Health care is poised to be front and center in the upcoming Presidential election. The Kaiser Daily Health Policy Report highlights a recent opinion piece by Atul Gawande in the New York Times describing the multi-layered crisis in the health care system. Gawande, a surgeon and New Yorker contributor, fears the rising apathy towards the crippling problems of the system: mounting costs to employers and individuals, over-crowded emergency rooms, and the growing rolls of uninsured and underinsured Americans. Thankfully, health care has featured prominently in recent Presidential debates and candidates are being pressed to develop and propose solutions to the broken system.

There are three major ingredients to creating a plan that will help fix the current utterly broken system. A successful plan must address creating healthcare options for the uninsured, lower costs for those currently insured, and reduce costs across the board. Vast inefficiencies in the health care system cause prices to rise across the board. One of the most expensive and visible problems is the lack of preventative medicine available to the uninsured. Common and treatable conditions worsen to the point where costly trips to the emergency rooms are necessary.

Most health care plans include some mixture of government subsidized medical care and stronger partnerships with insurance agencies. This multi-pronged approached was pioneered in Massachusetts when presidential hopeful Mitt Romney was governor. All of the Democratic candidates, and at least Tommy Thompson and Mitt Romney on the Republican side, have made healthcare reform a top priority in their campaign, though other Republican candidates rebuff any solutions that involve legislative intervention.

Instead, candidates like Giuliani advocate market-based solutions and praise the state of the current healthcare system in America. This popular claim about the high quality of the American healthcare system has been discredited in at least one recent article in the Journal of the American Medical Association which calls the current system a “dysfunctional mess.” A mess that is unlikely to improve, according to Gawande, by maintaining the current course.