Governors Vow to Revamp System

Leaders say if steps aren't taken soon, health-care costs could threaten national prosperity. HEALTH CARE

THE nation's governors, after days of emotional debate at their annual summer meeting, will launch an immediate effort to bring about a drastic overhaul of health-care policy in the United States.Alarmed over soaring health-care costs, the governors agreed unanimously that "the nation's health-care system is in trouble. The system costs too much and provides too little." Gov. Booth Gardner (D) of Washington, the outgoing chairman of the National Governors' Association, calls the health-care crisis "the most difficult, complex, and compelling domestic issue on the American agenda."

Rocketing costs Costs have rocketed upward, and are breaking state budgets. An estimated 35 million Americans have no health insurance. Governors told of spending so much for emergency health care for their citizens that they must cut back on education, roads, and the environment. Democrats, led by Gov. Lawton Chiles of Florida, unsuccessfully urged the governors to set a date - Jan. 1, 1994 - by which Congress, the president, and the states would have worked out a new health-care program. Republicans, led by Gov. Carroll Campbell Jr. of South Carolina and Gov. John Ashcroft of Missouri, opposed the 1994 deadline. "The date is arbitrary," Governor Campbell argued at the NGA meeting held in Seattle. He said the key word in the governors' resolution is "immediate that Washington and the states will immediately begin work on solutions. All sides clearly recognized that health care could become a cutting issue in the 1992 campaign. "Without question" health care will be a presidential campaign issue, Governor Gardner says. Both Democrats and Republicans can read the polls, which show growing unhappiness with the American health-care system, especially when compared with nearby Canada. A recent Gallup poll, for example, showed that 43 percent of Americans believe that the Canadian system, with universal, government-paid health care for all, is superior. Only 26 percent of Americans think the US system is better. The issue has high priority with governors because states must pick up the costs as Washington shifts more and more of the expenses of health care onto the shoulders of local government. Governors warn that unless steps are taken to contain costs, health-care expenses could devastate future budgets and threaten national prosperity. In 1960, just 6 percent of US gross national product was devoted to health costs. By 1990, that had doubled to 12 percent. Now it seems headed toward 17 percent in 2000. Put another way, health care cost Americans approximately $606 billion last year. By 2000, that could climb to $1.5 trillion. Gov. Bill Clinton (D) of Arkansas, who recently launched a presidential exploratory committee for the 1992 election, says Americans continue to live with the myth that this country is still the best in everything. Yet the US is the only advanced nation that does not provide health care to all, while at the same time spending 30 percent more on health care than anyone else. Democrat Chiles complains that in Florida "education is already being affected.... All of our money is being taken now for Medicaid.... We cannot control costs." Republican Campbell blames Congress for much of the problem. Capitol Hill mandates certain programs, ordering the states to pay for them, while refusing to give governors the flexibility they need to shift resources where they are most required, he says.

Lobbying for solutions Led by Gov. William Donald Schaefer (D) of Maryland, the governors vowed to lobby vigorously in Congress and the White House for solutions. Chiles urged Republican governors to join wholeheartedly in the effort. The Democratic governors, he said, are ready to "put heat" on the Democrat-controlled Congress; likewise, Republican governors should be ready to "put heat" on the Republican president. While health care will remain a top priority for the governors, the incoming chairman of the association, Republican Ashcroft of Missouri, says his prime objective will be education. On Sept. 30, the governors are scheduled to come out with their first nationwide report card on America's schools. Ashcroft warns that the report card "will not be very pretty." Among reforms sought by Ashcroft is a longer school year. Currently, he says, America is "the shortest school-year nation in the world."