As part of a project with The National Journal, Len Nichols helped assess health care proposals from presidential candidates Hillary Clinton, John Edwards, Barack Obama, Rudy Giuliani, John McCain, and Mitt Romney. Following the project, The National Journal published related articles on the uninsured, the economy, consumers, employers, and quality of care. Here is an excerpt from the cover story introducing the project:

Quality wasn't a big topic when presidential candidates debated health care in 2004. Today, most health care experts agree that improving the quality of care is essential to lowering costs and is an important goal in its own right.

The 2008 presidential candidates, especially the Democrats, are going into great detail about investing in technology and transforming the health care system to make price and performance information readily available for comparison shopping by patients, insurers, doctors, and hospitals. Overall, Democrats scored highest when National Journal's judges assessed the candidates' plans on how well they would enable consumers to make informed choices about medical care, and ensure that medical providers have the tools to improve care. Some judges said that the GOP plans simply aren't detailed enough yet to be scored accurately. Republican John McCain received praise for his innovative approaches to improving the health care delivery system.

One main difference between Democratic and Republican plans is that the Democrats propose spending federal money (Hillary Rodham Clinton and Barack Obama give estimates) to help doctors, hospitals, and other medical providers adopt electronic health care systems, including electronic medical records. Rudy Giuliani and McCain say they would push for standards, and Mitt Romney vaguely indicates that he wants to enhance the use of information technology.

Meanwhile, most plans count on a new health care buzzword, "transparency," to help consumers make better choices. Democrats are quite specific. Clinton would invest in a Web-based tool to help patients compare medical providers and to educate them about treatment options. Obama would require all medical providers to collect and report data on costs, quality, preventable medical errors, nurse-patient ratios, hospital-acquired infections, and disparities in care. John Edwards would create a consumer report that would compare the quality of hospitals. One judge scored Edwards's plan lower than Clinton's and Obama's in this area because Edwards's emphasis is on hospital information, not doctor information. "Most individuals don't choose a hospital. They need doctor data, too, to get people engaged," said Paul Fronstin, senior research associate at the Employee Benefit Research Institute.

McCain rated better than either of his fellow Republicans. He would require medical providers to make information available on outcomes, quality of care, cost, and price. "McCain wins on the Republican side since his emphasis is on transparency," said Len Nichols, director of the health policy program at the New America Foundation. ...

To learn more about the project and read the other related articles, please visit The National Journal’s website.