charges that his brand of reform would be costly, bureaucratic, and dangerous to the economy. To shape coverage as the Senate launched its debate, Hillary Rodham Clinton on Aug. 9 submitted to a rare interview with two dozen reporters.

RIPTIDE. But so far, opponents seem to be having more success at rousing the public. The Health Security Express--bus caravans of Clinton supporters from across the country--drew more anti-reform protesters than backers at most stops. Conservative groups such as Citizens for a Sound Economy and the U.S. Chamber of Commerce outhustled Clinton's allies, flooding local media with video news releases and spokespersons.

The most significant lobbying, though, is focused on a small slice of Congress--and isn't intended for the glare of publicity. Health reform will rise or fall on the question of whether employers must bear the insurance tab. As Corporate America joins small business in uniting against the main Democratic reform plans, every business lobbyist knows the list of a dozen senators and 60 to 70 representatives whose votes will tip that balance. The National Federation of Independent Businesses has swamped 65 House districts with 500,000 letters, urging small companies to call or write to oppose the mandate on employers. The AFL-CIO has countered by equipping local unions with cellular telephones that workers can use to call Congress from work sites. Hill aides report that calls and letters are running strongly against the Democratic bills--but the messages are almost all programmed by business opponents.

The health-care lobbying tide is big enough to carry other issues, too. The Family Research Council, a group promoting conservative social values, ran print ads linking Clinton's choice of Surgeon General Elders--noted for her advocacy of abortion rights, gay rights, and drug legalization--with the President's health plan. "We're opposed to Clinton's reform," says FRC President Gary L. Bauer, "but what we'd most like to do is get rid of Dr. Elders." The ad's first appearance in USA Today drew more than 3,000 calls in 24 hours.

So far, Clinton forces haven't stirred that kind of instant response. The reason is simple, says GOP pollster Frank I. Luntz: "The people who are against Clinton are far more intense than his supporters." So, even though polls show broad public support for such core Clinton themes as universal coverage paid by employers, the voters who oppose the Administration package are more likely to contact their lawmakers.

White House strategists insist that they, too, can mobilize intense interest. "If the debate is conveyed in understandable terms to people," declares Hillary Rodham Clinton, "there will be increasing support...for making hard decisions." But even Administration allies admit to increasing doubts. Will Marshall, president of the Progressive Policy Institute, a centrist Democratic think tank, believes the best the Clintons can do "is simply to keep the public interested in the concept of reform." That may be enough to pass a modest reform bill--but nothing like the ambitious goals the Clintons have set.


As debate on health-care reform moves to the floor in the Senate and House, lobbying has reached a frenzy:


President Clinton launches nightly paid speeches on CNN, which cost the Democratic National Committee $1 million. Republicans counter with a health-care "forum" beamed to 800 local Chambers of Commerce.


Cabinet members flack studies on the state-by-state impact of reform. The National Taxpayers Union's 800-pound "Trojan horse" circles the Capitol to symbolize "hidden taxes."


The AFL-CIO equips locals with cellular phones so members can call Congress with pro-reform scripts. National Federation of Independent Business mails 500,000 letters to stir up small-business opposition.

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