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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.

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.

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.

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.

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.

It's new. It's improved. And it's coming to medicare beneficiaries everywhere. It's the next generation of managed care, and it will happen even if Congress does nothing to reshape the medicare program this year.

As Congress gets closer to a showdown over medicare, groups for and against overhauling the program are getting ready to take their cases to the public and to target potentially vulnerable members of Congress.

The managed care revolution and crackdowns on government health care spending have put many of the nation's hospitals in a fiscal bind. Things could get worse if Congress makes big cuts in medicare and medicaid.

In previous Congresses, the chairman of the House Ways and Means Subcommittee on Health would have been free to write the medicare restructuring bill of his dreams. But William M. Thomas, like other chairmen, will have to accommodate his vision to that of the Republican leadership.