Medicare reform and other health programs are suffering because the new Bush administration still has many vacancies in key government jobs, executives of the American Medical Association charged.

"Almost four months after the elections, we are still wondering who will be named to the post of presidential science adviser," Dr. James H. Sammons said Sunday in a speech closing the AMA's 1989 National Leadership Conference."There's nobody in charge at the Department of Health and Human Services," Sammons, the association's executive vice president, added later. "And we don't have an assistant secretary of defense for health at the Pentagon."

The lack of people in top health positions delays progress on health programs and puts the executive branch at a disadvantage in dealing with Congress on upcoming legislation, said Dr. James C. Todd, the AMA's deputy vice president.

"We are terribly concerned about it," he said.

The Senate on Tuesday is likely to confirm Dr. Louis Sullivan for the Cabinet post at the health department, the largest federal agency. The 114,000-employee department administers a third of federal spending.

Sullivan's confirmation hearing before the Senate Finance Committee was delayed for three weeks because an FBI background investigation was incomplete and there were questions about his finances.

President Bush acknowledged last week that many positions remain unfilled in federal agencies. But he said he's not worried about the vacancies because the employees remaining from the Reagan administration share Bush's goals.

Sammons said the delay on appointments is just one problem, and that the administration and Congress have shown "neglect" on health issues since the election.

"During the campaign for a kinder and gentler America, . . . Bush and just about every congressman and senator you can name talked about taking care of the elderly and the needy," Sammons said. "Today, while 37 million Americans have no health insurance at all, and another 17 million have only partial coverage, the only thing I hear coming out of Washington is taking $5 billion more out of the Medicare budget."

Bush proposed a $5 billion cut to Medicare when he announced his revisions of former President Reagan's 1990 budget proposal, which already called for reducing spending on the program.

Sammons called on participants in the conference to influence government policy to help Americans with inadequate health insurance and to ensure long-term care for the elderly.