Both parties have health care prominently featured in their recent promotions around the conventions.

Sen. Hillary Rodham Clinton (D-N.Y.) used her bully pulpit at the DNC to underscore that health care reform must be proposed early within the next presidential administration if it is to pass Congress. Sen. Clinton made her comments at a forum jointly sponsored by Families USA and the Service Employees’ International Union in conjunction with the Democratic National Convention. Sen. Clinton said, “It's going to take all the good will of the honeymoon period, and I hope the Democrats in Congress can reach consensus." Sen. Clinton said for too long in health care reform, "the perfect has been the enemy of the good."  She will be in an incredibly good position to lead the challenge in the Senate with Ted Kennedy’s role uncertain, and she understands the labor push for Medicare for all (single payer) is not the way (my view anyway) to get this problem solved in the most effective fashion. Obama and Clinton seem to be getting closer in their approach to expanding coverage in recent weeks. Biden also needs to be convinced about why having a private sector solution is still a good thing — but he has been silent on single payer solutions thus far. Despite all the union pressure developing for a Medicare-for-all concept, it appears the lead Dems are not ready to go with a single payer … YET.

Meanwhile, the Republican Party on Aug. 25 released a draft version of its platform for the 2008 presidential election that would revise the federal tax code to allow individual purchasers of insurance to receive the same tax advantages as those who are insured through employers (the final version is available here). The platform also calls for Medicare and Medicaid reform. In addition, the platform states that Republicans will increase patient control of care; increase health insurance portability; encourage health information technology; eliminate “frivolous” medical malpractice lawsuits; and reward physicians for providing a high quality of care. According to the platform, health care reform must begin by giving "control of the health care system to patients and their doctors, not bureaucrats in government or business." 

These are all really GOOD things to pursue, but a bit gratuitous without any new money or reining in of insurance excesses! Like, forget national tort reform in an even more Democratic US Senate. Unless it’s at the state level — Texas proves that can work even now.

Incidentally, McCain’s very interesting and spirited choice of VP in Alaska Governor Sarah Palin is not going to change the dynamics of the health debate much for him. She WILL change the overall debate a lot though. She’s very articulate and incisive. Her health agenda is however pretty non-specific in promoting reduced government regulation (fat chance in a Dem Congress), reduced government control and spending in health care, and her strongly held view that patients should see transparently up front what their health care is likely to cost (not much use for ER or STEMI care, but cost transparency is something I think we should support for elective care at least). She so far is similar to McCain’s team in seeking voluntary solutions to expanding access, but without many specifics. [Read more about Sarah Palin on the WSJ's Health Blog.]

Nobody said this election season won’t be interesting. What a fascinating presidential race this in fact is turning out to be. But we need to keep our eyes wide open. The insurers are everywhere in this process, with lots of dollars. Nobody’s really on the side of physicians, but the profession has to be clearer about what we want. Despite all the rhetoric, patients and doctors are not yet at the center of these debates. We need to work on that, and we are. The College has been a lot more active than most of our colleagues — and the Quality First campaign is gaining interest.