When ACP talks, what do the presidential candidates hear?

Presidential candidates don't usually have to look hard for someone willing to give them advice on the issues, and there may be no issue about which this is truer than health care reform.

In addition to the clamoring campaign advisors and the talking heads on television, two recent high-profile reports from the Commonwealth Fund offered the next president advice on how to make the U.S. health care system both higher-performing and less costly.

To give you a very condensed summary of their findings, the reports recommend expanding coverage, rewarding quality (over quantity) of care, funding electronic infrastructure, and improving prevention and coordination. Read the full reports online for the nitty-gritty on how to fund and implement these needed changes.

The ACP recently added to the discussion with its position paper “Achieving a High-Performance Health Care System with Universal Access,” which outlined two potential routes to universal coverage: a pluralistic system in which government entities as well as not-for-profit and private, for-profit organizations ensure universal access; or a single-payer system in which a government entity is the sole third-party payer of health care costs.

The health policy paper leaves it up to policymakers as to which method would be the best path to universal coverage. According to a small, informal poll, the readers of ACP InternistWeekly are divided on which is the best route—38% supported a pluralistic system while 44% went for single-payer, with a few others disagreeing with the need for universal coverage at all. [“There should be universal health care for children, but not all adults should be able to get something for nothing,” said a respondent.]

One person who is not so undecided about the issue is presidential candidate Dennis Kucinich. He trumpeted the ACP position paper as an “emphatic” endorsement of single-payer health care in a press release promoting currently proposed single-payer legislation. Mr. Kucinich glosses over the fact that ACP presented another alternative for reform; still, it's nice to see that someone is listening to the College's ideas.

And Mr. Kucinich isn't the only presidential candidate listening to the ACP's suggestions, according to reports from our Washington, D.C. office. Advisors for both Hillary Clinton and Barack Obama contacted the College before making major announcements about their health care platforms, and ACP representatives had a second follow-up meeting with Sen. Clinton's staff. Although the College hasn't met with anyone from John Edwards' staff, his health care advisor specifically mentioned our advanced medical home proposal in a recent campaign forum.

As for the rest of the candidates, as of presstime, none of them had made contact with ACP, but our advocacy staff is ready and waiting to provide information on a non-partisan basis to any and all candidates who express interest in our proposals, they said. Once the presidential field has been winnowed down by the primary process, College representatives will proactively seek meetings with the health advisors for all of the candidates.

The D.C. staff is also hoping to get more feedback from candidates via a new candidate comparison tool on the College's Web site, which lets users compare the candidates' stands to ACP's. Candidates are invited to comment on the tool's description of their positions and those comments may be incorporated into the comparisons or provided separately.

As part of Internal Medicine 2008, to be held in Washington, D.C., in May, advisors to the presidential candidates will be invited to present their candidates' positions on health care. Members attending those sessions will have the opportunity to offer direct feedback on the various health care platforms presented.

With the Super Tuesday primaries scheduled for the beginning of February, it's possible that, by the time you read this, the Republican and Democratic presidential nominees will already have been chosen. In that case, ACP's meeting will be a chance to contrast the positions of the general election candidates.

For those who don't want to wait that long, of course the Web is the best source for the latest in election news. In addition to using our candidate comparison tool and reading ACP InternistWeekly, anyone interested in the health care details of the campaign should check out this site from the Kaiser Family Foundation, which catalogues every piece of presidential health care news, including the latest analyses, polls, even video and podcast interviews with the candidates. You can also sign up for regular e-mail updates of campaign news. It's definitely worth a look.