Governors call for reform of U.S. health care system

August 21, 1991|By New York Times News Service

SEATTLE -- The nation's governors approved a policy statement yesterday urging sweeping reform of the American health care system to make "health care affordable and available for all," but only after sharp partisan debate over whether to call for the Bush administration and Congress to act by 1994.

The policy statement passed unanimously, reflecting broad agreement that there is a growing crisis in both the cost and the availability of health care, which the governors said was straining state budgets already pressed by the recession.

But the governors, here for the annual summer meeting of the National Governors' Association, divided along partisan lines when Democrats unsuccessfully sought an amendment to demand that the federal government overhaul the system by 1994.

While several Democratic governors said they had sought to prod both Congress and the White House, there was a clear focus on President Bush, frequently accused by Democrats of ** neglecting the domestic agenda.

"When the president of the United States places the full force of his executive leadership and the power of his office behind any issue, things happen," said Gov. Robert P. Casey of Pennsylvania, a Democrat.

"We mobilized an entire country behind Desert Storm."

Democrats failed to get the two-thirds vote needed for the amendment to set a 1994 deadline (the vote was 19-17), but Gov. Booth Gardner of Washington, a Democrat who is retiring as chairman of the association, predicted that the health care issue would be at the center of the 1992 presidential campaign.

Mr. Gardner said there would be a "chain reaction" push for change, saying, "In my seven years in this association, I have never seen this intensity on an issue before."

The policy statement passed yesterday asserts that Medicaid, the state and federal program to provide health care to the poor, is "broken," has become "rigid and overly complex" and should be replaced.

It calls for a new program to provide care to people with low incomes, including those who are working but lack health insurance. It also suggests that the federal government, through Medicare, provide long-term care for the elderly and disabled.

The statement also calls for new flexibility from the federal government to allow states to experiment with ways of providing health care; many of the governors here envision states' leading the way to a new health care system.

The bipartisan consensus behind this proposal, however, was overshadowed by the intense skirmishing about whether to set a deadline.

"I hear Democratic governors ready to put the heat on Congress, which is controlled by the Democrats," said Gov. Lawton Chiles of Florida, a Democrat who led the fight for the deadline. "I don't hear the other side ready to put the heat on the White House."

Gov. Carroll A. Campbell Jr. of South Carolina, a Republican, dismissed the effort as simple politics. "That's all right," he said, "It's all over; we won. We got a good policy that was bipartisan to begin with."

Republicans opposed the deadline as unnecessary, unlikely to move Congress and unlikely to produce a good program if it did.

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