RICHMOND, FEB. 10 -- Virginia Gov. Gerald L. Baliles, still seething over the defeat of his administration's proposal for new fees on hospital and nursing homes, called today for a two-year freeze on medical beds and services to stabilize the state's skyrocketing health care costs.
In calling for a broad moratorium on new services at nearly every medical facility in the state, Baliles acknowledged a political defeat at the hands of Virginia's powerful medical establishment, whose monthlong lobbying effort at the General Assembly killed a proposal to assess daily fees on hospital and nursing home beds to help pay for health care for indigents.
At the same time, the governor, who issued an unusually harsh denunciation of the hospitals' lobbying tactics, said he hopes to use a moratorium to force the medical industry to help him solve a severe funding crisis in the joint state-federal Medicaid program, which helps the poor.
"I propose to force the issue," Baliles said in a statement. "For those already poor, we must find the means to provide adequate, affordable health care."
Baliles contended that a moratorium on new medical services would "encourage prompt action" by hospitals and other facilities to "ensure that health care in Virginia does not erode further."
A moratorium enacted by this session of the legislature would have no effect on the more than 4,000 nursing home beds already approved under the state's certificate of public need program.
In addition, if state officials can devise a Medicaid funding mechanism in the coming year, the moratorium could be relaxed by early 1989.
However, a moratorium would have the effect of stopping hospitals from relocating from cities to suburban growth areas, and would prevent institutions from buying major new equipment or providing new services, such as organ transplants.
The governor's call for a moratorium, which he coupled with a request for a formal legislative inquiry into health care costs, represents the latest tactic of an administration increasingly frustrated by a Medicaid program whose cost has risen more than 330 percent in less than 12 years.
Baliles has said that his $22.5 billion budget for 1988-90 contains enough money for the program, but today he repeated his warning that without new money and cost controls, Virginia could face an insurmountable fiscal crisis as it grapples with Medicaid in the years to come.
"What about the next governor, the next budget beyond?" Baliles said during an interview in his Capitol office.
"If we don't develop a funding mechanism within two years, the next governor and the next General Assembly will be faced with rather Draconian choices," he added.
To help raise $168 million to pay for health care for indigents during the next two years, state Human Resources Secretary Eva S. Teig proposed in late December a new fee of $5 a day on every hospital bed and $1 on nursing home beds. The proposal was presented privately to lobbyists for the Virginia Hospital Association, who immediately launched an effort to kill it even before its formal presentation to the legislature.
The hospitals, which have enjoyed a warm relationship with Virginia's dominant Democratic establishment, infuriated Baliles with their lobbying effort.
"One is tempted to draw certain conclusions as to how far the attitude on the part of those who run Virginia's hospitals, which was once distinguished by comity and cooperation, has changed," Baliles said in his statement.
The industry's lobbyists, he added, have "expressed neither sympathy for the situation nor any particular interest in cooperatively finding an alternative."
Teig acknowledged that Baliles proposed the moratorium, a concept embraced by some legislators, to bring the state's medical industry to the bargaining table.
"It elevates the issue to where everyone on the industry side has to participate and seek solutions on a joint basis," Teig said.
State Sen. Dudley J. Emick Jr. (D-Botetourt), a key figure in the Medicaid debate, said the governor's moratorium proposal should have applied to those beds now in the regulatory pipeline.
Additionally, the industry will still be able to "thwart and evade" the freeze by rushing in applications before its summer starting date, he said.
"As far as I could tell, I couldn't see anything in it that would make any of the providers very concerned," Emick said.