(2) The hospital industry exhibits the fastest rising costs in the health care sector.

(3) The largest expenditures for the hospital industry are payroll (wages and salaries) and employee benefits; in 1992, payroll and employee benefits accounted for almost 55 percent of total hospital expenses.

(4) Because registered nurses and licensed practical nurses comprise the majority of a hospital's expenses, in an effort to remain competitive, hospitals are restructuring their operations by decreasing payroll and benefit outlays for registered nurses and licensed practical nurses and either decreasing their number or replacing them with unlicensed aides to care directly for patients.

(5) While this reorganization is taking place, no mandatory, national, and systematic compilation of data is being undertaken to determine the correlation between skilled nursing care and patient safety.

(6) Several studies, however, have noted a basic relationship between skilled nursing care and patient safety: increased deaths result when inadequate nursing and lower levels of registered nurses and licensed practical nurses in combination with higher levels of unlicensed aides are utilized by health care facilities.

(7) A comprehensive effort is needed at the national level to collect data and develop a research and evaluation agenda so that informed policy development, implementation and evaluation are undertaken in a timely manner to protect the safety of patients, the well being of health care workers, and the integrity of the United States medical system.

(8) The quality of available health care will suffer in the United States if health care delivery is allowed to set priorities in which profit is made at the expense of patient care quality and safety.

(9) Core clinical staff, such as registered nurses and licensed practical nurses, are a key component in increasing quality, understanding patient care needs, and balancing costs in any reformed health care system.