31.   After peddling managed care plans for five years, Wayne Jenkins started Mutual Insurance Group of West Palm Beach seven months ago to specialize in medical savings accounts.

32.   Brewster, a pharmacist, said many consumers are opposed to managed care plans, because organizations often drop doctors or drugstores they have grown accustomed to patronizing.

33.   Breaux emphasized that Medicare beneficiaries who want to stay in the current fee-for-service program would not be forced to go into a managed care plan.

34.   But a patient in a managed care plan, receiving the regular preventive care that prolongs lives and spares the emergency room, is cheaper to care for.

35.   Bush spokesman Scott McClellan suggested that the governor supported legislation that included the right to sue managed care plans.

36.   But Gore did not directly address the most controversial issue of whether consumers should be allowed to sue their managed care plans for malpractice.

37.   But it also lets them choose among a variety of alternatives, primarily several forms of managed care plans.

38.   But many others say that they have so many patients in certain managed care plans that they cannot afford to quit.

39.   But Medicare officials say the assessment is justified because the handbook will serve as a marketing tool for managed care plans trying to gain Medicare customers.

40.   But some acknowledged they do not yet have evidence that the most challenging patients do as well in managed care plans.