The Clinton administration has a lot of explaining to do.
To convince the public that the president has the best solution for healthcare reform, the White House must describe a complex program in terms that will overpower the simpler buzzwords used by the opposition to assail it.
White House officials admit to the difficulty of combating threats of big government, higher taxes and less freedom of choice-all of which resonate deeply with the public-with technical explanations of how regional purchasing groups, called health alliances, will work.
Amid charges from Republicans that there is no healthcare crisis and evidence that healthcare costs are declining without massive reforms, the administration also must defend the need for a government solution.
Fear of bureaucracy. Americans' "main worry is that (the Clinton plan) is somehow a federal government takeover" and "too bureaucratic," said Ira Magaziner, President Clinton's chief healthcare adviser and the principal architect of the reform plan.
At a recent press briefing, he defended the plan as "less bureaucratic" than other alternatives offered in Congress, he acknowledged that the charge, though meritless, "works well as an argument."
Mr. Magaziner, who says he's trying to make weekly sojourns to the "real world" to deliver the administration's reform message, said the main challenge is to "keep people focused on the fact that (what the president has proposed) is a private insurance system."
No sales. The effort to do that has been frustrated by the virtual disintegration of the White House's sales campaign, which got off to a blazing start last September with the president's healthcare speech to Congress, but has since dwindled to a flicker.
Four months ago, under the auspices of the Democratic National Committee, former Ohio Gov. Richard Celeste was appointed to head a political campaign-style push for the administration's reform plan. At the time, Mr. Celeste vowed to use television ads and a grass-roots network to "expose" opponents of the program. Instead, opponents did most of the exposing.
After a brief ad blitz targeting the Health Insurance Association of America, which has spent some $10 million on ads critical of the president's reform plan, the DNC's campaign dropped from sight.
The issue was also put on hold at the White House, while Mr. Clinton turned his attention to other consuming tasks, such as winning enactment of the North American Free Trade Agreement and the Brady bill.
The White House recently appointed Harold Ickes, a New York lawyer, to reignite the campaign for reform, the new leg of which began with Mr. Clinton's State of the Union address late last month. But officials wouldn't give details of the strategy, which they said was still in the planning stages.
Filling the vacuum. Some consumer groups and health coalitions have tried to fill the vacuum left by the administration's inattention. The Kaiser Family Foundation is funding a $4.1 million advertising and educational campaign, which will be conducted in conjunction with the League of Women Voters. The ads purport to provide objective healthcare facts. The first series bears the message that most of the uninsured are working Americans.
The League will sponsor 60 town meetings around the country, to give people the chance to discuss reform with their elected officials.
"This is the biggest health policy decision we will make in this generation, and it is too important to leave to the interest groups and spin doctors," said Drew Altman, president of the Kaiser Family Foundation.
In addition, Families USA, a consumer group with close ties to the White House, unveiled a report last week showing the president's health plan would offer more assistance to ordinary families than two popular alternatives offered by Senate Republicans and conservative Democrats.
The report, compiled by Families USA, was released in cities in the areas represented by the chief sponsors of alternative plans, Sen. John Chafee (R-R.I.) and Rep. Jim Cooper (D-Tenn.). Both of the competing proposals omit key features of the administration's reform plan, namely an employer mandate to finance health insurance for workers and caps on private insurance premiums.
"American families get real security from the Clinton reform bill. But under the Cooper and Chafee bills, the real winners are the insurance companies, not the American family," said Ron Pollack, executive director of Families USA, a consumer advocacy group.
Arnold Bennett, spokesman for the group, said campaign for the administration's plan must be waged "congressional district by congressional district," with a focus on 10 key states.
While the administration has been slow to get its campaign moving, the delay hasn't been fatal, he said.