It only diminishes their hefty Medicare subsidy.

The Medicare subsidy will offset some $583 million of that increase.

The Medicare subsidy will offset $1.1 billion of that.

And hospitals, encouraged by Medicare subsidies, are all too willing to provide that training.

Another major piece of financing would cut Medicare subsidies for private insurers, ultimately affecting their executives and shareholders.

Before the Medicare subsidies were increased in 2003, insurers had little incentive to focus on such places.

Whether the new Medicare subsidies will halt the decline in retiree benefits, as some Bush administration officials have predicted, is unclear.

Some big employers, including Dow Chemical and I.B.M., said they planned to use part of the Medicare subsidy to reduce health insurance premiums for retirees next year.

Mr. Kaplan at Segal said that nearly two-thirds of his company's clients were taking the Medicare subsidy.

Some small employers that still provide retiree drug benefits say the Medicare subsidy may not be worth the trouble, at least for the first year.