Americans had better brace themselves for a new round in the continuing debate over what to do about the soaring cost of medical care.

That means they also had better expect fresh demands for the federal government to provide health care for all citizens regardless of the exorbitant cost to taxpayers.Such demands can be expected in response to the alarming new figures from Secretary Louis Sullivan of the U.S. Department of Health And Human Services. The figures show that outlays for heath care rose 11 percent in 1989 over the previous year. No doubt the figures for 1990 will indicate another huge increase.

This sharp escalation hurts badly. It limits access to health care, imposes a heavy burden on individuals, industry and government, and restricts the financial ability of society to meet other needs.

Employers who finance health insurance in total or in part for their workers are are finding it increasingly difficult to keep shouldering this obligation.

Perhaps most hurt are the estimated 30 million Americans who have no medical insurance. They aren't poor enough to be eligible for Medicaid, aren't old enough for Medicare and have no insurance program at their workplace. For them, a serious illness can have disastrous consequences.

Another phase of the problem is the increasing financial burden placed on state and local governments. For example, Congress last fall mandated broader Medicaid coverage for the poor but didn't provide the extra money to meet the higher costs.

What's the solution? Some officials want the government to crack down on hospital and doctor fees to Medicare and Medicaid patients, but past efforts in this direction obviously have had minimal success. Others favor a national health-care program covering all citizens, but that wouldn't necessarily reduce the costs and could reduce the quality of care.

After all, health costs amount to 11.6 percent of the U.S. gross national product, the highest for any developed nation. The figure compares to only 5.3 percent of GNP spent for medical care in this country in 1960.

What's more, this is certainly no time for costly new federal health efforts. Not when the federal deficit persists, the national debt is around a trillion dollars, the national economy is faltering, and war is threatening in the Persian Gulf.

Instead of looking for new ways to spend tax funds, Washington should look for new ways to increase the cost-effectiveness of present health care programs. But that won't happen until Washington gets out of the habit of bypassing state government plus the private sector and looking only to the federal government for answers to just about every problem that comes along.