Bection 202 Gection 202 would authorize $24.4 mi)lion (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 Giam. While we agree that current facilities are in need of upgrading, their ultimate cost should be more in line with health facility funds 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 modern 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 and 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 doubt that upgraded facilities are necessary. At the 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 urder- take, in cooperation with the Department of Health, Education, and Welfare, to report to the Congress by Jume 1, 1980, as to the Northern Marianas hospital needs and their costs. an er@savor's being statutorily required. We would not cifject, to such Sections 203, 301, 402, and 502 Sections 203, 301, 402, and 502 would have 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 and territorial governments under administration and collection of . duties by the Internal Revenue Service. —_ eee hn tea tre cemere apar ezerty,smmmmmme ny, EOE TE a Poa wey . Soe Met %