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Clinton's health plan: politics and State responsibility.

HEALTHCARE POLITICS The president's September speech recalled the passion and high public approval ratings that surrounded his state of the Union address . A September 22 Washington Post-ARC News poll reported that, after the speech, approval of the administration's plan jumped 13 percentage points, to 56 percent of those surveyed; 24 percent said they disapproved.' To achieve action on his plan, Clinton clearly needs to win and maintain a high measure of public support. Without strong public backing, the varied political and special interest groups will have a stronger influence on Congress in shaping the final legislation. Clinton must also keep the momentum going, stay focused on the issue, and not waste political capital on tangential issues, as was the case early in his presidency. Healthcare reform is a complex undertaking. Political analysts are citing the president's plan as the most significant domestic policy legislation in decades. At stake is the restructuring of the nation's S900 billion healthcare enterprise—one-seventh of the U.S. economy. At the moment Clinton and Congress appear committed to placing healthcare reform at the top of the political agenda. Indeed, the Washington Post editorialized on September 19, 1993: "The need to reconstruct the health care system is becoming increasingly urgent. For the next year, it is likely to be, properly and necessarily, the central preoccupation of American politics." Ms. White is