1.   Some patients report troubles persuading their managed-care health plans to provide cutting-edge care.

2.   An HMO, for example, frequently limits its patients to a roster of doctors with whom the health plan contracts.

3.   And a good health plan.

4.   Arbitration of grievances, for example, is common practice at brokerage firms and some health plans.

5.   As a result, the private rooms do not add directly to costs for insurance companies and employer health plans.

6.   Both require health plans to disclose certain information, so consumers can compare costs, benefits and performance.

7.   But neither worked for companies that provided pensions or retirement health plans.

8.   But the proposal reneges on introducing market competition when it denies health plans the right to rebate part of the voucher to enrollees.

9.   But with dozens of other employer-, consumer- and industry-supported health plan surveys already around, some question the need for the product.

10.   By pushing cheaper, older drugs, they say, health plans ultimately drive up costs for hospital stays, nursing homes and doctors.