President Clinton intensified his campaign to increase protections for patients in health care plans by giving a fiery speech at a hospital here today and contrasting Democratic ideas with rival Republican ones as a choice between "whether some people live or some people die."

Clinton dropped by the Harbor-UCLA Medical Center in this city just south of Los Angeles ostensibly to promote his "Patients' Bill of Rights" to a group of doctors and nurses, but there was no mistaking the real target of his stinging 20-minute address: Senate Republicans who are planning to renew debate on health care legislation -- and to try to thwart some of the president's goals -- as soon as Congress returns to work Monday.

Amid rousing applause from his sympathetic audience, which was crammed inside a small auditorium for the hastily scheduled event, Clinton called Republican alternatives to his party's package of health care proposals far too limited in their protections and in the number of people they would include. The president also denounced GOP leaders for waiting until now to bring the far-reaching legislation to the Senate floor.

He accused Republicans of being captive to the "raw political interest" of health insurers and said that party leaders had resorted to delaying debate on his plan for cynical political reasons. "They're not for it, but they know they can't afford to be caught being against it," Clinton said.

Last year, the House passed a GOP version of patient protections, but the issue never came to a vote in the Senate. This year's Democratic package would guarantee patients more rights to emergency room care and medical specialists, give physicians and not HMOs more power to decide treatment, and allow patients to sue HMOs if they withhold treatment.

By executive order, Clinton has already given many such protections to federal workers, military veterans and patients who are covered by Medicare and Medicaid. Since then, the president said today, their insurance premiums have risen only by about $1 a month. "Isn't is worth it to allow the system to work?" Clinton asked.

An estimated 43 million Americans still do not have any health insurance. The main source of health care for those that do are managed-care plans with patient rules and restrictions that have become the focus of an enormous political and medical debate. And with the Senate debate fast approaching, business and insurance groups on one hand and medical groups on the other are launching massive nationwide radio and television campaigns on the issue.

Republicans contend that Clinton's health care plan will be too costly and could even prompt some employers to drop or severely limit coverage. A number of Republican alternatives also would give patients more rights in managed care, but none have all the steps that Clinton wants.

When Congress returns, Republican leaders intend to employ an unusual parliamentary strategy in what is now scheduled to be a week-long debate. Instead of advancing their own plans, they vow to focus on a legislative package sponsored by Minority Leader Thomas A. Daschle (D-S.D.) and Sen. Edward M. Kennedy (D-Mass.). Clinton scoffed at that maneuver today and said it suggests that the GOP wants to hide its plan from voters.

Clinton, whose tour this week of poverty-stricken areas across America ended in Los Angeles, was joined at the medical center by John Lewin, executive vice president of the California Medical Association, which represents 35,000 doctors in the state. Lewin praised the president for "courageous leadership" on health care.

Before returning to Washington, Clinton will attend the championship game of the Women's World Cup in soccer, to be played Saturday at the Rose Bowl in nearby Pasadena.

Staff writer Amy Goldstein in Washington contributed to this report.

CAPTION: In a speech at a California hospital, President Clinton criticized GOP senators' approach to a patients' bill of rights: "They're not for it, but they know they can't afford to be caught being against it."