Reality Deepens Hillary Clinton’s Cause : Health care: Coming from her father’s bedside, she cites an agenda of profound questions.

AUSTIN, Tex. —  Emerging publicly from an 18-day vigil at the bedside of her seriously ill father, an impassioned Hillary Rodham Clinton Tuesday cast the need for health care reform in extraordinarily personal terms.

Clearly drawing on her own experience, the First Lady promised a comprehensive reform agenda that will seek to cope with such profound questions as when life begins and ends--and who should decide those questions.

“These are not issues that we have guidebooks about,” the First Lady said, speaking for half an hour without a text to nearly 14,000 people at a University of Texas arena.

“They are issues that we have to summon up what we believe is morally and ethically and spiritually correct and do the best we can with God’s guidance,” said Mrs. Clinton, who rushed to a Little Rock, Ark., hospital on March 19 to be with her father, Hugh Rodham, 82, after he suffered a massive stroke.

Since then, many in the nation’s health care industry have speculated about how her personal experience would affect her views as she works to reform the nation’s health care agenda.

Showing little emotion and speaking occasionally in somber tones, Mrs. Clinton left little doubt that her own family crisis has transformed what has been a public policy issue into one with a deeply personal meaning. Although she never mentioned her father directly, her comments marked the first time that the First Lady has discussed the need for health care reform in such terms. Mrs. Clinton’s aides have said privately that her father’s chances of recovery are not good. He remains in critical condition.

She also confirmed that the May 3 deadline for unveiling the reform agenda will not be met.

“Certainly, as long as it’s finished in May, I think the President will be satisfied,” said Mrs. Clinton, who chairs the Cabinet-level White House Task Force on National Health Care Reform.

She also said that all the pending budget-deficit reduction efforts will be for naught unless comprehensive health care reform is enacted by Congress.

“Dealing with health care is not just a human imperative,” she said. “It is a budgetary necessity--not just for the federal government . . . but for every state government, for most county governments and, equally important, for most businesses and households in this country.”

Even cutting the deficit “by the approximate $500 billion that’s now projected over the next four or five years will not be sufficient unless we gain control over the exploding health care costs . . . .” Unless they are contained, the deficit will rise to the extent that it wipes out the gains under the Clinton economic plan, she said.

As she has on many previous occasions, Mrs. Clinton said that the road to reform will not be easy, given the inevitable opposition from special-interest groups.

Later, Mrs. Clinton said resolutely: “Every single interest will have to give up something.”

The First Lady appeared here as this year’s featured speaker at the university’s annual Liz Carpenter Distinguished Lectureship, which is named for a former press secretary to Lady Bird Johnson, widow of President Lyndon B. Johnson.

Mrs. Clinton focused much of her address on what she called “a crisis of meaning” and “a spiritual vacuum” in American life. She urged every citizen to take personal responsibility in helping to restore a “civil society.”

Most of her comments about health care reform came during a post-lecture panel discussion moderated by television commentator Bill Moyers, who called her speech a “formidable address.”

Mrs. Clinton said that her task force, in designing a comprehensive plan, is asking “hard questions about every aspect of our health care system,” such as:

“Why do doctors do what they do? Why are nurses not permitted to do more than they do?”

She also criticized the current system for only “taking care of sickness,” but not for “advancing and promoting health.”

“What we need to do is recognize how each of us--whether we are a care-giver or a care-receiver, and that role may change from time to time as we go through life--will have to think differently about health care,” Mrs. Clinton said. “And we will have to come up with a system that promotes wellness, promotes health and provides care for us when we are sick that we can afford.”

High-tech medicine, Mrs. Clinton said, is confronting society with questions with which previous generations did not have to cope, such as: “When does life start? When does life end? Who makes those decisions? How do we dare to impinge upon these areas of such delicate, difficult questions? And yet every day in hospitals, in homes and in hospices all over the country, people are struggling with those very profound issues.”

The First Lady vowed to create a system that “gets rid of the micromanagement, the regulations and the bureaucracy, and substitutes instead human caring, concern and love. And that is our real challenge in redesigning our health care system.”

Mrs. Clinton also generally confirmed some widely reported elements of the emerging reform agenda, including its reliance on a “standard, comprehensive package of benefits” that, depending on the money available, will include some mental health coverage and gradually move toward long-term care.

She also said, without elaboration, that “there will be some steps taken” to minimize malpractice litigation, which she called an “extraordinary burden” for doctors. These steps, she said, will include “alternative approaches to resolve” physician-patient disputes.

Mrs. Clinton was joined at the two-hour appearance by Texas Gov. Ann Richards and Mrs. Johnson, among others. The First Lady ended the day with a strong plea for public backing of the Administration’s drive to overhaul the health care system.

“I hope that the speed with which the President is trying to move on this . . . will be recognized and acted upon by the Congress. But, of course, the only way to make sure that happens is if the people in this arena bring some pressure and urgency to bear once this plan is unveiled and the President moves forward with it.”