Scott McNeil, a junior at the University of Miami, takes chemotherapy to battle brain cancer. ''It's working, but it's really tiring.'' He'd like to take a semester off, but he can't, because the only reason he has health insurance is that he's included on his mother's policy as a full-time student. ``I just hope I don't get really sick.''

''What we need in this country is quality health insurance,'' says McNeil, 20. ``And it needs to be accessible to all equally . . . and it needs to be affordable.''

But how do you pay for that? That's where the arguments get nasty, although a consensus seems to be building among experts -- everyone from the head of the nation's most powerful business group to the leader of a major labor union -- for a radical solution. (More on that later.)

Now, as the campaign moves into its final chapter, the nation's financial crisis continues to dominate the news, but surveys show that healthcare remains very much on voters' minds.

Asking what were the two most important issues for the government to address, a Harris Poll in late September found that healthcare reform ranked No. 2, after only the economy and ahead of the Iraq War and gasoline prices.

A Commonwealth Fund survey in August found that one-third wanted a complete rebuilding of the healthcare system and another half thought it ``required fundamental changes.''

That's powerful ammunition for change, but what change? Experts question the viability of the healthcare proposals of both presidential candidates, Democrat Barack Obama and Republican John McCain -- proposals that are radically different.

''Whatever the outcome of the election, . . . there has to be a deal somewhere in the middle,'' says Drew Altman, head of the Kaiser Family Foundation, which focuses on major healthcare issues.

''I don't think there's any question that 2009 is going to be the biggest year ever for healthcare in America,'' says Tommy Thompson, former secretary of Health and Human Services in the George W. Bush administration. ``There's a lot of things that need to be done -- and can be done.''

Perhaps so, but Thompson and others agree that the challenges are enormous. Finding the money for healthcare will be difficult when hundreds of billions have gone to fund bailouts and the Iraq War. What's more, many believe that any reform requires a basic change in how providers like doctors and hospitals are paid -- a change that would meet hard resistance from the industry.

''Healthcare reform doesn't lend itself to a nice, neat package,'' says Alan Sager, director of the health reform program at Boston University. ``This is a $2.4 trillion part of the economy. . . . You don't change that with a nice 30-page piece of legislation.''

What follows is an analysis of the candidates' proposals for healthcare -- and what might take place after the election.

McCain's main proposal focuses on tax credits. He believes the present system is unfair. That system works something like this: The worker at the large corporation gets, on average, insurance that costs about $12,000, out of which about $3,000 comes from his own paycheck. That $9,000 difference is a freebie -- it doesn't count as income for tax purposes. Meanwhile, the small-business person buying his or her own policy on the individual market has to pay $12,000 out of personal funds, with no tax advantage.

McCain's proposal would tax the $9,000 as income if a person continued to get insurance through the employer. For those who didn't, he offers a tax credit of $2,500 for individuals, $5,000 for a family, which they could use to buy insurance directly.

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