Question Number Eight: President Bush and Sen. Kerry have unveiled their health care plans. How would you structure a health-care plan? Would it be universal, or only for indigents? Would you feature privatized health-related savings accounts? What would you do about malpractice lawsuits?

My health-care plan would be along the lines of that proposed by Physicians for a National Healthcare Program (see www.pnhp.org). Details have been written into House Resolution 676, The United States National Health Insurance Act, introduced before Congress by Rep. John Conyers (D., Mich.). This is a universal, single-payer system, with most health-care delivery remaining private.

Who and what would be covered? All residents in the United States and U.S. territories would receive care by simply walking into a doctor's office, hospital, clinic, or other facility of your choice and presenting your card. No money would change hands. Premiums, deductibles and co-payments are eliminated. No one would receive a bill from a doctor, hospital, pharmacy, or insurance company. All necessary medial expenses would be covered, including dental, vision, mental health, and long-term care. The rationing that currently takes place in our system is unnecessary.

Not covered would be over-the-counter drugs, such as aspirin; luxury, long-term care surroundings; and cosmetic surgery or other purely elective procedures. These could be paid out of pocket or through private insurance companies.

Who would run and manage the health-care system? Medical decisions would be in the hands of the patient and doctor. Most hospitals, clinics, and health-care delivery systems could remain private. Cost containment measures would be publicly managed at the state level by an elected body that represents the people of that state. This body would plan and effect the distribution of expensive technology; create a budget; and negotiate payments. Gone would be the decision-making of private medical insurance companies, except for elective procedures.

Would we have to raise taxes? With a universal, single-payer system, at least 95 percent of people would end up paying less for health care than we do now. Any necessary tax increases would be more than offset for most people in what they would save in premiums, co-pays, and deductibles; most of these would disappear or be much less. This is because there is tremendous waste in our current system. Compared to other advanced countries that have health coverage for everyone, we pay much more for health care both as a percentage of GDP and per capita (each and every man, woman and child - whether covered by health insurance or not) - yet not everyone is covered. As much as 30 cents of every premium dollar is squandered on enormous CEO salaries, shareholder profits, advertising and administration due to a plethora of insurance companies creating mountains of paperwork.

Insurance companies probably would let many workers go. What of them? We should use money saved through increased efficiency to help such employees make the transition into different careers. There must be enough money for education, retraining, and relocation to the sites of other jobs paying at least as much as the lost job.

What about medical malpractice lawsuits? The main force driving up med-mal rates is not the amount and frequency of outrageous jury awards. Rather, we should look at the enormous salaries of insurance company CEOs, and the way that a few physicians with large numbers of lawsuits drive up the rates for all other physicians. Each state should offer public malpractice insurance for doctors, which should help stabilize rates.