Gore touts health plan to elderly in Philadelphia

PHILADELPHIA — PHILADELPHIA -- The vice president approached his task with the precision of a surgeon, slowly extracting tales from elderly Philadelphians impoverished by their reliance on prescription drugs.

Al Gore was on a mission here yesterday to build enthusiasm among the nation's 35 million senior citizens for President Clinton's health care reform proposal. And he wanted to make sure no detail was lost on the attending gaggle of news media people.


One couple he interviewed, Al and Angelina Nicotra, were struggling with bills totaling $500 a month for drugs. Neither Medicare nor their private insurance plan was much help. Many times, they said, they do without drugs.

Lisa Russo told Mr. Gore that she and her siblings pitched in to help their disabled parents buy drugs for the infirmities of age, in addition to traumas from an auto accident. But their own finances are limited.


When a reporter shouted that Pennsylvania's Republican Sen. Arlen Specter considers Mr. Clinton's proposed overhaul of one-seventh of the economy too ambitious, Mr. Gore had the moment he was waiting for.

"Why don't you ask these people if they need some help," he said, gesturing to the families next to him on the podium at a CVS Pharmacy in South Philadelphia. "Under the president's health care proposal, prescription drugs would be covered. What we've got to do is keep the focus on why this is so necessary."

Mr. Gore is one of about 35 senior administration officials, including the president and first lady, who are fanning out across the nation during the two-week congressional break in hopes of breathing new life into the Clinton plan.

Although the reform legislation has begun to move through Congress, polls show that public support has plummeted after months of opposition advertising and confusion about the effects of the measure.

"The public is still very confused about what the president is trying to achieve," said John Rother, executive director of the American Association of Retired Persons, which supports the thrust of the Clinton bill but has not endorsed its specifics. "It's a better plan than it's perceived to be, but how it's been sold is the problem. They should have been out like this at least six weeks ago."

While the president and his top advisers have been preoccupied with other issues such as crime, foreign policy and the Whitewater affair, the health insurance industry and other critics of reform have been pounding away with waves of advertising.

Even among the friendly crowds that waited for hours to catch a glimpse of the vice president, there were skeptics.

Matilda Biscardi, 70, who said she basically approves of the Clinton plan, said, "Part of it is kind of scary."


In many cases, administration officials say, the ads have created a negative impression of the Clinton proposal that is based on a faulty understanding of it. In a recent Wall Street Journal poll, 76 percent of those surveyed said they favored major elements of the Clinton plan when the provisions were described to them. But when asked simply whether they supported the president's bill, 37 percent said yes, down from 51 percent in September.

Mr. Gore and the other administration figures have hit the streets, armed with charts and "talking points" on a few targeted themes.

A high priority is the fear driven by negative ads, particularly among older people who already have health insurance and doctors they like, that people would be forced into group plans, known as health maintenance organizations, that would limit their options.

"Those ads have been very misleading," said Ira Magaziner, an architect of the Clinton plan. "In fact, the plan provides for greater choice than most people have now, both in terms of picking a health plan as well as picking a doctor."

Further, Congress seems united on the issue of guaranteeing a choice of doctors. The first subcommittee to act on the plan wrote a requirement into its version of the bill that even HMOs must let members use a doctor outside the plan if they so choose.

The elderly are particularly sensitive because much of the Clinton plan is supposed to be financed by unidentified cuts in Medicare, the relatively generous government-run health care program for the elderly.


So, Mr. Gore's visit was designed to highlight what the elderly stand to gain from the Clinton plan: low-cost prescription drugs and phased-in assistance for long-term home care.

The likelihood is that of those two, only the drug benefit will survive when Congress completes its whittling process. Long-term care is simply too costly, lawmakers say.

But senior citizens are such a powerful force that, by themselves, they could turn the tide, the vice president said.

"You can make the difference," Mr. Gore exhorted about 100 senior citizens at the South Philadelphia Older Adult Center. "If older Americans decide that this is the time, that this is the year we must have guaranteed private insurance that can never be taken away, that is what we will have."