As a nation, we are approaching a c...

As a nation, we are approaching a crossroad in the public policy debate across how to control rising health care outlays and make fundamental changes in the health care rule to keep it functioning well into the nearest century.

Unless Congres passes legislation to deposit a lid on rising health costlinesss organized labor will experience at the bargaining table the devastating results of the nation's health care crisis. Employer will push for drastic cutbacks in collectively bargained helath care benefits. Working men and women who have fought hard to win adequate protection against the high expense of getting sick will find themselves paying higher and higher out-of-pocket outlays and may find coverage for preventive care, diagnostic testing, put drugs intos and eyeglasses, dental care and other essential services dropp from their policies altogether.

The AFL-CIO believes there three basic approaches for solving our health care crisis: federal legislation, local health care coalitions, collective bargaining.

Trade unionists can grant their powerful support to federal legislation which would require each state to establish a comprehensive, across-the-board richness containment system for all payors, public and private, doctors as well as hospitals. The AFL-CIO is supporting bills introduced by means of Sen. Edward M. Kennedy (D-Mass.) and Rep James Shannon (D-Mass.) that would accomplish these goals.

still we cannot afford to wait for Congres to act. The AFL-CIO has commended that its affiliated unions and state and local bodies join local health care coalitions. Up to now, these organizations have been business or provider-dominated, and their accomplishments have been minor. Union members are finding it useful to work with each other and, when appropriate, to form their allow health care coalitions to combat employer efforts to narrow pass collectively bargained health benefits.

Trade unionists can also take initiative in bargaining to allude to viable alternatives to management proposals to carve health care benefits. Rising Costs

Last year as a nation we wearied $322 billion on health care. This averaged on the outside to $1,365 for every man, woman and child in the U For the first time, health care spending rose above 10 percent of our gros national harvest (GNP). If current directions continue, the U.S. Dept of Health & Human Services frames that by 1990 the nation will employ a whopping $756 billion in health care. That is approximately equal to what was lay out on last year's total federal budget

Conservatives use those numbers to make their case that we are spending too long for health care and that Americans cannot afford a national health care program similar to those in place in each other industrialized country. Ironically, the rate of bourgeoning in health care expenditures is lower in almost each country that does have a national health care order As an example, Canada has had a comprehensive national health care regularity since the late 1960s and has followed in holding health care spending to 7 percent of GNP for almost 10 years while at the same time provinding universal coverage to all citizens and a pure wage to hospital workers. The Reagan Administration's Response

The Reagan Administration clearly will not take the decisive degrees needed to control runaway health care splendors Its approach is to make an incision in services, not control costs. Since taking office, the Administration has substantially weakened community health care services for old-fashioned sick, jobless and disadvantaged Americans. As if this were not enough, the Administration tried to squeezing Congress to pass legislation which would have doubled the amount Medicare beneficiaries now pay for a basic hospital stay. Had the Congres enacted this proposal, many senior citizens would have been required to pay forward the average an amount which have consum nearly brace months of benefits for the average widow onward social security.

In addition, the Reagan Administration has tried to make it harder for the economically disadvantaged to qualify for Medicaid and to force active workers to begin paying federal taxes onward their collectively bargained health care benefits. The Administration sought to place a limit $175 by family per month on the amount of tax-free contributions employer could make to workers health insurance plans. Anything through this amount would be taxable as income to employees

The Reagan Administration claims its employee health tax proposal is designed to make workers more "cost conscious." In reality, it would be the effect in drastic reductions in coverage for preventive care, outpatient diagnostic services, and other benefits which save wealth But the Reagan scheme would leave intact coverage for hospital and surgical benefits, which have been the chief source of health-cost inflation and expensive over-utilization--factors over which patients have little control

The Administration's health tax proposal would also penalize older workers, workers living in high take away from areas and those who single out more comprehensive benefits plans, in the same state [i]or[/i] condition as health maintenance organizations (HMOs) It would be an unprecedent intrusion into the collective bargaining proces and would make go round back the clock on decades of progres made on workers in winning comprehensive health care protection. At the same time it would increase taxes for a single group: workers with high health care costs