The best health policy writing on Tuesday's US election

It's finally here. Tuesday marks the culmination of the seemingly never-ending battle for the US presidency between Democratic Senator Barack Obama and Republican Senator John McCain.

This year's election has featured an unusually large amount of discussion about health insurance reform -- as opposed to the scant attention paid to the topic in the debates leading up to last month's Canadian election -- and change is in the air. That change may come as a result of a presidential initiative, but perhaps more likely is a change pushed through a Democratic-majority Congress. The Democrats appear to have learned their lessons since the dramatic failure and political disaster of Hillary Clinton's early-90s health insurance reform attempt, and the consensus opinion will almost surely be a measured and decidedly unradical push to insure millions of the uninsured while maintaining the large role that private firms currently enjoy in providing insurance.

We've compiled a list of the most interesting writing that's come out lately on the subject of the American election and health reform.

• A very comprehensive and well researched New York Times editorial, published last week, provided excellent synopses of the two candidates' plans, as well as an overview of what some nonpartisan experts have said. The Times endorses Obama's plan hesitantly, importantly pointing out, "Neither candidate has persuasively explained how he would pay for his plan." To readers (and taxpayers), that failure to explain how the plans would be funded merited more than a couple of paragraphs at the end of the editorial. Take a look at the letters to the editor in response: their content sounds vaguely Canadian. "Your editorial accurately describes the candidates’ plans. But it doesn’t reveal how inadequate they are," wrote a representative of Physicians for a National Health Program. "These plans continue to rely on a privately run insurance system that has shown itself to be too costly, too inflation-prone and too unreliable to meet our needs." That sentiment was echoed in most of the letters' messages.
  
  
• A pair of front-page stories by Amy Goldstein in the Washington Post last week analyzed the two candidates' visions for healthcare. The article on McCain's proposal is here, and Obama's is here.
  
  
• Health Affairs proposes a compromise reform plan, taking the best pieces from Obama's and McCain's ideas, in "Blending Better Ingredients for Health Reform," by Mark V Pauly.
  
  
• One of the major obstacles to achieving tangible reforms is that lack of understanding of how health insurance actually functions, write Katherine Baicker and Amitabh Chandra in"Myths and Misconceptions About U.S. Health Insurance," in Health Affairs.
  
  
• An older article, "Yankee Doodling," from February, in the British Medical Journal, bemoaned the absence of a genuine plan to repair the primary care mess.

Illustration: Shutterstock

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