Beneficiaries who went outside the network of preferred providers were often "liable for the full cost of their care," the report said.

But Medicare officials said that patients would generally have to pay more if they used doctors and hospitals not listed on the roster of "preferred providers."

Doctors and hospitals that wanted to be named as "preferred providers" would have to meet new Federal standards for the quality of care.

The Government would publicize the names of "preferred providers."

Under such plans, patients can typically see any doctor, but receive discounts if they use "preferred providers."

Patients gain by paying lower out-of-pocket costs if they choose a preferred provider.

After all, when it came to government discounts, there were only three companies the Secret Service travel office listed as "preferred providers."

Meanwhile, many of the same institutions have formed looser links to create their own "preferred provider" networks.

After she reluctantly agreed to an inpatient hospitalization, I was told by her insurance company that my hospital wasn't a "preferred provider."

If only Dr. Carter were on my list of preferred providers!