A study by the trade journal Health Affairs concluded that McCain's plan would ''greatly reduce the number of people who obtain health insurance through their employers'' -- perhaps a drop of 10 million to 28 million of the more than 150 million who now have employer coverage.

Many, including some of the 45.7 million people now uninsured, would move to the individual market, resulting in a net reduction in the uninsured of about one million, according to Health Affairs.

But since the average employer-based policy now costs $12,680 for a family, according to a Kaiser study, people in the individual market are likely to opt for less coverage with the $5,000 they have to spend -- meaning higher deductibles and co-payments.

What's more, says Health Affairs, administrative costs on individual policies are considerably higher, meaning that purchasers of individual policies get less for their money. McCain's health advisors believe that savvy consumers should be able to force the insurers to offer better benefits.

The Brookings Institution, considered by some to be a liberal think tank, estimates that the McCain tax shifting would cost about $130 billion a year, but McCain's campaign says changes might not increase taxes because the tax credits would be offset by companies losing their health-insurance deduction. The McCain plan would also save money by major cuts in Medicare and Medicaid, an aide told The Wall Street Journal in an article published Monday.

Regina Herzlinger, a Harvard business professor, insists that reforming the tax code is ''essential for the survival of the U.S. economy,'' because each General Motors car now includes costs of $1,500 in employee health benefits -- while foreign manufacturers may spend $100 a car on those.

Even so, the tax credits are questioned by the Business Roundtable, a group representing the largest companies in the country, including Ryder and FPL Group. Ivan G. Seidenberg, chief executive of Verizon and the Roundtable's leader for healthcare, calls McCain's plan ''a theoretical answer -- not rooted in a practical base'' because it undermines the employer-based coverage that many Americans like.

Critics argue that under the McCain plan, seriously ill people forced to get their own insurance will be rejected because of preexisting medical conditions.

McCain's answer is to advocate the expansion of state-run high-risk pools, the last refuge for the uninsurable. Critics respond that such pools are notoriously short on money and can't help all who need them. Florida's pool, for example, was closed to new applicants in 1991 for lack of money and now serves a mere 300 people.

Obama emphasizes that anyone who likes his or her present health plan would be able to keep it. He concentrates on helping those struggling to get or keep insurance.

Medicaid for the poor and a state-federal children's insurance program would be expanded. A new National Health Plan, similar to what's available to members of Congress, would be guaranteed to everyone who wanted it. No one with preexisting conditions could be excluded or forced to pay higher premiums -- a requirement that experts say could cost a lot.

Large employers that didn't offer insurance would have to pay into the fund. Those that did provide coverage would be reimbursed for some costs of employees with catastrophic illnesses.

The plan would allow coverage for many of the uninsured, but critics are deeply concerned about the costs. The Obama campaign estimates that the plan would cost $50 billion to $65 billion a year. That's less than the cost of the AIG bailout and about half of the annual war costs in Iraq.

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