I'm desperate to see health-care reform in the United States.

But I'm not so desperate that I'll consider supporting the plans proposed by the Democratic candidates for president. Nearly all of them are proposing a health-care plan that continues the practice of tying one's health insurance to one's employment.

First, why should my employer have to participate in administering my health insurance? They have enough to do, thank you, and they really don't have any business sticking their noses in my health. Plus, this is an expensive burden for businesses. I gather business organizations are eager to see this change--especially small businesses where the cost is much higher, proportionately. Second, you still have to build a secondary system of insurance for those who are either not employed or not employed in any traditional sense.

Of course one Democrat isn't proposing an employer-based system. Dennis Kucinich, in an effort to be the true believer in all things that the far left of the party desires, wants to simply have the government take over all health care. That's a non-starter for me! First, insurance companies would collapse, along with a fair number of hospital systems, unless they became the administrators of the government-paid health system. So, now you've managed to add a layer of federal bureaucracy to the health-care system without getting rid of the insurance companies. Congratulations, sir!

How about this? We require every insurance company to offer a minimum package of health benefits as a condition of staying in business (say, preventive, emergency, prescription drug, and other necessary care with no co-pay, plus a wide choice of physicians and hospitals). The federal government then reimburses each health insurance company for every subscriber to their plans at a fixed rate. The insurers can offer more than the minimum in this basic plan if they wish to try and attract more subscribers--they can also offer plans that exceed the minimum and charge whatever fee they think people will pay for the premium plans and the feds will still reimburse the basic rate.

In order to stay profitable, the insurers will need to keep costs down with hospitals, drug companies, and physicians. We'll rely on them to keep costs down as a profit motive--but there would be heavy penalties for refusing claims that are ruled to be legitimate by the feds. And one more thing: we'll allow insurers to band together to negotiate rates with physicians, hospitals and drug companies. Did you know that's illegal? It seems one problem with health care today is that the powerful lobbies for the drug companies and other providers have managed to greatly limit competition in the health-care economy. It needs to stop and not one national candidate from either party has said a word about this.

Sorry for the free-market lecture.

CDs listened today:

• Esa-Pekka Salonen: L.A. Variations
• Peter Lieberson: Garland
• The Muffs: Blonder and Blonder
• Matias Aguayo: Are You Really Lost
• Olivier Messiaen: Turangalila-Symphonie (Myung-Whun Chung conducting)
• Edith Piaf: The Very Best Of Edith Piaf