The editorial regarding Sen. Daniel Inouye's (D-Hawaii) initiative to grant George Washington University Hospital $50 million {"In the Emergency Room," Oct. 24} related to more than a local problem. We face a national crisis in our emergency rooms.

According to the National Public Health and Hospital Institution, 65 percent of all hospitals nationwide experience decreased quality of care because of overcrowding in the emergency department. Patients wait on stretchers in hallways for hours before receiving treatment, and ambulances are often turned away from emergency rooms. No American, rich or poor, urban or rural, is immune from this crisis.

The House Select Committee on Narcotics Abuse and Control, which I chair, held a hearing in September to explore causes of the emergency room crisis and proposals to avert disaster.

Drugs, lack of personnel and a shortage of bed space fuel the crisis. The biggest contributor to the emergency room crisis, though, is the 37 million Americans without health insurance. Emergency rooms must accept anyone coming through the doors. If an individual has no insurance, the hospital absorbs the cost. Too many uncompensated patients leads to emergency room closings, worsening the strain on the remaining hospitals.

Uncompensated care grew from $3 billion to $8.3 billion between 1980 and 1988. Also, uninsured people, unable to get primary care, are forced to wait until their illness reaches a critical stage before they enter an emergency room, where procedures cost more than routine admissions.

The federal government can, and must, confront this crisis in meaningful, structural ways. Recommendations to the Narcotics Committee include:

Expand Medicaid to include partial or total coverage for emergencies. This would help alleviate the burden of uninsured intakes on hospitals and would prevent further closings.

Expand the supply of nurses and emergency physicians by reinstating scholarships and other financial incentives that were eviscerated during the 1980s. Subsidize emergency staff salaries.

Expand the health care system to get to the root of the drug crisis: permit Medicaid reimbursement for drug treatment and community-based programs.

For those who would argue that such provisions cost too much, consider this: a procedure can cost twice as much in the emergency room as it does in the doctor's office. If we really wanted to reduce the cost of medical care to society, we would allow every citizen to receive a basic level of preventive, primary care. Barring universal coverage, however, the next priority is to keep as many emergency rooms open as possible. The cost of doing nothing is the health and safety of every man, woman and child in America. CHARLES B. RANGEL U.S. Representative (D-N.Y.) Washington