Shalala Vows to Stick to Health-Plan Goals

THE danger to the administration's health-care proposal, according to Health and Human Services Secretary Donna Shalala, is what she calls the ``politics of `but....' ''

After a glowing first wave of reception to the plan, she says next waves are going to be more critical. ``Everyone says: `I agree with the principles, but...,' '' she said yesterday at a Monitor breakfast. The challenge is: ``Keep your eye on the ball, or you'll lose.''

Many parts of the plan will shift in the horse trading to come, she says, such as the $91 billion of federal savings the administration plans to apply to the deficit or the eventual size of the $124 billion in proposed Medicare cuts.

But the goals should not change. ``We've got to stick to the principles and the general framework,'' she says, such as universal health-insurance coverage and an employer-based financing system.

Many financial estimates the administration produced in figuring the health-care plan's cost and funding are still being ``scrubbed'' for accuracy at the Office of Management and Budget and the Treasury Department. But even if these estimates change, she doesn't foresee a general tax hike ever working its way into the proposal. ``I would be shocked if anyone next spring proposes a broad-based tax increase,'' she says.

Even if the next waves of response to the plan are more negative than the first, she adds: ``You can't assume that the fifth and sixth waves won't be hopeful.''