Vice President Sees Common Ground In Health Care Bills

LATE in the Bush administration, as the president's public approval began to deflate, frustrated White House officials began proposing Harry Truman as a model for President Bush.

Now the Clinton White House, faced with a disapproval rating that sometimes splashes past its approval, is also seeking comfort in the example of President Truman.

Vice President Al Gore, at a Monitor breakfast with reporters yesterday, noted that Truman had actively pursued new programs, from national health insurance to the Marshall Plan, yet his public approval dropped into the 20s.

President Clinton is also an activist and still has the approval of a percentage of Americans in the mid-40s.

``We have passed more good changes for the American people in the past 18 months than in any comparable period in two generations,'' Mr. Gore said.

One explanation for Mr. Clinton's low ratings is that watching the politics of how legislation is put together is so much more unattractive than the final product. As Americans see more results, their approval will rise.

``It's the difference between the sausage factory and the finished product,'' Gore said.

Gore is working hard these days at reaffirming Clinton's commitment to universal health insurance coverage. Covering everyone, he says, is the only way to control costs. It is also the only way to remove the incentives for insurers to reject people with the most medical problems, he said. ``Non-universal plans contain powerful economic incentives that will lure or drive millions out of the system,'' Gore said. He finds some principles emerging that are common to all the health-care reform plans now before Congress:

* The health-care system should be less bureacuratic. All five bills that have come out of House and Senate committees standardize minimum benefits and funds to reduce paperwork in hospitals.

* Everyone should have access to insurance at a reasonable price. So all the bills require insurers to equalize the rates they charge different people and to offer coverage to people with health problems.

* Low-income people and small businesses need subsidies to be able to afford insurance premiums.

The GOP plan proposed by Senate minority leader Bob Dole of Kansas includes these measures as well. Universal coverage, however, would entail a legal mandate requiring employers to help pay for insurance, or it would force people to buy their own with subsidies as needed.

Gore defends the expense of universal coverage, noting that budget rules require any expenses in the bill to be paid for. The referee on this issue is the nonpartisan Congressional Budget Office. The Dole plan has never actually been introduced as a bill, Gore noted, so it has not been ``scored'' by the CBO for its budget soundness.