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border=0> The plan, to be unveiled fully in January, will probably spark broad complaints from the health care industry, Rendell predicted. For instance, he said, he wants to rewrite rules to allow nurse practitioners to play a greater role in patient care and create new regulations designed to guard against hospital-acquired infections.

"The test for us is, are we going to have the intestinal fortitude to look down the barrel of the special interests and say, 'Uh-uh guys, not this time, health care is too important of an issue for the people of Pennsylvania,'" Rendell said during a traditional end-of-year interview with reporters.

Rendell said parts of the package would involve winning regulatory and legislative approval, and would also include an expansion of the state's low-cost health insurance program for adults that he previously discussed.

A clamor against the rising cost of health care, he said, has created a mandate for the state to take action. Forcing down the cost of health care will be important to businesses that compete internationally with businesses that do not have to help pay for employee insurance, he said.

The state has a wider set of tools it can use to keep down costs in government health care programs, and Rendell said his administration will talk to business groups about what should be done in the private sector to cut health care costs. One idea, he said, is offering cash bonuses to employees who stay healthy, which the state already does for its employees.