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President Bush was recently asked about the 45 million Americans who have no health insurance. The president, who is not famous for erudition or eloquence, briskly outlined the George W. Bush Health Care Plan as follows:

"I mean, people have access to health care in America. After all, you just go to an emergency room."

President Bush may be blind to the nation's health care problems but Americans are not. On the local front, you've read about the financial flap between Moses Cone Health Care system and Blue Cross Blue Shield insurance. Unless this is settled, Cone will not honor Blue Cross policies, and thousands will go without Cone's medical care except in certain emergencies.

Some national polls find that health care is the top domestic issue for Democrats and independent voters while Republicans rank it second only to immigration.

And no wonder. First, there are the

45 million Americans who have no health insurance — a number expected to jump to

56 million in five years.

And don't forget the

250 million Americans who do have insurance but whose premiums are steadily going up. And by the way, insured Americans help pay for those emergency room visits by the uninsured. Hospitals and insurance companies raise our rates to defray the loss, meaning we're all the losers.

American businesses, which offer group policies and pay a portion of workers' premiums, are also feeling the pain. Rising health care costs has led to the cost-cutting layoffs of thousands of workers.

Americans like to boast that "we have the best medical care in the world." We do if you can afford it. All European democracies, Canada and Japan have universal health care, meaning all citizens are covered. The United States is the only major democracy without it. As a result, consider the following:

People in 41 other countries live longer than Americans. Infant mortality is higher in America than in 40 other countries, including Cuba. African Americans have a shorter life than whites by five years. Much of the blame for these appalling statistics is attributed to lack of health insurance.

Surprisingly, most countries with universal health care pay less but have more to show for it. Jane Bryant Quinn, the Newsweek economic columnist, wrote in the July 30th issue: "In 2005, the United States spent 15.3 percent of gross domestic product on health care for only some of us. France spent 10.7 percent and covered everyone." Most international surveys rank France's health care system among the best in the world. The French live longer, infant mortality is low, etc.

Universal health care is not perfect, however. In some countries, Britain and Canada especially, it may involve long waits for non-emergency treatment. It all depends on how a country funds and administers its system. "Many countries that cover everyone, including France, Belgium, Germany and Japan, report no issue with waits at all," writes Quinn in Newsweek.

Presidential candidates are not deaf to voters concerns. Democrats John Edwards, Barack Obama, Hillary Clinton and Bill Richardson favor universal health care but details of their plans vary. For example, Edwards would require all Americans to be insured and the costs would be subsidized by the government and employees. Republicans Rudy Giuliani and John McCain oppose mandated insurance and prefer tax credits for private insurance.

Ever since the 1920s, American politicians have proposed universal health care at various times. But it will take Americans will to make that radical change, because it involves 1) higher taxes to pay for it and 2) reliance on government, which American often distrust.

But consider the alternative: a horrendously expensive health care system that leaves 45 million without insurance. Then ask yourself this question: Should health care be a privilege for some or a human right for all? All major democracies, except the United States, embrace the latter by providing universal health care.

Rosemary Roberts writes a Friday column. E-mail: rmroberts@triad.rr.com.