doc_text: To date, the administration's prescription for the nation's health-care problems has been: Take two aspirin and call us in a couple of years.
  Despite skyrocketing health costs and more than 30 million uninsured people, the White House has virtually steered clear of the subject.
  In recent weeks, though, at least some of the president's advisers have begun to call for a change.
  While Mr. Sununu continues to argue against addressing the issue, Budget Director Richard Darman has said publicly he believes the White House should propose a sweeping health-care reform by next year.
  And others, like presidential pollster Robert Teeter, are reluctantly concluding that the issue may be too hot to be ignored.
  "Clearly there is a real need to get behind this," says GOP political consultant Rich Bond.
  "Just as the Democrats can be seen to be floundering around on foreign-policy issues, the Republicans have not yet put their best minds to work on the health-care issue."
  Former Bush campaign adviser Deborah Steelman, one of the few Republican strategists who has been following the issue, says many of her party have come to believe that "health care is to the '90s what taxes were to the '80s."
  She adds, "If we give away this issue, we are giving away the game of the decade."
  Political pressure for health-care reform is clearly on the rise.
  Business and interest groups are up in arms, members of Congress are restless, and Health and Human Services Secretary Louis Sullivan has been sounding alarms about rising needs and costs.
  So far, however, President Bush has said little.
  The administration has made some modest proposals on infant health care, immunizing preschool children and capping medical-liability costs.
  But the president has put little effort into promoting them -- in one case abandoning a long-planned trip to Chicago and sending Vice President Quayle as a substitute.
  In part, the White House reticence dates back to the 1988 campaign.
  Health care for the uninsured was a signature issue for Democratic candidate Michael Dukakis, who started a plan to provide benefits to the uninsured in his native Massachusetts.
  Bush advisers, however, paid only cursory attention to the issue, preferring to focus on education and the environment, issues where they felt they had a stronger hand.
  Many political strategists continue to defend a low-key approach through the 1992 campaign.
  At a health-policy group last month, GOP pollster Bill McInturff reiterated the view that "people most concerned with the {issue} were not big parts of the Republican coalition."
  Mr. McInturff's review of ABC News exit-polling data for the group showed those who identified health care as their primary concern mainly fell into four subgroups: the uninsured, the poor, Hispanics and blacks.
  These groups voted for Mr. Dukakis in margins ranging from from 56% to 88%, he said.
  Republican National Committee Chairman Clayton Yeutter, who has been at White House strategy meetings where health care has been discussed, also plays down the issue.
  It's "an issue that will have to be confronted by the nation sometime in the next few years," he says, but for now "there clearly is not a consensus in the Republican Party . . .
  about what the answers should be."
  His advice: "I wouldn't put it in the top five" problems facing the country.
  Mr. Yeutter's comments echo those made by Mr. Sununu in April at a meeting with Republican Reps. Bill Archer of Texas and John Kasich of Ohio, who had been tossing around ideas on the issue.
  At present, health is a losing game for the GOP, Mr. Sununu said, because the Democrats will always "up the ante" -- promising more benefits and more coverage with little regard for the costs.
  Republicans inevitably will be cast as a bunch of Scrooges, he argued, unwilling to help the nation's helpless Tiny Tims.
  Spearheading the other side, however, is Mr. Darman.
  In a meeting with reporters earlier this month, he argued that the White House should come up with a comprehensive health-care-reform plan before the 1992 election.
  The issue could then be debated during the campaign, he said, clearing the way for a giant legislative package shortly after the election.
  Asked whether Mr. Sununu agreed with his view, Mr. Darman paused, then replied: "I don't know."
  Mr. Teeter, a close political adviser to the president, also seems to be slowly acknowledging a need to address the issue, although he continues to express skepticism about plans for a big fix.
  "My view is that . . .
  when you've got a problem this big . . .
  that has huge financial implications, it never gets solved in a democracy in one fell swoop," he says.
  "You bite off pieces of the problem and let the system digest the changes."
  Some Republican officials have found an even more persuasive argument for addressing health-care problems closer to home -- in the illness and death of former party chairman Lee Atwater.
  Mr. Atwater was stricken in March 1990 with what turned out to be an inoperable brain tumor, but he remained on the Republican National Committee payroll and health plan.
  The insurance carrier threatened to triple the committee's rates unless it dropped Mr. Atwater's coverage.
  Instead, the committee changed insurance companies.
  But rates are now so high, says Mr. Yeutter, "that many of our not-very-well-paid young people can't afford the coverage."
  (See related story: "Congressional Republicans Find They Are Facing `Revolt of the Haves'" -- WSJ June 24, 1991)
summary_text: The Bush administration`s approach to Democratic proposals for reform can best be capsuled in the attitudes of Chief of Staff John Sununu who complained in a meetin with AMA officials at the White House that the doctors were too sympathetic to the Democratic proposals to overhaul the health-care system.
  In contrast is the attitude of another Bush official Budget Director Richard Darman who argues that the Administration should come up with a comprehensive health-care -reform plan befire the 1992 election.
  GOP pollster Bill McInturff dismissed the topis as not being a big issue in the Republican coalition since those to whome health care was a primary concern were four subgroups: the uninsured, the the poor, Hispaniucs and blacks.