The nation's health care system can be overhauled through market-based proposals tailored to individual states - not through a federal government takeover, Republican presidential candidate Mitt Romney said Friday.

As Massachusetts governor, he signed a law to help bring coverage to people who lack insurance in 2006. He is trying to take an issue popular among Democrats and put a conservative spin on it.

"A one-size-fits-all national health care system is bound to fail. It ignores the sharp difference between states and it relies on Washington bureaucracy to manage," Romney said. "I don't want the people who ran the Katrina cleanup to manage our health care system."

The government's role is to facilitate changes, not mandate them, Romney said during a speech at the annual meeting of the Florida Medical Association. His campaign released details of his plans Thursday.

Health insurance costs can be reduced by deregulating the insurance market, capping malpractice damages and making sure everyone is insured, Romney said.

"The problem of the uninsured is a problem for all Americans," he said, because those who can pay for health insurance help foot the bill for those who cannot.

Instead of using federal money to reimburse hospitals for treating people without insurance, that money should be used to help low-income people buy insurance at a lower cost, Romney said.

"No more free rides," he said. "Everybody pays what they can afford."

Romney said states can tailor their approach to suit their specific populations.

"We made sure we did no harm," Romney said of his experience in Massachusetts. The employer-based insurance system works for many people, but for those who don't have that option, individual insurance needs to be made affordable, he said.

"We've got to get the cost of health insurance down," Romney said, without instituting new taxes or having socialized medicine like some European countries.

Glenn Zellman, a dermatologist who attended the meeting, said it was unrealistic for candidates to put forward proposals, delivered in stump speeches, that claim to fix such a complex issue.

"I think it's a little naive," Zellman said. "The goal is well-intended."

Still, Zellman said any change will have to address the malpractice issue. He estimates he spends $100,000 a year on tests that aren't necessary but which would help protect him from being sued.

"It's really a nightmare situation for doctors," he said.

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By RASHA MADKOUR

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