A look at key issues in the health care debate:

THE ISSUE: How can Americans control medical costs without it leading to rationing of health care?

THE POLITICS: There's broad agreement that health care costs are too high and that if left unchecked, they could bankrupt the government, not to mention businesses and families. The $2.5 trillion the United States spends each year should be enough to provide quality care for everybody _ even if that means fewer tests and procedures. But politicians of all stripes are reluctant to confront the public with that message. That means any health care overhaul may wind up adding to costs, instead of curbing them.

WHAT IT MEANS: Cuts in Medicare and Medicaid payments to service providers may only check costs temporarily. Prevention programs can sometimes cost more than they save because of the additional services provided to large numbers of patients. The key to controlling costs seems to lie in changing the economic incentives for hospitals and doctors, so that they focus on keeping patients well and preventing serious complications among those who are in poor health. Such a cultural change could take a generation to bring about, and many experts believe that although Congress' health care bills take some steps in the right direction, they don't do nearly enough.

_ Ricardo Alonso-Zaldivar