Iconoclastic congressman taking leading role in health care reform legislation


WASHINGTON -- The lawmaker who hopes to finally break the logjam over President Clinton's health care reform proposal has devoted much of his career to being outrageous.

Rep. Pete Stark arrived in Washington in the early 1970s as a hippie millionaire banker whose first instruction from senior Democrats was to get his jaw-length hair cut. A few years later, the white liberal from Northern California tried (and failed) to join the Congressional Black Caucus, and he worked to oust Jimmy Carter, his own party's incumbent, from the White House.

Since then, Mr. Stark, 62, has been raising eyebrows and tempers mostly by saying whatever comes into his mind -- like the time he called President George Bush's health and human services secretary, Dr. Louis W. Sullivan, who is black, "a disgrace . . . to his race" for supporting "bankrupt" policies affecting the poor and minorities.

"He's colorful, unpredictable and controversial," said Rep. Benjamin L. Cardin, a Baltimore Democrat who noted that Mr. Stark's eccentricities have often gotten him into trouble. "He likes that, though."

this morning, as bargaining begins in earnest over Mr. Clinton's proposal to overhaul the one-seventh of the nation's economy devoted to health care, it seems odd to find Mr. Stark cast in the centrist role of consensus-builder.

"An unfamiliar role, to say the least," observed Rep. Jim McDermott, a Washington Democrat who, like Mr. Cardin, serves on the Ways and Means Committee's health subcommittee that for nine years has been Mr. Stark's domain. "But I think he's doing pretty well."

It's not as if Mr. Stark is expected to bridge huge philosophical differences. The four Republicans on the subcommittee all oppose the Clinton plan and are refusing to compromise. The one conservative Democrat on the panel, Michael A. Andrews, has been busy with a Senate race in Texas. The remaining five Democrats range along the ideological scale from the middle left to far left. But the chairman needs all five in that working majority as the subcommittee begins voting today, section by section, on a Stark rewrite of the Clinton plan.

The California Democrat is treading where other Democratic leaders have feared to go. In the vast cobweb of committees that make up the Congress, his tiny 11-member panel is the first to put together a health care reform proposal and to try to put it on the road to enactment.

"Certainly, this bill is not going to be finally the way we get there," Mr. Stark said. "But I think we set the standard because we met the goals" Mr. Clinton set forth. "The real test is what gets 218 votes. This is just the first step."

The Stark proposal has been generally welcomed by the White House because it embraces the most crucial element of the president's plan: guaranteed health coverage for all Americans, with a basic benefits package.

Like Mr. Clinton, Mr. Stark would place most of the financial burden on employers. They would have to pay 80 percent of the cost of insuring their employees, at an annual rate of about $2,000 per worker.

But unlike the president, Mr. Stark would not have the government subsidize small businesses.

The Stark bill would control health costs by limiting the growth of spending as an inducement to economize. This approach is not as aggressive as the Clinton proposal but has raised the same fear that it would lead to the "rationing" of health care to conserve costs.

Mr. Stark has taken advantage of the opportunity to include in his bill a longtime pet proposal. He would expand the Medicare program for the elderly to serve younger people who lack private insurance. The existing Medicaid program for the poor would be folded into this new program.

Ambitious as it sounds, his Medicare proposal is much simpler than the vast bureaucracy proposed under the Clinton plan, Mr. Stark says. The president would require all Americans to obtain their insurance through a system of regional health alliances regulated by the federal government.

Mr. Stark and his allies on the subcommittee say they want to minimize interference with the majority of Americans who already have health insurance and are relatively satisfied with it.

Among the most heated issues for subcommittee members is whether to endorse Mr. Stark's proposal for a temporary payroll tax on employers to help subsidize health care benefits for the poor, the working poor and the unemployed.

Mr. Stark calls the payroll tax just a "place-holder" that could be replaced with some other means of raising new revenue. But Rep. Sander M. Levin, a Michigan Democrat, insists that the subcommittee stick to Mr. Clinton's goal of avoiding any general tax increase.

But according to the Congressional Budget Office, Mr. Clinton's proposal would swell the budget deficit. Mr. Stark is determined to avoid that.

Mr. Stark, who became famous as an anti-war candidate, says he feels like a cavalry general who charges on to the field of battle, fearing he'll turn around and find no troops have followed.

"That's what I'm going to be looking for every day," he said. "And then we'll have to wait for somebody else to jump out of the trench and see who follows them."

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