But it sidesteps the single-payer approach, which has been successful in other industrialized countries but is not politically palatable here.

The single-payer approach would rein in the insurance companies.

Through these experiments, Sanders believes the single-payer approach will be proven to be the most cost-effective program and will expand nationally.

"Over time," the press release says, "the system may evolve toward a single-payer approach if individuals and businesses prefer the public plan."

The single-payer approach, similar to Canada's system, is co-sponsored by 92 House Democrats and one independent.

Indeed, forceful advocacy of the single-payer approach offers a golden opportunity for any serious presidential candidate.

Does a candidate who couldn't persuade voters to embrace the single-payer approach deserve to be president?

Mr. Stark supports a single-payer approach, in which the Government pays all health bills.

One Democratic Senate aide, who has strong misgivings about a single-payer approach, nevertheless said the influence of those who support it could not be discounted.

Instead, the program is an example of a single-payer approach that is failing.