WE CAN'T AFFORD CURRENT HEALTH CARE PLAN, MUCH LESS A NEW ONE

Late last week, the Congressional Budget Office announced that next year's federal budget deficit would be a stunning $362 billion primarily because of the S&L debacle and the "explosion of Medicaid costs." Further, the National Governors' Association declared that states could no longer cover the costs of long-term health care for example, nursing homes now borne, in significant measure, by the states under the Medicaid program.

When it was created in 1965, Medicaid was targeted to pay for health care for welfare mothers and their children. It has grown to cover 28 million people of all ages. For practical purposes, it is our second-rate national health insurance system. It covers many high-risk and expensive medical situations that no one else dares cover. Crack babies in intensive care units are under Medicaid. AIDS patients without insurance are covered by Medicaid. Nursing-home patients without funds are under Medicaid.

It is those nursing home costs that particularly trouble the governors. Medicaid is the fastest-growing governmental nursing home program in the world. The governors advocate that all health-related programs pertaining to the elderly should be transferred by the federal government presumably out of higher payroll taxes collected from employers and employees.

Politicians love the old folks, but few politicians want to be their real-life fiscal guarantor. Medical science causes more people to live longer, and, as a consequence, causes more people to live in an ultimate state of medical dependency. Medical science, in violation of Seneca's rule, equates old age with happiness. Forty percent of today's senior citizens will end up in nursing homes. The galloping genius of modern medical technology will put perhaps 60 percent of the senior citizens of the year 2000 in nursing homes at life's end. The number of persons 85 and older, the group at highest risk for long-term care, will increase five-fold over the next 40 years, from 2.5 million to 12 million. If you want to pick an industry with an assured growth future, buy a nursing home and let the process of American governance pay for its services as patients' private funds are exhausted.

Faster than we are willing to admit, we are approaching the crash site of research medicine's unbridled desire to prolong life at all cost and society's ability to pay all costs connected with the scientific appetite. States are broke. The federal government is broke with the aforementioned $362 billion deficit for the coming year. Corporations say they cannot be saddled with more of the health-care burden and remain competitive in the international marketplace. Hospitals and insurance companies say society can't dump much more of health-care costs on the private insurance system.

This cost calamity already exists under the present quasi-system, which most observers deem to be in urgent necessity of repair. If we can't afford our beaten up model, how do we afford the newer model? Whatever its design, the newer one will cost more federal dollars. Americans are wont to revel in social benefits and wont to rebel in paying for them.