minority of Americans do not have access to proper health care.

And this has doctors across the nation worried. So worried in fact, that they spent all day Saturday discussing therapeutic methods to ease the current predicament.

Dr. Louis Sullivan, who was the former Secretary of Health and Human Services during the Bush Administration, delivered the lead off speech at the conference, which was held at the Marriott's Castle Harbour Resort.

While not as revolutionary in his approach to healing the crisis in American health care when compared to current first lady Mrs. Hillary Rodham Clinton, Dr. Sullivan believes that reforms hold the best hope for success.

At the very least he says, reforming the system is inherently more practical than attempting to change or get rid of the current scheme.

"The United States has the most advanced and sophisticated health care system in the world,'' he explained. "There are new developments and advancements each year.

"But the problem is that costs continue to increase and this is where the difficulties arise.'' However, spiralling costs are just one part of an equation access is the other. Together both elements combine to present a problem for doctors and politicians that refuses to be balanced, in spite of all the tinkering and adjusting that has been done so far.

Currently, some 13 percent or 37 million Americans do not have access to health care and this, Sullivan said, is the basis for the situation in the simplest of terms.

"What we want to do ideally,'' he continued, "is to expand access, while keeping costs under control. The sweeping changes proposed by the Clinton Administration are just too costly.'' Dr. Sullivan, whose stint in the Bush Administration began in 1989 and lasted until 1993, attempted to introduce his vision of health care to the American public. But a Democratically held Congress, prevented its passage.

"Basically there were two features to my plan to expand access,'' he said.

"I proposed a tax voucher so that low income people -- the unemployed and the homeless especially -- would be able to purchase health insurance.

"It was worth $3,750 and it was to be provided by the Government.

"Secondly for the middle income groups, their health insurance premiums would be tax deductible. This, however, would be phased out as their income increased so that by the time they reached an income of $80,000 they would be no longer eligible for the tax break.'' Costs, Dr. Sullivan noted, could be approached systematically with a focus on health prevention, which would incorporate measures such as reducing cigarette and alcohol use, promoting exercise and reducing calories and saturated fats in the diet.

Furthermore, costs could also be reduced through tort and insurance reform.

This would have the effect he said, of cutting down on inappropriate law suits and allow people with diseases such as diabetes and AIDS to get coverage.

Dr. Sullivan said insurance reform would also look at enabling Americans to avoid the "job lock''. This is the name given to the practice that forces an individual to loose coverage when they switched jobs.

"We want to change that so insurance coverage becomes portable and transferable as people change jobs.'' Also contained in Dr. Sullivan's plan, is an incentive to medical students to go into primary care or general practice instead of specialising.