>Washington lawmakers are playing a high-speed game of chicken over a plan to revoke drastic cuts in the fees paid to doctors to treat Medicare patients. If someone doesn't swerve, the result will be tragic.

On one side is the House, which passed a bill to scrap the 10.6 percent cuts and increase the physician payment scale, albeit far less than the annual rate of health-care inflation. On the other side is a Republican contingent in the Senate that includes Judd Gregg and John Sununu of New Hampshire. Their support could have given the Senate the 60 votes needed to send the bill on to President Bush and test his threat to veto it. Gregg voted no. Sununu didn't participate in the 58-40 vote. He opposes the House version and supports a rival Medicare bill sponsored by Iowa Sen. Chuck Grassley.

Though neither senator wants to see the cuts made, they stymied the bill's passage in hopes of passing rival legislation. In Sununu's case particularly, since he faces one of the toughest reelection battles of any incumbent next fall, the vote was courageous, in a way. It was nonetheless wrong.

Delaying even this temporary, two-year solution to such a serious problem is wasting time that should be spent solving what is becoming a crisis in American health care. Instead, the Senate is arguing over Band-Aids.

Doctors lose money on every Medicare patient they see. The situation is particularly grim in New Hampshire, since the federal program pays physicians just 65 percent of what they spend to treat someone on Medicare. Healthy young and middle-aged residents are struggling to find primary-care doctors willing to accept them as patients. Older residents have a far harder time, and the task will become impossible if the cuts, which were supposed to go into effect last week, are eventually made.

Many physicians are already limiting the number of Medicare patients they accept or closing their practices to them entirely. And the low payment rate is just one more reason why so many idealistic medical school students who start with the goal of practicing primary care medicine change their mind when economic reality sets in.

This year marks the fifth time that Congress is playing chicken with cuts in payments to doctors. Presumably lawmakers will give enough ground to avoid a crash in the primary care availability for Medicare recipients. That's still no cause for celebration if all it does is postpone discussion of a more lasting solution to rising Medicare costs and the coming surge in those eligible for the program.

Below-cost reimbursements force health-care providers to shift costs to those with insurance. That, in turn, drives up premiums, makes coverage ever less affordable and increases the rolls of the uninsured. It is an exercise in madness.

The long-term solution Medicare's problems can't be separated from the rest of the system's ills. Reforming Medicare means reforming the way health care is used, administered, delivered and paid for to ensure the highest possible quality at the lowest cost.

The bill to delay the physician pay cuts will come up again soon. When it does, Gregg and Sununu should stop the political maneuvering, help it pass and join the search for a lasting solution a problem that vexes virtually every American and endangers the lives of millions.