President Carter will choose between two main ways to launch national health insurance -- step-by-step motion toward more coverage for everyone or a plan to cover only a few needy groups -- federal health officials said yesterday.
If he picks the first route, and accepts a plan presented to him Thursday by Health, Education and Welfare Secretary Joseph A. Califiano Jr., each part of the population would acquire some coverage at every step.
If he picks the second, the main choices would be among more insurance for the aged, the poor, mothers and children or the very ill.
These are the leading alternatives, the officials said, in a still unrevealed set of options given the president by Califano.
Califano explained to the president at a two-hour meeting attended by Vice President Mondale, chief domestice adviser Stuart Eizenstat, budget director James McIntyre and Council of Economic Advisers Chairman Schulze.
The president ordered Califano to discuss the alternatives with members of Congress, governors, labor leaders and others and report back to him in four weeks, a source said.
National Health Insurance for all was one of Carter's major campaign promises. But he sasd last summer that he would ask Congress to enact it in phases, with each to start only if economic conditions or health costs permit.
An administration health official said: "Now he [Carter] must make another decision. He must decide whether to give Congress the comprehensive, universal plan in one piece this year -- the plan that would eventually cover everyone, even if it's phased in -- or to send Congress only a first, limited phrase."
Some in the White House have been urging the president to seek only a catastrophic health insurance bill during this session, or perhaps a bill to combine catastrophic insurance with expanded Medicaid for the poor.
Catastrophic insurance -- coverage of the big bills left after ordinary coverage runs out -- might cost the government about $7 billion a year at the start, at current medical prices.
But many health economists think the catastrophic insurance would soon run up the prices of all medical services by encouraging use of the most costly kinds of care.
Some health leaders are urging other options:
Expanding the present Medicare program for the aged and others.
Replacing the federal-state Medicaid program by a purely federal one with uniform benefits and eligibility requirements.
Starting a new program to buy more care for prospective mothers and newborns.
Almost any plan the president picks will almost certainly clash with one now being completed by labor and other liberals for introduction by Sen. Edward M. Kennedy (D-Mass.), a cradle-to-garve national health insurance advocate.
Kennedy's plan is expected to be ready in March and call for a far firmer commitment to complete coverage for all than the president has backed.