The flat premium is paid by all 33 million Medicare beneficiaries.

The Senate bill would continue the monthly flat premium, now $4, paid by all beneficiaries.

However, the surtax and flat premium took effect immediately.

And after several years of relatively flat premiums, we now expect more significant increases in the cost of health care."

The Senate had sought to retain the hospital benefits, along with the flat premium, while eliminating the surtax.

"High-tech industries with fewer retirees are more likely to lean toward a flat premium.

But in recent meetings with business executives, Administration officials have suggested that companies would pay a flat premium of 7 percent of payroll.

"The flat premium will remain the same," Mr. Bentsen said.

The Senator would not change the flat premium of $4 a month that is deducted from Social Security checks.

The flat premium paid by employers for Federal insurance of pension benefits would rise to $19 for each participant in a pension plan from $16.

"The flat premium was never fair," he said in a telephone interview from Oakland, Calif. "It's a regressive tax."

The Senate had voted 99 to 0 to retain the ceiling on hospital payments, financed by a flat premium paid by all Medicare beneficiaries.

A flat premium fare of $2.45 or two fare zones is charged (which is a different fare structure from other Metro routes).

H.M.O.'s are typically paid a flat premium for each member for projected costs that do not show up in actual doctor and hospital bills until months later.

It is financed by a surtax paid by Social Security recipients and a flat premium of $4 a month paid by all Medicare beneficiaries.

Accepting the retention of the hospital benefits and reducing the flat premium, which is deducted from Social Security checks, would be "a reasonable compromise," Mr. Archer said.

Many House liberals, who had initially opposed repeal, eventually decided that it was better than the Senate version, which would have retained a flat premium of $4.90 a month for all beneficiaries.

The Administration's public position so far has been to oppose repeal because the program brings in needed revenues through a flat premium and a surtax on the relatively well off Medicare recepients.

The House Ways and Means Committee chose the second option shortly before the recess, voting to halve the surtax and increase the flat premium that all individuals pay, from $48 a year to $58.80.

He said that refunding the surtax paid in 1989 to the more affluent while not refunding the flat premium paid by all Medicare beneficiaries showed that "it's low-income people who don't have the advocates."

To stave off repeal, the House Ways and Means committee recommended cutting the surtax in half, increasing the flat premium paid by all beneficiaries by $42 annually and increasing the deductible for prescription drugs from $600 to $800.

But the Senate voted 99 to 0 to eliminate the surtax of up to $800 a year and retain a flat premium of $4 a month that is deducted from Social Security checks, along with the ceiling on hospital payments.

The health insurance program is financed by a flat premium of $4 a month deducted from the Social Security checks of the 33 million Medicare beneficiaries and a surtax of $22.50 on every $150 of income taxes paid by the elderly.

The issue arose when the Commissioner of Social Security, Gwendolyn S. King, disclosed Monday that the Government would continue to collect the flat premiums for up to six months in 1990, even though the insurance program had been repealed, because computers could not be reprogrammed any faster.

Some large industries, including auto makers, as well as the A.F.L.-C.I.O., prefer an income-based payroll tax, these people said, while other industries were more receptive to paying a flat premium per employee, and some employers wanted the costs paid from general tax revenues.