The National Capital Area Health Care Coalition, signaling renewed frustration over the continuing escalation of medical expenses, yesterday stripped doctors, hospitals and labor of their voting rights in the medical cost-containment group.

The move marked the culmination of a controversial campaign by several Washington-area companies to assume control of the coalition. The group was founded in 1983 to bring together all parties in the health care system on an equal basis, but proponents of the move say the coalition's broad membership has hampered progress in adopting effective cost-controls.

Business leaders said that one of their prime goals is to increase the clout of employers, who pay for most of the cost of health insurance, in order to negotiate lower rates from doctors and hospitals. Medical costs have continued to rise, despite several years of cost-containment efforts.

Under the restructuring approved at a coalition meeting yesterday, two new classes of membership were adopted -- one for business members, who would have voting rights, and one for hospitals, labor groups, doctors and others, who would be limited to an advisory role.

The restructuring was approved on a vote of 63 to 16, with heavy support from business members of the coalition, including George Hyman Construction Co., Woodward and Lothrop, Washington Gas Light Co., Bell Atlantic Corp., Pepco, Perpetual Savings Bank F.S.B. and many others.

However, roughly one-third of the support for the proposal came from groups that would lose their voting rights, including several hospitals, health maintenance organizations and health care consultants.

"I think that the physician community, as much as it wants to, can continue to play a role," said Dr. John Lynch, a prominent Washington oncologist who supported the proposal at yesterday's meeting. "I don't think that my being on an advisory committee will make me any less of a peer."

But Lynch said the coalition needs to show more concrete results if it is to continue to attract business support. Without that support, the coalition faces financial troubles and its possible demise, advocates of yesterday's change said.

Nonetheless, the move drew heavy opposition from much of the rest of organized medicine, including the D.C. Hospital Association and the city's Medical Society, who said they have been shut out by yesterday's vote. The proposal was also criticized by labor groups in the coalition.

Howard Jessamy, president of the Hospital Association, said the restructuring has the potential of putting businesses and hospitals "in a situation of confrontation."

"It is hard for me to accept the premise that our vote was hindering progress," added Dr. Carlos Silva, a surgeon who serves as president of the Medical Society. "I personally felt that our rights were being infringed upon."

But Silva said the society would continue to cooperate with the coalition. "The associate membership will give us the right to be heard," he said. "By being absent, we would be shirking our responsibility ... We are the best judges of what is and what isn't good patient care."

In the wake of yesterday's vote, coalition members said they would move immediately to enlist greater financial support from the business community, including raising dues as much as 10 times the current dues, which range from $350 to $1,250 a year.

One of their goals is to build closer ties with the Greater Washington Board of Trade, in order to tap the large number of local companies that belong to that business organization, according to Al Burfeind, vice president for human resources at George Hyman Construction Co. Coalition members have also started discussions aimed at developing low-cost programs for businesses in mental health care and workman's compensation health