As we approach the election, all of us in health care would do well to think about one thing. How can we help the people we elect wrangle with the American Association of Retired Persons? It will be critical to the future of health care to do so.

Amid all the talk of budget surplus, we sometimes forget that Medicare's hospital insurance fund has been running in the red since 1992. Last year, the program ran a projected cash deficit of $7 billion. By the year 2026, the year the last of us baby boomers retire, the program is projected to have a $200 billion annual negative cash flow.

Congress, of course, is well aware of this, and its members resolved to do something about it in 1997 with the Balanced Budget Act. Unfortunately, what they decided was to give it to hospitals, but good. They successfully cut hospital reimbursement by more than $200 billion, and now nearly a third of all hospitals are running in the red.

To its credit, the House of Representatives also wanted to get seniors to contribute a little bit to the effort of making Medicare solvent. The House tried hard to raise the eligibility age from 65 to 67 (Our life expectancy has increased by seven years since Medicare was implemented) It also tried to make wealthy seniors foot the bill for their own outpatient services insurance, often called "Part B."

The AARP, which employs 2,000 people in its Washington office, would have nothing of it. This powerful lobby fought tooth and nail and was successful in protecting its members from making even one sacrifice to help keep Medicare solvent.

Now the AARP is now pushing hard for and very likely will be successful in getting a prescription drug benefit for Medicare beneficiaries. It is fighting to preserve the fee for service option in Medicare, something almost none of us workers have. And it remains opposed to the two measures I mentioned above. To the extent that it is successful, health care providers will continue to suffer.

I think we need to do at least two things. First, those of us in health care need to do a better job of letting lawmakers know that we vote. We also need to let them know that the cuts we have sustained are forcing some of us out of business, some of us to cut services, and many of us to reconsider our career options.

Second, we need to do a better job of communicating to the AARP's consituency. The members of "The Best Generation" are not at all averse to giving for the good of their country's future. They just need to understand why it's necessary.

Make no mistake: challenging the AARP-the group one highly placed Health and Human Services official called it "the best, most sophisticated public policy and advocacy lobby in America"-will take blood, sweat and tears. But for the future of health care in America, it is our duty to do so.

Stan Herrin, Publisher and Editor in Chief