Bettion 202
Section 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 Guam. While we agree
that current facilities are in need of upsrading, 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 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 an 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 reconmends
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 wfll witer-
take, in cooperation with the Department of Health, Education, and
Welfare, to report to the Congress by June 1, 1980, as to the Northern
Marianas hospital needs and their costs. We would not diject to such
an enGsavor's being statutorily required.
Sections 203, 301, 402, and 502
Treasury
'
laws in the territories of the Northern Mariana Islands, Guam, 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 @Llection of
ee
duties by the Internal Reveme Service.