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America's teaching hospitals are world-renowned for their medical know-how. But they're being thrown for a loop by cost-conscious managed care plans and leaner federal budgets.

With managed care plans discovering that it's difficult to control costs and give consumers what they want, some conservatives are saying it's time to revamp the health care system.

As one of capitol hill's premier behind-the-scenes operators, Sen. John Breaux seems the ideal choice to chair the save-medicare commission. But he may need more than backroom savvy if he is to succeed.

The new budget bill means big changes in Medicare. The elderly are expected to help save the program by switching to less costly health care options. But some experts warn seniors that more choice means more risk.

Medicare is racked with more waste, fraud and abuse than anyone had imagined. Ending overpayments would keep the program from going bankrupt in 2001. But can the government hunt down all the swindlers? Don't count on it.

There's at least $16 billion available to help more children get health care. But on Capitol Hill, there's a bitter dispute over how the money should be spent. Give the states the money, some say, and let them bolster novel health care programs such as Florida's Healthy Kids. Others want to expand Medicaid.

With health care costs soaring, almost everyone rushed into managed care plans to save money. But consumers have discovered that price isn't everything. And business, government and unions increasingly have embarked on a quest for health care quality.

For senior citizens enrolled in medicare HMOs, the size of payments depends on where they live. As HMOs for seniors become uneconomical in rural areas, the system is in danger of breaking down.

Recent battle cries to boost health care coverage for children might suggest help is on the way. Yet as politicians tout their new-found generosity, they've also been snatching away some government money for kids.

A presidential loser in 1996, Sen. Phil Gramm, R-Texas, is back. The head of the Republicans' health care task force and the new chairman of a key Finance subcommittee, Gramm is pushing for dramatic changes in medicare.

A bruising battle for scarce research dollars is being waged among competing advocacy groups that seek cures for dread diseases. Many activists are unwilling to leave decisions to the scientists. They want Congress to decide which diseases deserve the most bucks.

The stakes have risen in the fight to save medicare from demise at its own hands. The program could go bankrupt as early as 2001, and campaign rhetoric may have harmed chances for bipartisan cooperation. Here's a look at some key administration, congressional and health care players in next year's second round.

As managed health care proliferates, states are enacting laws to ensure patients' access to specialists and treatment information, among other protections. Congress is following suit. Managed care plans have gone along with the changes to an extent but fear over-regulation.