WASHINGTON — If Mayor Bloomberg runs for president, watch for a radical approach to framing the health care debate to be one of his principal planks.

The mayor yesterday offered the outline of a plan to reshape the American health care system, calling for a technology-based “pay for prevention” program that would shift government attention and resources toward heading off diseases that have proved increasingly costly to treat.

In a 30-minute address to hundreds of health practitioners, researchers, and policy-makers, Mr. Bloomberg harshly criticized the current system, saying the government is fundamentally misspending money on health care by paying mostly for treatment rather than prevention. “It’s not stretching the truth very much to say that we’re paying for a disease care system, not a health care system,” the mayor said. “We’re managing how to die, not postponing it.”

Mr. Bloomberg also had stinging words for the many politicians who have focused on pushing for universal health coverage, which, he said, “grossly oversimplifies the problems that we face.”

“Politicians love to propose the magic-bullet answers to our biggest challenges,” he said. “But in the real world, simple solutions to complex problems just don’t exist.” Mr. Bloomberg was addressing the Academy Health National Health Policy Conference, an annual two-day summit in Washington.

Coming as the 2008 presidential race is kicking into gear, the mayor’s words appear to be a jab at the top Democratic hopefuls, senators Clinton, Edwards, and Obama, all of whom have said a universal health care plan will be central to their campaign platforms. Mr. Bloomberg even finished his speech with a presidential-sounding flourish, quoting President Lincoln and calling for Americans “to think anew, to act anew, and to set a new course for our nation.” Afterward, even as he pointedly refused to rule out a presidential run, Mr. Bloomberg told reporters he was not offering his proposals as a candidate, but simply as the mayor. “I’m not running for president,” he said, repeating a denial that has become a regular refrain as he has spoken out more and more on national issues.

Introduced by his health commissioner, Dr. Thomas Frieden, as “perhaps the greatest mayor the city has ever had,” Mr. Bloomberg in his speech ticked off a list of public health initiatives during his tenure, including his successful bid to ban smoking in bars and restaurants and to phase out artificial trans fats in city eateries.

As a key to preventive care, the mayor focused heavily on the need for electronic health records, which can allow doctors immediate access to a patient’s medical history and which hospitals can use to evaluate performance and send automatic notices to people reminding them to schedule appointments. The city’s 11 public hospitals already use electronic records, Mr. Bloomberg said.

In his most specific policy proposal, he called for every doctor’s office, clinic, and hospital in America that accepts Medicare or Medicaid to implement the technology within five years. He noted that doing so could cost the federal government as much as $20 billion, but he said in the context of a $2 trillion health care industry, “it seems to me that it is well worthwhile.”

Mr. Bloomberg is far from the first elected official to champion preventive care or vouch for electronic health records — he even noted in his speech that a couple of high-level political opponents are big proponents of the technology, Mrs. Clinton and a former House speaker, Newt Gingrich. Earlier yesterday, an assistant secretary for health and human services, Admiral John Agwunobi, voiced support for devoting more resources to prevention.

Unlike other officials, however, the mayor argued that he would make prevention an even higher priority than the current issues dominating the national debate on health care: cutting costs and expanding coverage to the 47 million uninsured Americans. “This national conversation is, I think, missing the biggest point,” he said. A spokeswoman for the Department of Health and Human Services, Christina Pearson, said the Bush administration was pushing for electronic health records and viewed them as “a cornerstone of transforming the health care system.” She and other health officials attributed delays in implementing the technology to disagreements over how to design a system that could be used nationwide.

The mayor’s remarks were met with general agreement from industry experts, but also skepticism. “He has defined the issue perfectly,” the vice president of the Center for Medicine in the Public Interest, Robert Goldberg, said.

A senior fellow at the institute, Doug Badger, noted that “everybody is for electronic health records,” but how beneficial they will be is not yet known. “It may well be the case that emergency health records usher in a new golden age of medicine,” Mr. Badger said. “But that remains to be seen.” Mr. Badger, a former health policy adviser to President Bush, also said that government influence in prevention could be limited. “The problem with prevention is that so much of it is about individual behavior and individual choices,” he said. “I just don’t know what sort of government programs would encourage people to take better care of themselves.”