I have observed a number of candidates for both State and Federal offices promising to work to achieve "affordable health care for all". Very enticing, but these aspirants provide few details of how the worthy goal would be accomplished.

To be fair, such an undertaking would be far from simple and implementation would require enormous changes in our current health care system not to mention overcoming significant resistance from industry and individuals.

There is certainly an ideological split inherent in the issue. One side supports the concept that it is government's responsibility to provide the same level of health care for all of its citizens; the other side argues with equal fervor that government intervention would result in loss of freedom of choice and the rise of a massive bureaucracy with the aaccompanying huge rise in taxation to support the new government function.

The concept of government-sponsored health insurance has encountered difficulties at the state level, primarily because of the cost involved. Maine is having problems funding Dirigo (in addition to owing millions to hospitals for treatment provided under MaineCare). Massachusetts is currently faced with a growing funding deficit for its mandatory health insurance program and Tennessee was financially unable to continue some of its free health care programs because of larger than anticipated utilization. The case might be made that state governments do not have the financial resources to support such an ambitious undertaking.

Then where to turn?

The Federal government currently funds health care programs for the elderly, low income individuals and families, military personnel and their dependents and veterans, among others, resulting in coverage for approximately 25% of the U.S. population. To increase the coverage to "universal health care" levels would necessitate an enormous increase in tax revenues.

Most of the nations who supply government-sponsored health care have income tax levels near or exceeding the 50% level. Also, nearly all of these programs require some of the health care costs to be borne by every participant, usually through some form of copayment. Notably, in nearly all of these countries there is still some sort of private health insurance available for those willing to pay additional premiums.

Proponents for universal health care argue that even with greatly increased taxes, the overall price of health care for the individual would decline since the profit margin for the health care and health insurance industries would no longer be a factor.

Opponents counter that government programs are not known for saving money and speculate that any savings would be more than overcome by the new and burgeoning government agency that would be required to oversee such a massive program.

There is ample room for discussion regarding the promises of politicians running for office. Despite glowing promises, there is no "free" involved in the concept of universal health care.

For many voters, the choice may hinge on whether one prefers a government that can be viewed as providing the solutions for life's problems, or a more limited government that allows the individual freedom to make choices on how to manage life's opportunities, problems and yes, hardships.

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