Governors and other state leaders have the leverage to slow rising health costs and should not wait for action by the federal government, a commission chaired by two former governors said in a report Wednesday. State leaders can use their clout as large purchasers of health care as well as regulators to set goals for health spending and quality, said the report by the State Health Care Cost Containment Commission. "This must be led by the states," said former Colorado Gov. Bill Ritter, a Democrat and co-chair of the commission along with former Utah Gov. Michael Leavitt, a Republican. Other commissioners included members representing insurers, hospitals, employers and consumer groups.