REPUBLICANS

Generally, Republican candidates favor an overhaul of the US healthcare system but typically favor free-market principles with limited government involvement. The leading three candidates in December were Rudy Giuliani, Mike Huckabee and Mitt Romney.

OVERALL APPROACH

Giuliani: The former New York City mayor would provide individuals without employer-based coverage a health insurance tax deduction to subsidize their health insurance premiums and award a tax credit to lower-income families to help subsidize their premiums. He also proposes tax changes designed to shift millions from employer-based coverage into individual insurance.

Huckabee: Huckabee proposes the use of tax deductions and tax credits to encourage people to purchase private health insurance. He would encourage "other market-based solutions" to problems of cost and access.

Romney: A Romney administration would seek to expand and deregulate the private health insurance market, adjust the tax treatment of health insurance and promote state-based innovation. (While governor of Massachusetts, Romney launched an initiative requiring all citizens to obtain health insurance.)

EXPANSION OF PUBLIC PROGRAMS

None of the three top Republican contenders proposes any expansion of current government healthcare programs. Romney, however, proposes the block-granting of federal Medicaid funds while providing states with full flexibility to restructure Medicaid by removing administrative requirements. States could use block-grant funds to purchase private coverage for their low-income uninsured populations.

COST CONTAINMENT

Giuliani: Giuliani proposes investments in health information technology to lower costs through "improved efficiency and quality." To expand competition and reduce costs, he would create transparency for prices, provider qualifications and risk-adjusted procedure outcomes. He also supports medical liability reform.

Huckabee: As president, the former Arkansas governor would encourage the private sector to seek "innovative ways" to bring down costs and "improve the free market" for healthcare. His program would require participants in health-insurance plans to pay more out of pocket and open health savings accounts as incentives to stay healthy and limit the use of services. He also would waive cost-sharing for preventive benefits to encourage their use; promote chronic-disease-management programs; enact medical liability reform; and adopt electronic record-keeping measures.

Romney: Romney supports medical liability reform through federal caps on economic and punitive damage awards and additional state reforms.

CONCLUSION

Because healthcare ranks at the top of voters' domestic concerns, there almost certainly will be shifts in the ways Americans pay for and receive healthcare services, perhaps as early as 2009, when the new president takes office.

Presidential candidates on prescription drugs

Regarding pharmaceuticals, among the six candidates featured in this article, four – all three Democrats, plus Rudy Giuliani – make specific reference to prescription drugs in their healthcare proposals. Their comments are included in the box.

Because pharmaceutical care is such an integral part of healthcare today, everyone in the industry should anticipate the likely need to adapt to new models of pricing, reimbursement and service delivery in the years ahead. Whichever political party is in power and whatever the changes, new policies and programs will invariably filter down to the field level, and every sales professional will need to respond accordingly.

As the campaign proceeds, pay close attention to the healthcare positions of those who remain in the race. When policy changes are implemented in 2009 or later, watch for shifts in your company's strategies and take a proactive approach to addressing market trends that impact your company's products.