Interested parties in the various sectors of the health care industry are said to be marshaling their forces to press for changes in Medicare. They are particularly incensed by changes forced by the Balanced Budget Act of 1997.

That law reduced projected Medicare spending by $115 billion over five years and ordered up an array of new payment systems and regulations. The various lobbies want some of the money restored and some new rules delayed or killed. "Everyone is lining up at the cash register," is the way Brandeis University health-care professor Stuart Altman describes it.

• Health Maintenance Organizations are complaining about reimbursement levels and added regulations.

• Physical therapists don't like the $1,500 cap on outpatient rehabilitation services and want it eliminated.

• Home-health agencies want increased funding and contend they have been hurt badly by a temporary new payment system that has sharply reduced reimbursements.

• Skilled-nursing facilities want reimbursement for drugs, respiratory services and wound care.

Meanwhile the National Bipartisan Commission on the Future of Medicare is meeting and debating how to save the system. It has a March 1 deadline for coming up with recommendations.

Whatever the commission's recommendations, many in Washington doubt Congress will attempt a major Medicare overhaul anytime soon.

Source: Laurie McGinley, "Quick-Fix Push May Derail Long-Term Medicare Plan, Wall Street Journal, January 5, 1999.