PORTLAND, Ore. - The voters here have the chance to create the first universal health-care system in the nation - one where everybody would receive medical coverage for everything, from massage therapy and marriage counseling to brain surgery and long-term care.

The sponsors of the November ballot initiative acknowledge their plan is audacious, but they contend that the health-care system is headed toward a meltdown brought about by rising numbers of uninsured individuals and spiraling costs.

They are pressing their case with 4,000 phone-bank volunteers on a shoestring budget of $22,000, led by unpaid campaign and media directors, both age 22.

The measure could pass: The most recent polling, by the Portland Tribune, found that 36 percent approved of the plan, 39 percent opposed it, and 25 percent were undecided, with a margin of error of 4 percentage points. The initiative was winning among Democrats and women, and trailing with men, Independents, and Republicans. An earlier poll by The Oregonian newspaper found 49 percent against the measure and 40 percent for it, with the remainder undecided.

The next week will be crucial, because Oregonians vote by mail and their ballots must be received by Nov. 5. The organized groups opposing the health-care experiment have yet to run television spots, though they have about $400,000 on hand and are expected to start their ads any day. If the initiative passes, said Rachel DeGolia, a director of Cleveland-based Universal Health Care Action Network, ''it will really wake people up.''

DeGolia said efforts are now targeted at the state level as universal health-care advocates have been frustrated in their bids to revive debate and congressional action in Washington after the Clinton administration's failed attempt to retool health-care finance in 1993-94.

The issue still resonates, though it has fallen from prominence after the terrorist attacks and threat of war with Iraq.

In Oregon, organizers spent only $30,000 to gather a near-record number of signatures to put the issue on the ballot.

Oregon's ambitious proposal calls for potentially steep increases in payroll and personal income taxes. But supporters say those costs would be offset because residents would no longer pay premiums for private health insurance plans. Instead, they would rely on a single-payer system that would reimburse doctors and other providers for their medical bills, with no copayments or deductibles for the patients. And everything would be covered, including counseling.

Opponents, including business leaders, insurers, and health maintenance organizations, say the plan could cost as much as $20 billion a year, wreak economic havoc, and cause an exodus of investment and jobs from Oregon, which already has the nation's highest unemployment rate, 6.8 percent in September. The state budget for Oregon is $16 billion.

''Few people disagree about the goal: health care for everybody,'' said Lisa Trussell, a lobbyist for Associated Oregon Industries, which represents 25,000 businesses. ''But this goes way beyond most people's idea of basic health care. It's unsustainable.''

Trussell and other opponents said that if the measure passes, it would cripple small businesses and encourage larger firms to leave the state. Doctors also would flee, Trussell said, to be replaced by herbalists and acupuncturists, whose services could be reimbursed. At the same time, sick or dying individuals would migrate to the state to take advantage of its largess.

The measure would be funded by an 11.5 percent payroll tax for employers and increases in personal income tax rates, from 1 to 8 percentage points, depending on a resident's income. The wealthiest residents would see their state income tax rate rise to as high as 17 percent.

In the last year, universal health-care bills were introduced in at least 10 states, including Illinois and Michigan, but none became law. In Vermont, Rhode Island, and Massachusetts, the legislatures have convened panels to study the possibilities of universal care.

© Copyright 2002 Globe Newspaper Company

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