IT IS FAR more important to pass the IMF bill, in its revised and embroidered form, than to quibble about the quality of the embroidery. The bill would authorize the Treasury Department to lend another $8.4 billion o the International Monetary Fund. It needs the money to steady the world's system of trade and finance, now threatened by high interest rates and the great accumulation in the Third World. Passage of the bill is urgently necessary, and the new restrictions do not alter that reality.

It's been an interestieek. It began with cheery assurances from the Treasury Department that it had the votes to pass the bill, and it pressed a dubious House learoceed. By Wednesday it was unhappily obvious that Treasury was wrong, and the leadership pulled the bill back. Overnight the chairman of thg Committee, Fernand J. St Germain, drafted a substitute with a series of changes calculated to placate some o It's a truly strange opposition, a coalition of populist right and populist left among whom the unifying sentostility to big banks.

The St Germain modifications would, among other things, hold up nearly a third of the $8.4 billion unlesreasury could certify that it's needed to prevent an "impairment" of the international monetary system. With Brazil teetering on the brink olt, that condition may not prove difficult to meet. The more dubious amendments are the changes that the new bill would make in the Americanng laws. Perhaps some of them are justified, but it would be a good deal wiser to deal with them separately after orderly hearings. This billly, only authorizes the loan to the IMF; to add to the confusion, the appropriation is moving through Congres Amid the great outpouring in the House of resentment against bankers and foreigners, congressmen might usef Third World's debt crisis came from. It started with the leap in oil prices a decade ago. A lot of the OPEC money went into American banks, and a lot of Third World countries, desperately pressed by the high cost of oil, borrowed to keep their economies developing. The debts were not unmanageable until the end of the 1970s, when interest rates soared. Before you repeat the line about Brazil's having borrowed too much, think for a moment what those loans bought--among other things, longer life expectancies and a lower infant mortality rate.

If infant mty rates don't concern you and you seek a more practical reason for supporting the IMF bill, you might observenot a good year --Brazil spent $3.4 billion on exports from the United States. Latin America altogether spent e customers that would not easily be replaced. If the IMF runs out of resources and any of them slide into bafely say that things won't be the same in this country--many things, starting with the American unemployment ra w0060 ----- r b BC-07/29/83-2-EDIT 07-29 0001 St. Elizabeths: What Gives?

LIKE SO MANY of the people who come to it, St. Elizabeths Hospital is nobody's fond charge. It is an institution that neither the federal government nor the District of Columbia has decided how best to care for. As a result, when money is short all around, St. Elizabeths is left in a financial vise. And if this year's federal and D.C. budget actions takest severe turns possible, the hospital could be forced to let hundreds of employees go and to cripple or elimialth programs. Neither federal nor city officials are predicting this worst-case situation, but the current firious and does call for new attention.

It is this grim possibility that prompted a memo to St. Elizabeths fachtenberg, deputy administrator for the federal Alcohol, Drug Abuse and Mental Health Administration, calling plan to meet the worst possible budget shortages that might occur in the fiscal year that begins Oct. 1. The rder" to fire anyone, Mr. Trachtenberg emphasizes, but merely a necessary response to the possibility that the$25 million short of what administrators had thought was necessary just to stay even with last year.

That ipossibility of a 653-employee reduction came up, as well as other suggestions for curtailing or killing programs, Mr. Trachtenberg says. Butr this year's budget comes out, negotiations over an eventual transfer of St. Elizabeths from the federal government to the District--which heen going on for years--should be stepped up.

For example, the vast majority of patients are from the District, and many could--and should--red for through other local programs, from nursing homes to alcoholic and drug treatment centers. To ease what would be a sudden severe finathe city, the federal government could phase out its responsibility over a period of years and assist in financing this kind of care throughssistance to the city.

These ideas are neither novel nor inexpensive. The General Accounting Office, among es, is considering what should be done. But until the governments involved agree on an arrangement for pickingl as the responsibility for St. Elizabeths--it will continue to be an uncertain institution with unclear functiugh money to get better.