To Rep. Thomas J. Bliley Jr. of the Richmond-area 3rd District, the notion of a single, nationwide health insurance system such as Canada's hints of budget-breaking costs at a time the federal government already is troubled financially.

U.S. Sen. Charles S. Robb, D-Va., belonged to another prestigious commission that in 1989 advocated a somewhat similar approach using both private sector and government reforms. That group was named the National Leadership Commission on Health Care.

"Unless we have universal coverage, people will continue to fall through cracks in the system. The United States is far behind other industrialized nations in this regard, and 'bandage' legislation will never be able to patch up all the holes in the system," a Richmond woman wrote.