Governors' group drafts call for national health care, U.S. takeover of costs

August 13, 1991|By New York Times News Service

WASHINGTON -- The National Governors' Association has drafted a policy statement saying that health care should be available to all Americans within 10 years and that the federal government should eventually take over the costs of long-term care now borne by the states.

The statement was developed by a bipartisan group of 15 governors.

Dr. Robert A. Crittenden, special assistant to Gov. Booth Gardner of Washington, the Democrat who is chairman of the association, predicted that the policy statement would be adopted "with little controversy" at the organization's semiannual meeting, which begins Saturday in Seattle.

Regulation of insurance has historically been a state function. But Congress laid the groundwork for federal intervention last year when it adopted detailed standards for private insurance sold to elderly people to fill the gaps in Medicare coverage.

Philip C. Smith, director of the Washington office for the state of Iowa, said Gov. Terry E. Branstad, a Republican, "favors state government action, rather than federal mandates, to reform the insurance market." Mr. Branstad generally supports the rest of the policy statement, Mr. Smith said.

The governors' pronouncements on health policy are significant because the Bush administration has said it would be guided by them in developing national health policy.

An aide to a governor said that White House officials urged them to "go slow" and not to propose anything too ambitious or costly. The governors' statement gave no cost estimates.

A White House official said yesterday, "The concepts in the governors' draft policy statement are not wholly beyond reason and, in some ways, represent an attractive approach."

The official, who spoke on the condition of anonymity, said that the administration wanted to know how the governors would pay for their proposals.

The draft policy statement says, "By the end of this century, the governors believe the nation needs to have a system that makes health care affordable and available for all Americans."

It encourages states to experiment with comprehensive schemes to control health costs and expand access to health care, saying that "states are perfect laboratories for testing a wide range of approaches."

The statement says that the federal government should eventually take full responsibility for the costs of long-term care now borne by the states, including payments to nursing homes and institutions for the mentally retarded and people with other disabilities.

The cost of such services accounts for a large and growing portion of Medicaid and has become a huge burden on the states.

Although the statement does not estimate the cost of its proposals, nursing homes and institutions for the mentally retarded account for about 40 percent of all Medicaid spending. The states spent $11 billion on such services in the last fiscal year.

The statement says that for Washington to take responsibility for long-term care would release money that the states could then spend on "a new public program to provide health care" for low-income people and the 34 million Americans who currently have no health insurance of any kind.

Social Security and Medicare, which are financed entirely by the federal government, "provide the obvious framework" for delivering long-term care to the elderly and disabled, the statement says.

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