Have you ever wondered, in this day of options for health care of the elderly and disabled, if sometimes the home is overlooked as an appropriate setting’? When Congress reconvenes late this month it is expected to consider legislation that encourages the home option. A Heritate Foundation reports says the bill sponsored by Orrin G. Hatch, R-Utah in the Senate and Guy Molinare, R-N.Y. in the House potentially could save million of dollars “by reversing the trend toward over-institutionalization. ” Foundation analyst Peter Germanis says the proposed measure emphasizes the need for treatment. not the setting, but stresses that the home “may often be the most appropriate and costeffective place for needed health care,” By the year 2000, an estimated 2 million people may be living in nursing homes and other institutions unless the trends change. The cost of institutional care is one of the concerns, says the Foundation. In 1979, such expenditures amounted to $17.8 billion nationally, with 56.7 percent paid by the federal government. Germanis says the new legislation seeks to eliminate Medicare and Medicaid polices that create financial incentives which favor care for the chronically – ill elderly in health care institutions. The various federal programs offer little or no financial coverage for home care. One of the arguments for the bill is that home care often can be provided at a lower cost per day, which could reduce public outlays. The Hatch and Molinare measure would expand Medicare and Medicaid coverage of home health services and make a $500. tax credit available to individuals who support a dependent person in their home. Obviously quality health care can be provided in various settings ranging from the home to nursing homes and hospitals, The institutions generally render a fine service and will continue to do so. V But the proposed new legislation is intended to give the elderly and disabled who need longterm care a home distinct choice and minimize monetary costs in years ahead. It deserves serious consideration. ‘