A closely divided House Commerce Committee headed yesterday toward a crucial vote on legislation to control hospital costs, with members arguing whether the effort would eliminate waste or eliminate care that saves lives.
Stating his view for the first time since President Carter asked Congress for hospital controls 14 months ago, Chairman Harley O. Staggers (D-W.Va.) called the plan a vital part of the president's attempt to curb inflation.
What Staggers endorse - and the administration now supports - is a plan to give the nation's hospitals two years to reduce their average cost increase for inpatient care by 2 percent each year. But if hospitals failed to do so in either year, a set of federal controls would automatically go into effect to hold the rate increase to what now might be 12 percent yearly.
The voluntary approach and the 12 percent lid - the estimate yesterday of health subcommittee chairman Paul Rogers (D-Fla.) - are both retreats. Carter asked in April 1977 for a compulsory ceiling of around 9 percent to start that Oct. 1.
"Unless we pass" even the compromise legislation, the country's $65 billion annual hospital bill will double every five years, Staggers said as he kicked off a morning-long debate, a curtain-raiser for a vote scheduled today, with neither side confident of winning.
Setting the tone for much of the debate, Rep. David A. Stockman (R-Mich.) said better but costlier care has been the main cause of hospital price increases, and if it curbed "people are going to suffer."
Lab tests, X-rays and new equipment would all be curtailed, he said, and "the elderly, infants people with lower health status and poor people" would be first to feel the effort.
Rogers called Stockman's statement "absurd."
Big, "expensive" Johns Hopkins Hospital in Baltimore has held its cost inflation to 9 percent, Rogers said, adding that Mount Sinai Hospital in Miami has kept the figure to 3 percent, nine states are already controlling all their hospitals' rate increases, and no one is suffering.
Most hospitals engage in "waste" and "duplications of services," Rogers said, "because everyone is paying [his] costs" without complaining.
Rogers said the long delay since Carter first proposed a controls bill had given hospitals time to start their own cost control programs, which they maintain are already working. The Labor Department has reported that hospital services rose only 0.5 percent in March at least and again in April, compared with a general April cost of living increase of 0.9 per cent.
Hospital and medical groups maintain that any federal cap on their rates - whether mandatory immediately or mandatory if they momentarily falter at rate control - is unfair and unworkable.
They have actively lobbied the four Senate and House committees that must act. The voluntary approach, first proposed by Rep. Dan Rostenkowski (D-Ill.), was approved by Rostenkowski's Ways and Means health subcommittee by a close, 7-to-6 vote.
As a first order of business yesterday, Rogers proposed the Rostenkowski bill as an amendment. It is that plan that the committee will vote on today.
The vote has been delayed three times because proponents did not think they had the votes. If they plan passes today, it still must face a reputedly cool full Ways and Means Committee, as well as a Senate Finance Committee whose health subcommittee chairman, Herman Talmadge (D-Ga.) favors a different approach - a change in the ways hospitals are reimbursed to give them incentives to coys hospitals are reimbursed to give them incentives to control their costs.