A main obstacle has been the decreased time patients can spend with their doctors, dictated largely by managed care and other medical reimbursement plans.

"I think the money is pretty close to right," Mr. Gallagher said of the deductible reimbursement plan.

But yesterday, the M.T.A. argued, among other things, that a reimbursement plan could be worked out.

Investigators say the reimbursement plan was first discussed at a 1996 Chinese New Year's celebration at Ms. Chu's house.

But Mayor Brater said the Legislature in recent years had allocated only 47 percent of the money authorized by the legislation for the reimbursement plan.

Yet the question remains: how will the mutual fund companies - who were also the victims in this price-fixing case - carry out a reimbursement plan of Wall Street's making?

Corporations can set up medical reimbursement plans, for example, under which the company deducts medical expenses paid and employees are not taxed on the reimbursements.

Eli Lilly, the drug company, instituted a direct reimbursement dental plan in 1974.

He blamed managed care and frozen reimbursement plans, and he called the Othmer bequest "extraordinary timing for us."

Mr. Dodd cited a few of these cases in an effort, he said, to reflect the need for the reimbursement plan.