CONGRESS DOES NOT HAVE ALL HEALTH COST ANSWERS

Watch out, a change is coming. You might regard this as good since the looming change involves the escalating costs of American health care. While we might be convinced that these costs are out of control, and while we would welcome some redress, any expectation that the federal government will step in with some legislative solution should be dashed. There are some "sure cures," particularly in the form of congressional elixirs, you should be wary of.

Cape Girardeau, a regional hub for medical care with a high stake in the resolution of the cost dilemma, is no different from other communities in feeling the effects of this problem. Local companies are struggling to come up with employee health insurance packages that won't destroy the corporate bottom line. In some cases, the benefits have been cut back and employees have been asked to share in the burden. In the case of more than 30 million Americans, there is no health insurance of any kind.

The scope of the health care quandary is massive. In the United States last year, about $660 billion was spent on health care, an amount representing more than 12 percent of the gross national product. This amount of spending has more than doubled in the last 10 years. Despite the immensity of the problem, and despite the capacity of Congress to effect change on major institutions, legislation should not be counted on to improve the situation.

One murky treatment is being offered by Senate Democrats, including George Mitchell, Edward Kennedy, John Rockefeller and Donald Riegle. In addition to the unspoken political hope that national health care becomes an issue in the 1992 presidential campaign, these senators envision legislation that will limit health-care costs and provide insurance for everyone. That brief description sounds appealing enough. Taking the luster off the appeal are the measure's provisions to require a payroll tax for employers who don't tender health insurance for their workers and to establish a National Health Care Expenditure Board to set targets (voluntary compliance, not mandated) for health care costs.

When you push one button, however, another is likely to pop up. Putting the burden of the uninsured on businesses not now offering health benefits for employees seems a dubious solution. Most businesses not providing worker health benefits are not doing so out of greed but to remain solvent. Placing more government regulations and tax burden on small businesses might only lead to the closure of those businesses, a result that benefits the employees not a bit.

Plus, in setting up an independent board to limit health-care costs, the federal government might be adding a new layer of bureaucracy that will only add to the sluggishness of the system. Remember, the government has a less-than-superb track record in dealing with health care; languid and inadequate reimbursements of Medicare charges have been cited in the cash-flow pro~blems that led to the demise of some rural hospitals, including a recent one at Chaffee.

This is not to say that Congress does not have a rightful place in addressing this national concern. Lawmakers, along with medical, business, insurance and consumer groups, must join in the national debate. But we are kidding ourselves to think that Congress can come up with the definitive answer. We might also be harming ourselves to think so.