White House presses AMA on health care reform


WASHINGTON -- Fearing that support for the administration's health reform goals is slipping away, President Clinton fought back yesterday with a high-profile ceremony to trumpet the endorsement of 10 doctors' groups.

The event featuring the president, Hillary Rodham Clinton and the doctors was a not-so-subtle slap at the American Medical Association for its wavering support of employer-paid health insurance -- the foundation of the White House plan to guarantee all Americans health care.

Mr. Clinton gleefully noted that the 10 groups represent more than 300,000 doctors, topping the AMA's membership of 296,000. Emphasizing the importance of an employer-paid insurance requirement, he said that physicians "know that if we're ever going to control the cost of health care and provide quality health care to everyone, we simply have to have universal coverage."

Mr. Clinton would pay for universal coverage by 1998 largely by requiring employers to pay 80 percent of workers' health insurance premiums, with employees paying the rest.

Despite popular support in polls for requiring employer-paid health insurance, Congress is divided over this issue, and lawmakers are considering alternative reform plans that would not achieve universal coverage.

After initial optimism, Clinton aides are "really worried whether they have the votes" to require employer-provided insurance, said John Rother, legislative director of the American Association of Retired Persons, which supports the mandate and is working with other groups for the president's reform goals.

The AMA, the largest and most politically powerful doctors' group, undercut the White House last week when it backed off from its longtime support of mandatory employer-paid health insurance. The AMA urged Congress to consider ways to make individuals more responsible for buying insurance -- which the White House believes will not achieve universal coverage.

AMA officials, seeking to tell the president "where we stand," sent him a letter yesterday that was both conciliatory and critical. Executive Vice President James S. Todd requested a meeting to "narrow the policy differences" with the administration. But he warned of "significant disagreements" over "excessive government regulation," the "absence of meaningful" reform of medical malpractice laws and "lack of protection of the physician's role in medical decision-making."

To counter the AMA's action last week and encourage support for an employer insurance requirement, the White House and its reform allies took a series of steps this week.

Yesterday, the president and Mrs. Clinton met with the American College of Physicians, which represents internists; the American Academy of Family Physicians; the American College of Obstetricians and Gynecologists; the American Academy of Pediatrics; the National Hispanic Medical Association, and the National Medical Association, which represents black doctors.

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