Yet, while President George W. Bush and his sycophants dither about trying to "reform" a Social Security system that isn't half as dilapidated as health care into a windfall gift for Wall Street fat cats, the numbers predict a national disaster if health insurance isn't looked after soon.

The ranks of the uninsured swell by 100,000 each month. Huge companies that once viewed health insurance for workers as a no-problem benefit are going broke partly because of the premiums; General Motors -- which just announced a layoff of 25,000 full-time workers -- is an example. Some firms encourage lower-wage workers to sign up for Medicaid, which is drowning in so much red ink that governors in many states, such as New York, offload much of the cost on already-poor counties and already-burdened taxpayers.

In just three years, if current trends hold true, government-sponsored programs such as Medicare and Medicaid will spend more insuring retired Americans than on the already-immense defense budget. Now, that's going some.

Until about seven or eight years ago, in return for loyal service, retirees from big American firms could look forward to having their health care coverage and that of their spouse paid for by their company until death. Then the accountants and Ivy League business graduates started showing the boss how many millions could be saved by simply eliminating that perk. The spouses were the first to go, then the worker. Now, it is an expected elimination.

Workers who planned a retirement of early leisure have to take new jobs just to pay for health care. I know about this. It happened to me. I expected the coverage and planned on it through a 40-year career, then "poof," it disappeared. When I mentioned it as a possible inclusion in the severance package during negotiations with the human "services" director, she looked at me like I was nuts.

The Republican CEOs who run many of the largest corporations spend much of their time now bitching at their Gucci-shod lobbyists about the crippling costs of premiums. Just slicing the workforce quarter after quarter, however, is obviously not a long-term solution, and eventually will ruin the currently beleaguered economy. And if you think health care provision is a problem only for big firms, think again. Studies show that premiums to cover workers at smaller firms run more than 20 percent higher than for the giant corporations -- a big impediment to development and growth of the small business segment that is the backbone of the American economy.

The Democrats in Congress are leery about taking on the problem directly because of their experience a decade ago with Hillary Clinton's disastrous attempt for her president-husband to shape the U.S. health care system into a streamlined reflection of other government-administered single-payer systems like Canada's or France's. Instead -- mainly because she attempted to fashion the whole thing behind closed doors without public or press scrutiny -- the effort ended up an indecipherable mishmash of hybrid ideas with a flow chart that resembled something out of "Mad" magazine.

The failed effort had political consequences. The next election saw Republicans increase their numbers in Congress just by focusing on the Clinton health care failure.

Copying the Canadian system -- which drew loud cries of support just a few years ago -- is considered folly now, because even while drugs are cheaper there and it is generally fairer to recipients, our neighbors are having problems sustaining it, and treatment delays are considered incredible by many in the program.

It is more likely in Washington -- with conservative, business-minded Republicans running the show with an iron hand in a mailed glove -- that the GOP will be the first to come to grips with the problem, simply because the corporate sponsors of so many Republican members of Congress are wailing so loudly about it. The Republicans, without much luck, have already tried to promote so-called Health Savings Accounts, which -- while carrying an embedded tax break -- still would load the greater share of health care premiums onto individuals and wouldn't extend coverage all that much.

So, who will fashion a plan that would cover every American, cut current waste, give us more choice of insurance carriers, provide us expectation of reasonable outlays for maintaining our health, reduce government bureaucracy, tamp down the increase in future medical costs, strengthen the economy, and yet be politically viable by offering advantages to Big Business and the other powerful interest groups involved?

Well, somebody already has. Actually, two somebodies.

In the June issue of the excellent magazine "Washington Monthly," two health experts -- Dr. Ezekiel Emanuel, an author and cancer physician, and Victor R. Fuchs, a Stanford University professor emeritus of economics -- describe their proposed Universal Healthcare Vouchers, or UHVs. As they maintain in their article, their idea might just "achieve goals long sought by both sides of the political divide: the progressive dream of universal coverage and the conservative values of free choice and efficiency."

The plan?

Every American household would receive a government voucher "entitling its members to enroll in a private health plan of their choice." The current private health insurance carriers and any new ones would by law have to guarantee coverage for doctor visits, hospitalization, pharmaceutical medicines, emergencies and catastrophic coverage.

Those with pre-existing conditions and higher expected costs would be covered by adjusting reimbursement values of the vouchers to the differing risk levels the insurance companies absorb. Thus, for covering older and sicker patients, the insurance company would receive a higher payment -- eliminating the current incentive to exclude high-risk patients.

Medicare would be replaced, or more accurately, phased out. Senior citizens currently enrolled in Medicare would see no change, but there would be no new enrollees. Americans who turn 65 will simply keep their voucher-paid coverage. Medicare, its hideous payroll tax that financed it, and, as the authors call it, its "calamitous fiscal future," would over time be completely replaced by the voucher system.

Because every American would be covered regardless of income, Medicaid and its terrible burden upon states and localities would also be eliminated.

Private doctors would, like today, choose to accept or reject different insurance plans. But they would avoid the massive paperwork and fighting with bureaucracies that causes many to retire early.

Doctors and hospitals would no longer have to absorb, and pass on to insured folks, the cost of "charity care" for uninsured patients who lack payment means.

"Frills" coverage, such as for Viagra and cosmetic surgery -- the source of unending debate in localities and legislatures -- would not be provided under the UHV plan; you'd have to pay for these non-essentials on your own.

The workplace would be reformed. You could switch jobs, be your own boss, go to part-time work or any combination of the above without fear of losing your health coverage.

Employers would be free to hire workers without figuring in the health insurance costs, thus improving the economy.

A new Federal Health Board would administer the system. It would be modeled after the Federal Reserve Board, with regional sub-boards.

The voucher system would be paid for by a Value Added Tax, which would probably increase the cost of your new car by eight percent, but would spread the tax burden broadly and encourage savings. VATs are much harder for the affluent to evade than income taxes. Most Americans would be paying about the same for health care coverage.

But all Americans would have it, and your paycheck would be bigger. The authors say the cost of extending coverage to all 250 million Americans under 65 would be about $713 billion. The current cost to employers and the government on health insurance is about $800 billion, and the system leaves 45 million Americans without any coverage at all. As the fella says, a billion here and a billion there, and it adds up to real money.

That doesn't even take into account the tens of billions of dollars spent each year by Medicaid just to figure out who is eligible and who isn't.

The beauty of this system is this: Very little change would be noticed by people in the current private delivery system or by users of health care insurance, and it's politically viable. When the Pew Research Center in 2003 asked Americans if they would support universal health care even if it meant rescinding Dubya's tax cuts, 72 percent said yes, including a majority of Republican respondents.

Once the Big Business lobbyists start to study this thing, my prediction is the Republicans will get serious about backing it. No more health care costs? CEOs would snap at it like bass to a fat minnow.

We'll see, of course. The current non-system has so many special interests involved that anything could happen. But almost anything is better than the status quo.