Walk into the modest brick building at Wells Avenue and Taylor Street with a medical problem and you'll find a doctor and bilingual staff ready to treat you.

What you won't find are the insurance forms and a large billing staff. "Usually when you take insurance you have to hire two or three extra people just to handle the paper work," says Zeller.

So, he's chosen a different setup. Dr. Ryan Zeller doesn't bill insurance. You'll pay $60 dollars for the visit, a little more if treatment is more extensive. That's it. Neither you nor the doctor, nor his assistant will deal with insurance. This is what medical care looks like when streamlined.

Zeller says he's worked under the more conventional system, but ever since being introduced to this business model when he was in school, he's wanted to try it as a family practioner. He admits it might have been difficult if it weren't for his wife's income--she's a anesthesiologist--but after 2 years his practice has now turned the corner financially. He's not making the income other doctors are, but he's doing alright and says it doesn't feel like a sacrifice.

"It took me over a year in practice before I could afford to hire an assistant, but now it's getting to the point where I'm able to pay my bills without a problem and now I'm starting to feel like I'm a real asset to the community."

That's because almost all of his patients come from that sizeable portion of the population living without health insurance. Locally he estimates that's about 20 percent of us and it may be much higher among Hispanics which make up about half his patients.

Whatever solutions emerge from the debate in Washington, Zeller says, they should simplify the process. He expects there will be problems with any new system that will have to be worked out in time, but says there are problems with the present system and many of them have little to do with caring for the patient.

"We have insurance companies which really provide no health care. They are in the denial business. I mean they do make money by saying 'no', by denying claims," says Zeller. "

That's a big portion of our health care expenditure taking care of all this administrative infrastructure and there's no health care being provided there."

What would he do if some sort of universal health care emerges from the current debate?

He says he'd probably sign up and be part of it.

For now though, he says he's filling a need and doing it by keeping his practice simple, concentrating on the patient with few distractions for paper work.