Section 202 Section 202 would authorize $24.4 million (indexed to October 1979 prices) for health care services in the Northern Mariana Islands. The $24,400,000 authorization for health care facilities for 16,000 people appears to us to be excessive when compared with health care facility costs in the Virgin Islands and Guam. While we acree that current facilities are in need of upgrading, their ultimate cost should be more in line with health facility fumds already appropriated for Guam and authorized to be spent in the Virgin Islands. Public Law 95-134 authorized $25,000,000, which has been appropriated for the purchase of a mdern 250-bed hospital facility to service 100,000 people on Guam. Public Law 95-348 authorized about $52,000,000 for two 250-bed hospitals on St. Croix and St. Thomas, a small facility on St. John, and related outpatient facilities and clinics to service a 1983 population of 161,000 in the Virgin Islands. Additionally a 90-bed hospital in the Northern Marianas would provide 5.6 beds per thousand people; the HEW ceiling standard recommends 4 beds per thousand. Considering these statistics, the proposed facilities appear to be larger than necessary for the population of the Northern Marianas ard the projected costs for the facilities appear to be excessive. Furthermore, the ability of the government of the Northern Marianas to staff and maintain elaborate facilities on a cost-effective basis is uncertain. We do not douwdt that upgraded facilities are necessary. At the present time, however, we cannot offer a firm figure to substitute for the one in the bill. = The Administration, therefore, cannot support the authorization contained in section 202. The Department of the Interior will undertake, in cooperation with the Department of Health, Education, and Welfare, to report to the Congress by dime 1, 1980, as to the Northern Marianas hospital needs and their costs. We would not abject. to such an endeavor's being statutorily required. Sectioms 203, 301, 402, and 502 Sections 203, 301, 402, and 502 would have the Secretary of the Treasury administer and enforce, to varying degrees,income tax and customs laws in the territories of the Northern Mariana Islands, Guan, the Virgin Islands, and American Samoa. We understand that the sponsors of this concept believe that additional revenue would accrue to the territorial governments under administration and collection of taxes and duties by the Internal Revenue Service. - — ee . ome amorn rte ° oe 6 Cy eer' po suPerse tae CO ee ge Sag -~_-——-- -——* eee eee ener FF aa mre . . re ue .