We have all heard the competing stories and theories about the need to reform the health care system with which we all live. There are those who want to tell you about their awful experiences with the Canadian system and those who want to tell you about having to wait for months for care in Toronto or Ottawa. There are also those who are pleased to tell you about their pleasure at the services and ease with which they were cared for.

Both accounts are probably true and accurate. We are being flooded with scare stories from insurers and the American Medical Association to prove that we should continue to live with what we now have, even if it is imperfect. Unfortunately, following that scenario offers us many more problems than solutions.

Many of us have friends and neighbors who need medical care. We tell ourselves that it's not our business to know whether they have health insurance, whether they are "covered" for the treatment they need or want today, or whether their own private insurance has denied them service because they have a pre-existing condition. Or whether they are at risk of losing their home to the bill collectors when it becomes impossible for them to pay for the care they have received.

Much of the cost is attributable to the charges for tests which many lay persons declare to be unnecessary and a defensive move to ward off malpractice lawsuits. Has anyone actually totalled up the number of such actions per doctor or per hospital or per

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insured in recent years? Is this a real concern, or is it a wonderful marketing tool from the insurance industry?

Much of the opposing "information" warns us that health care will be rationed. That we will lose our choice of physician, that we will be subjected to assembly line medicine and that we will have to settle for less than optimum medications and procedures. Again - stick with the devil you know. As Americans we have the opportunity for first class treatment - if we live in large and affluent metropolitan areas, have sufficient money to supplement the insurance our employers are paying for, or in the case of our elected officials the insurance which the taxpayers (employers) provide. We have come to believe that we should be cared for as if we were kings and queens as we approach the end of life.

We tell ourselves that we don't need to make our wishes known in writing because the doctor and the hospital will know what to do. Especially in the case of catastrophic accidents or total breakdown of the body systems, we have not made clear - in writing - that we understand that some of us may not win the race to live to be 110 or older. Just a bit of palliative care and hospice attention should be OK.

Certainly, there are situations when horrific accidents occur to folks we love and hope to bring back to full functioning life. And it should be so. We have the tools and talents to do just that. But - there are many of us who have already lived a good life - who have reached an age when I believe we should be ready to step aside from hanging on for months in an ICU or critical care center - costing our insurance or our loved ones over $2,000 per day, while not making discernible progress. We should be having conversations with our loved ones about the morality of demanding what we might graciously let go of, so that others may gain some more life and love and laughter.

Affordable, accessible, adequate health care is indeed a human right. The best available and most compassionate care should be afforded to every person of any age and stage. The continuing process of paying high premiums so that the insurance industry is able to make huge profits from which to employ lobbyists and buy advertising to defeat us in our efforts to see that every person who needs care gets it in appropriate amounts is, at the very least, self-defeating.

Decent, ordinary Americans are losing their homes, while those who invest in insurance companies want us to believe that denying this particular profit experience will add to the economic downturn (depression) the nation is suffering. Selective self-rationing of our sometimes outrageous demands seems the most democratic approach we can take.

With all this, we - as consumers of life affirming service - need to consider how we will make the financial transition to "single-payer" or "everybody pays a share based on gross income" so that the delivery of health care can indeed by based upon need and not check-book.

The majority of medium and large companies are paying for health insurance as a benefit of employment. This is obviously affecting their corporate profitability and health. So - let's phase out employer based expense over the next three years and eliminate the worker's share of the cost of the insurance. Instead, the worker and all other persons who receive any income from any source should be levied a "flat tax amount - perhaps 1.5 percent of their total income - the proceeds to go into a fund with the money from the employers' previous contributions.

Within three years there should be sufficient dollars to pay for treatment and perhaps a small debt, which will disappear within the next few years. Employers will be let off the expensive hook, employees will no longer have to pay off a deductible or a co-pay and the health care for all should be flush enough to exact tough bargains with the big pharmas.

We will need to expand the numbers of primary physicians so we should be prepared to pay for their education and malpractice insurance costs in exchange for specific numbers of years as practicing physicians. After World War II, we paid for teacher education with the caveat that the students would teach for a number of years. Why not repeat that success?

Most of all we need to give up being afraid of the bullies in the insurance industry and the pharmaceutical companies. They live on K Street and they deserve eviction notices.

Anita Bellin lives in Bennington.