Health Care ID Card Seen Aiding Insurers, Consumers : Medicine: Task force aides say plan’s basic elements are set, including role of federal, state governments. Clinton close to making key decisions.

Administration advisers Thursday described the proposed national health care identification card as a computer-based personal medical history that could be used by doctors and hospitals to instantly bill a patient’s insurer.

And to help consumers evaluate and choose from among competing insurance plans, everyone in a health purchasing alliance would receive a brochure detailing prices and provider quality, as well as polling data on consumer satisfaction with any particular plan in the alliance.

In a series of public briefings at a health care conference here, a half-dozen senior White House health policy analysts and consultants also provided other peeks at what a restructured health care system would look like--most notably the probable divisions of authority between federal and state governments.

The revelations came as President Clinton is on the verge of making key decisions that will enable his health care planners and economic advisers to put the finishing touches on a complex plan that could change the way every American receives and pays for medical care.

“We’re basically on track,” Ira Magaziner, manager of the White House Task Force on National Health Care Reform, said late Thursday, noting that he and his planners have numerous meetings scheduled with Clinton in the coming days.

“We hope to have the key decisions made by Monday,” he said in an interview.

Even as the President and First Lady Hillary Rodham Clinton, who chairs the White House task force, ponder the final key decisions on health care reform--especially on how to pay for it--the basic elements of their agenda are clear.

Consumers will be pooled into huge health alliances that have the economic clout to purchase affordable insurance from competing provider networks. And over time, the 37 million uninsured Americans will receive health insurance and be guaranteed a basic package of benefits.

Administration officials have said all along that states would be granted considerable flexibility within the framework of a federal reform initiative.

Adding new details Thursday, Walter Zelman, a senior task force official, said that the federal government will define the elements of a standard package of benefits, come up with the specific financing mechanisms for overall reform, set a nationwide health care spending budget, regulate the use of medical technology and decide what size employers, if any, might be exempt from joining the purchasing alliances.

States, on the other hand, will be allowed a “primary role” in determining how to deliver care and how to structure the health alliances--such as deciding how many such consumer cooperatives to create within their borders, Zelman said.

Another task force official, Michael English, said the reform agenda will include coverage for mental health services--with an emphasis on individual case-management, including providing for related services, such as child welfare.

English, co-chairman of the task force’s mental health working group, also said that attempts will be made to reduce the 100,000 psychiatric hospital beds now being maintained at a cost of $7 billion a year.

Other Administration health planners at the conference emphasized a theme that is likely to dominate the White House campaign for health care reform once the plan is unveiled, now expected to be sometime in June.

“Health care reform is an economic security issue for all Americans,” said Judith Feder, a key task force figure and top official at the Department of Health and Human Services.

That message also was sounded on Capitol Hill Thursday by Laura D’Andrea Tyson, chief of the White House Council of Economic Advisers.

Health care costs, she told the Senate Labor Committee, are rising by about $100 billion a year, sapping money from the government, businesses and workers’ paychecks.

“Without a change in the existing health care system, American workers will continue to see low rates of wage growth as an increasing share of their total compensation is consumed by health care premiums,” Tyson said.

According to Sen. John D. (Jay) Rockefeller IV (D-W.Va.), a speaker at the National Health Policy Council meeting here, annual health care spending will reach $2 trillion by the year 2000 unless Congress enacts reforms this year that include tough cost-containment measures.

Rockefeller also touted the health security card as a device that could virtually eliminate insurance paperwork. But some insurance industry officials at the conference said civil libertarians are likely to view the cards as a threat to privacy.

Another Administration task force consultant agreed, saying that revisions in current law governing privacy issues may be necessary before such cards can be distributed.