Regardless of which party wins the November election, it will likely initiate some sort of nationalized healthcare. Many people say it’s about time. Those with underinsured children will probably warm to the idea, along with aging seniors who are living longer than generations past and finding Medicare not up to the task of helping with medical bills. Others believe that a national healthcare system would let U.S. companies better compete with firms in countries that already have one. The attraction, of course, is that a national system would relieve companies of the overhead of many individual health plans. (The details of one plan proposed by Physicians for a National Health Program, that is also HR676, is online at phnp.org. Actually, it sounds pretty good.)

Opponents point to horror stories from Canada and the U.K., where some Brits pull their own teeth because of a dentist shortage, as reasons to derail a national plan. Proponents counter that such tales are rare, and any system has aberrations.

However, the great concern of a one-payer system, is that once in place, new devices and drugs will become scarce because of the enormous effort to keep costs down.

In the current system, private money, human energy, and doctors willing to try new things generate new ideas and useful devices. Capitalism (the profit motive) built our R&D facilities with offices and labs in every state. Would a tight- fisted government throttle this engine?

This next objection should give proponents pause: If individuals and companies are paying the government to run the healthcare system, why should anyone donate to private charities, such as the American Cancer Society, which professes to be working on a cure for cancer?

Funding, of course, will be a constant concern. Consequently, health- plan designers may find useful lessons in the elective end of the healthcare industry. Lasik and cosmetic surgeries are powered by vanity alone and flourish without insurance funds or reimbursements. What’s more, the cost of these procedures is dropping because of competition and technological advances. If the profit motive brings down prices and spurs innovation here, it should work in other areas of healthcare.

What would you design into a national healthcare organization? Speak up. You’re going to pay for it. Here are a few ideas:

Fix broken things fast. Set up the organization to function as a start-up company. When things go wrong and flaws come to light, local leaders must have authority to fix them immediately.

The plan must be self supporting and cannot add to the national debt.

Everybody is in, or forget it. No special treatments, dual systems for federal employees, or trust-fund babies.

Reshape the FDA so it functions in harmony with similar organizations in Europe. There is no reason drugs and procedures must go through multiple trials to satisfy the FDAs and NHSs around the globe.

Harry Truman would agree that the national-healthcare issue is too important to be left to politicians.