The Carter administration late last year considered shelving the national health insurance bill the President promised to send to Congress in 1978.
President Carter reaffirmed his intention to submit the bill this session only after Douglas Fraser, president of the United Auto Workers - early supporters of the Carter campaign - personally interceded with Vice President Mondale.
But although a bill will now be introduced this year, that action is expected to be no more than a gesture. No one expects its passage, and key congressional Democrats regard it as a kind of political imposition, a burden they would rather not bear in an election year.
Congress already voted for big increases in Social Security taxes last month, and with few exceptions almost everyone expects national health insurance to cost more than what is now being spent for medical care. Who will pay and how much are among the many difficult issues not yet settled.
But even before the administration begins deciding on the details of its legislation, opposition is sprouting in Congress to introducing a bill at all this year.
Rep. Dan Rostenkowski (D-Ill.), chairman of the House Ways and Means Health Subcommittee and a key figure in passage of any health legislation, said that he sees "no real great enthusiasm for national health insurance." Rostenkowski said that if Carter decided to send a bill to Congress, "he'd better marshal his White House staff to pass it because I don't find it one of the big issues among the individual members."
Rostenkowski and others see taking up a major new program, that will need a significant amount of new money as a critical problem. High officials in the administration have the same concern.
In early December, Health, Education and Welfare Secretary Joseph A. Califano Jr. took a tentative crack at withdrawing Carter's campaign pledge - reiterated in May, 1977 - to introduce national health legislation in 1978.
Califano said in a television interview that he did not know whether a bill would be sent to Congress "late in the year or early in 1979."
Even before that comment by Califano, according to a well-informed labor source, word was coming out of the White House and HEW that the administration was considering backing away from national health insurance in 1978.
"We did launch something of an offensive," this source said. The UAW's Fraser said in a speech a few days after Califano's remarks that "disturbing" reports about a delay in submitting a bill were coming from Washington.
Fraser recalled Carter's public promise last May to introduce a bill in 1978. "We're not going to surrender and silently steal away," Fraser told UAW members in New Orleans. "We're going to look for new allies and continue the fight until we get quality health care for every man, woman and child in Amercian."
On Dec. 21, Fraser met with Mondale and with Carter's chief domestic adviser, Stuart E. Eizenstat, to drive home the point. Fraser met later that same day with Califano and by the end of the day agreement had been reached that a bill would be submitted.
During that same period, Sen Edward M. Kennedy (D-Mass.), chairman of the Senate Human Resources Health Subcommittee, met privately with Carter. According to knowledgeable sources. Carter assured Kennedy that the administration would send up a bill by mid-May to late June - in time for Kennedy to hold extensive hearings.
Kennedy, along with Rep. James C. Corman (D-Calif.), is the sponsor of a mandatory, comprehensive national health insurance bill that has the sanction and active support of organized labor. Kennedy is described by one informed source as being "in very close contact" with Fraser.
Proponents of national health insurance oppose delaying introduction of a bill this year, arguing that eventual passage will take two or three years. If Carter wants national health insurance passed before the 1980 presidental election, one source said, "You must start now."
For precisely the reasons that Rostenkowski and others argue against introducing the bill in an election year - that it will beva burden to endangered members of Congress - labor wants legislation submitted.
"We want the issue out there, because in the case of the '78 elections we want to find out who is for it and who is against it," said one labor offical. "It's going to make those people who've been avoiding the issue uncomfortable and that's a good reason to do it. Some people tell the administration not to force them to take a position, assure labour they've for it and tell doctors not to worry."
No one expects the bill to pass this year. Carter said during a televised interview on Dec. 28 that Congress would not be able to pass the bill in 1978, "but it will be introduced."
When the administration does introduce a bill, several sources expressed doubt that it would satisfy labor. One administration official described the political climate for national health insurance in these terms: "Nothing that labor doesn't support can pass. And anything that satisfies labor won't have any other support."
A Senate source described labor as having "an all or nothing approach," wanting a comprehensive, total system of national health insurance - or nothing.
Califano said in an interview that he is trying to get a "consensus" on the legislation. "Every Democratic President since Harry Truman has proposed national health insurance. Nobody's been able to get it passed," Califano said. "The trick is to get it passed.