Clinton on offensive to reform health care: The President demands that Washington end its 'rhetoric and air-filling bull'

FRESH from his bloody but successful political brawl with Congress over his deficit-reducing budget, President Bill Clinton yesterday fired the first shot in a new battle that promises to be every bit as fierce as his last.

In a speech to state governors, Mr Clinton sketched out the groundwork for his much delayed plans to overhaul what he has described as 'topic number one in America', the nation's troubled and expensive health- care system.

He is due to unveil detailed proposals next month to introduce universal health care, launching what is likely to be one of his administration's most critical challenges to date.

In reforming health care, Mr Clinton is tackling the most emotive issue in the United States, where 37 million people have no health cover and many millions more have inadequate insurance policies. The US is spending a record 14 per cent of its gross domestic product on health - 5 percentage points higher than its nearest health- spending rival, Canada, and 6 percentage points more than either Germany or Japan.

Mr Clinton is also entering politically hazardous territory. He is likely to win support from millions of Americans who live in fear of losing their health insurance through illness. His legislation would prevent insurance companies from dumping people when their ailments become too expensive.

But he faces staunch opposition on several fronts. Small businesses are not enthusiastic about the possiblity that they will be required by law to pay a large slice of employees' health insurance. Some states have already begun introducing their own reforms and do not want Mr Clinton to jeopardise them. Many Americans also see his plans as a threat to their right to choose their health care.

Mr Clinton and his team were busy working behind the scenes before he delivered his speech, circulating gloomy predictions about the consequences of failing to act. These forecast that, without reform, health costs per US family will double by the end of the decade, denying workers dollars 655 ( pounds 458) in annual wage increases. They also predicted that some big companies will end up paying dollars 20,000 a year per employee for health care.

In his address to the National Governors' Association in Tulsa, Oklahoma, Mr Clinton was, in effect, selling policies crafted by his wife, Hillary Clinton, who is head of a White House task force on health. He described health costs as the 'biggest outstanding culprit' in creating the runaway US federal deficit.

Referring to his struggle early this month to introduce his budget-cutting plan, which passed through Congress by the narrowest margin, Mr Clinton spoke bitterly of the perils of 'partisan bickering' and Washington's 'rhetoric and air-filling bull'. Health reform, he said, was not a matter of party politics but 'an American challenge which we face together'.

But Mr Clinton did not say who will pay for his plans to reform health care. There are mutterings about 'sin taxes' on cigarettes and alcohol, but the picture remains unclear.

(Photograph omitted)