WASHINGTON -- At a time when many Americans reject anything that smacks of Big Government, almost 100 liberal Democrats in Congress are pushing ahead with a health reform plan that would require Washington to pay everyone's medical bills -- an idea some conservative critics label "socialized medicine."
Just this week, backed by an analysis done by a Johns Hopkins health care expert, leading congressional advocates of this so-called "single-payer" system asserted that 75 percent of Americans would save money under their plan.
The idea is to have a government agency replace the current system of private health insurance.
Instead of paying premiums to an insurance company, you'd pay health care taxes to the government, which would use the money to pay everyone's medical bills.
Though most politicians believe the plan has no chance of becoming law in the near future, it has attracted a surprising amount of support: 92 of the 257 Democrats in the House are formally backing the idea by attaching their names to it as co-sponsors; so are five Democratic senators.
That's more support than any other health reform plan, except President Clinton's, which has 101 co-sponsors in the House and 31 in the Senate -- many of whom signed on merely as a courtesy.
But the single-payer plan isn't as radical as it might seem. It's modeled on Canada's system and isn't socialized medicine in the way the public medical system is in Great Britain, for example, where doctors work for the government.
The U.S. medical profession would remain private, and patients would be free to choose any doctor.
The plan's chief sponsors, Rep. Jim McDermott of Washington state and Sen. Paul Wellstone of Minnesota, insist Americans would support the idea, if only the news media and most other lawmakers did not dismiss it as politically hopeless.
In fact, where the liberal reformers may exercise their greatest influence is in helping the president meet his central goal of guaranteeing all Americans a comprehensive package of benefits.
With the president's package under fire from Republicans and many Democrats who believe it is too costly, the White House is counting on supporters of the McDermott-Wellstone bill.
The Minnesota senator and the representative from Washington state are, at first glance, unlikely leaders in the health reform movement. Both are fairly new to Washington -- Mr. Wellstone was elected in 1990, Dr. McDermott in 1988 -- and neither holds a powerful leadership post.
But each was elected on a promise of health care reform, and each is aggressive.
In addition, Dr. McDermott brings credentials that only one other House member can match: He's a physician, specifically a psychiatrist, qualified by personal experience to diagnose the ills of the health care system.
Dr. McDermott, 57, is also a dead ringer for country singer Kenny Rogers. He has a white beard, a full head of snowy hair, stage presence and a biting sense of humor.
Skewering lawmakers who want a more modest reform plan that would assure Americans better "access" to health care but not guarantee them health benefits, Dr. McDermott says, "I have access to every BMW dealer in the city, but I don't have a BMW."
NB Mr. Wellstone, 49, comes to health reform from a vastly differ
ent background. He taught political science at Carleton College in Minnesota, a base from which he became a well-known activist on behalf of farm workers and mothers on welfare.
A decided long shot in his race to unseat incumbent GOP Sen. Rudy Boschwitz, Mr. Wellstone won with the help of humorous ads that poked fun at his own lack of campaign funds.
An impatient activist, Mr. Wellstone refused to wait to gain influence through seniority. As a result, he has offended the sensibilities of some colleagues with his abrasive style and aggressive pursuit of legislation.
He has not won any friends with his proposal to require all lawmakers to be covered by the lowest-cost health benefits plan that would be available under the president's bill.
One of his closest advisers is his wife, Sheila, whom he married when he was 19. They have three grown children, and she works as an unpaid aide in his office.
Pushing for a Canadian-style health plan has been frustrating at times for Mr. Wellstone, especially because of the lack of news coverage.
"What I find is all too many media people kind of join in with the conventional wisdom of what will fly, and this is even before the public knows much about any of the plans," he says.
"It strikes me that, first things first, journalists are obligated to present an analysis of all of the plans based on the pluses and the minuses, so the people have that information."
He and Dr. McDermott offered new information on their plan this week, presenting a financial analysis done with the help of Gerard Anderson, director of the Johns Hopkins Center for Hospital Finance and Management in Baltimore.
They contend the plan would save money for three out of four Americans, largely by eliminating the insurance industry as a middleman in the health care system.
Taxes would have to be raised, but insurance premiums would be eliminated.
"While there may be new taxes, there will not be new costs," Dr. McDermott says.
The taxes would include an 8.4 percent charge on payrolls of large employers and 4 percent on businesses that have fewer than 75 workers earning an average wage of less than $24,000. Individuals would also pay an additional 2.1 percent of their income as a health-care tax.
There also would be taxes on handguns and ammunition and a $2-a-pack tax on cigarettes.
All of the money raised would go into a trust fund earmarked for health care and shielded from other uses.
Nursing home care
Though their main goals are universal coverage and good benefits, which Mr. Clinton shares, Dr. McDermott and Mr. Wellstone say their bill is superior because it would also pay for nursing home care, which the president's does not, and would guarantee complete freedom to choose doctors. It's also "easy to understand," Dr. McDermott says.
However, critics of the plan tick off a list of objections.
Some focus on the Canadian system, which, they say, denies patients the range of expensive care and technology available in the United States.
Sen. John Chafee, a Rhode Island Republican who is sponsoring his own reform alternative that would require everyone to buy insurance, says the Canadian system is "not a panacea" because health care costs there are rising.
There are also fears that relying on taxes to fund the system would make it harder to raise funds in the future, should the need arise.
But superseding all these concerns is the belief that, in the current anti-tax climate, a huge tax increase is not doable politically, no matter the benefits.
And this is the issue that supporters of the McDermott-Wellstone bill must overcome if they are to have any chance.
Dr. McDermott is confident there's still time to persuade the public.
"I really think," he says, "in this debate, we're very early in it."