According to those who responded to ADVANCE's most recent Opinion Poll, posted April 28 through May 9, John McCain's health plan presents the most feasible solution among the proposals espoused by three main candidates for president.

As of this posting, McCain had received 55 percent of the votes.

Barack Obama trailed McCain with 30 percent of the votes.

Hillary Clinton received 15 percent of the votes.

Do you think McCain made a positive impression with his campaign's recent emphasis on explaining his health care policy in detail?

Advisors to the Obama, McCain and Clinton campaigns participated in a panel discussion titled "The Presidential Health Care Agenda" at the World Health Care Congress April 21 in Washington.

ADVANCE attended the session and captured video highlights from each of the candidates' representatives: Jim Cooper for Obama, Thomas Miller for McCain, and Chris Jennings for Clinton. Former U.S. Secretary of State George Schultz and Kaiser Foundation CEO George Halvorson provided analysis.

Click here to access the video feature.

The ADVANCE Online Poll that appeared on our Web site's main page from April 14-28 asked readers who John McCain would select as his running mate on the Republican ticket.

Respondents could choose among the following frequently mentioned possibilities (in alphabetical order):

Charlie Crist

Mike Huckabee

John Huntsman Jr.

Tim Pawlenty

Rob Portman

Condoleezza Rice

Tom Ridge

Mitt Romney

Mark Sanford

The results:

Rice topped the poll with 29 percent of the vote.

Huckabee placed second with 26 percent.

Romney gathered 23 percent.

Ridge received 13 percent of the vote.

All others received less than 10 percent.

Attendees at this week's World Health Care Congress in Washington voiced their collective opinion on presidential politics through an instant poll. During a keynote session titled "The Presidential Health Care Agenda," attendees were asked the following:

Do you think a candidate can win the presidency if he or she proposed a workable [health care] plan -- that is, a plan that controls costs?

58 percent of respondents said "yes."

At the conclusion of last night's debate between Democratic presidential candidates Hillary Clinton and Barack Obama in Philadelphia, moderator Charlie Gibson of ABC News posed the following question:

"It is hard to see how either one of you win this nomination on the basis of pledged delegates in primaries. And it could well come down to superdelegates. And I know you've been talking to them all along. But let's say you're at the convention in Denver, and you're talking to a group of 20 undecided superdelegates. How are you going to make the case to them why you're the better candidate and more electable in November?

Gibson gave each candidate 90 seconds to respond. By virtue of winning a coin flip, Clinton went first. Here's what she had to say (unedited quotes sourced from the New York Times via the Federal News Service):

SENATOR CLINTON: Well, I say to them what I've said to voters across America -- that we need a fighter back in the White House. We need someone who's going to take on the special interests.

And I have a plan to take away $55 billion of the giveaways and the subsidies that the president and Congress have lavished on the drug companies and the oil companies and the insurance companies and Wall Street. And I have a plan to give that money back -- give it back in tax cuts to the middle class -- people who deserve it, who have been struggling under this president, who feel invisible, who feel like, you know, they're not even seen anymore.

And we're going to make everybody feel like they're part of the American family again. And we're going to tackle the problems that have been waiting for a champion back in the White House.

Now, obviously, I can't do this alone. I can only do it if I get people who believe in me and support me and who look at my track record and know that, you know, I've spent a lifetime trying to empower people, trying to fight for them.

And I think it's going to be challenging, but it is absolutely what we must do in order to keep faith with our country and to give our children the future that they deserve.

So I will tell everyone who listens that I'm ready to be the commander in chief. I've 35 generals and admirals, including two former chairmen of the Joint Chiefs of Staff, General Wesley Clark and others, who believe that I am the person to lead us out of Iraq, to take on al Qaeda, to rebuild our military.

And I will turn this economy around. We will get back to shared prosperity and we will see once again that we can do this the right way so it's not just a government of the few, by the few and for the few. And I need your help. I need the help of the voters here in Pennsylvania, first and foremost, in order to be able to get to those conversations.

And I hope that I have demonstrated not just over the last weeks or even over the last hour and half but over a lifetime that you can count on me. You know where I stand. You know that I will fight for you and that together we're going to take back our country.

Here's what Obama had to say:

SENATOR OBAMA: Well, when we started this campaign 15 months ago, it was based on a couple of simple principles: number one, that we were in a defining moment in our history. Our nation's at war. Our planet's in peril. Our economy is in a shambles. And most importantly, the American people have lost trust in their government, not just Democrats but independents and Republicans who've been disillusioned about promises that have been made election after election, decade after decade.

And the bet I was making was a bet on the American people; that they were tired of a politics that was about tearing about each other down, but wanted a politics that was about lifting the country up; that they didn't want spin and PR out of their elected officials, they wanted an honest conversation.

And most importantly, I believe that change does not happen from the top down, it happens from the bottom up. And that's why we decided we weren't going to take PAC money or money from federal registered lobbyists, that we were not going to be subject to special- interest influence, but instead were going to enlist the American people in a project of changing this country.

And during the course of these last 15 months, my bet's paid off because the American people have responded in record numbers, and not just people who are accustomed to participating, but people who haven't participated in years. I talked to a woman here in Pennsylvania, 70 years old, she whispered to me, "I've never voted before, but I'm going to vote in this election."

And so my point to the super delegates would be that if we're going to deliver on health care for every American, improve our schools, deliver on jobs, then it's going to be absolutely vital we form a new political coalition in this country. That's what we've been doing in this campaign, and that's what I'm going to do when I'm president of the United States of America.

Clinton said that, if elected president, she would set a goal of finding a cure for breast cancer within 10 years. The AP report noted that approximately 40,000 women died of breast cancer in 2007, and 240,000 cases are expected to be diagnosed this year.

Clinton's plan would increase funding through programs at the National Institutes of Health, the National Cancer Institute and the Department of Defense Congressionally Directed Medical Research Program, the AP report stated.

Clinton said the plan would also help more low-income women gain access to screenings such as mammograms by making them more affordable. Clinton said the plan would eliminate Medicare co-payments for mammograms.

When it comes to health care, Democrats are trusted more than Republicans by a margin of 50 percent to 35 percent. That's according to research firm Rasmussen Reports.

Each month, Rasmussen Reports' tracking poll on issues asks likely voters to rank the importance of 10 electoral issues. Poll respondents are also asked which of the two major parties they trust more on the top 10 issues: the economy; national security and the war on terror; the war in Iraq; immigration; government ethics and corruption; taxes; health care; Social Security; education; and abortion.

In the March 2008 report, health care ranks as the sixth most important issue among likely voters, with 61 percent of respondents describing the issue as "very important." 

Which issue topped the list? The March telephone survey found that 81 percent of likely voters think the economy is a very important electoral issue.

In Rasmussen's January 2008 survey, respondents favored Democrats over Republicans by a margin of 54 percent to 32 percent on the issue of health care.

Earlier today, Barack Obama revealed his picks for the Final Four and eventual champion. He's got Kansas, North Carolina, Pitt and UCLA making it through to the semifinal round.

With perhaps a bit of political motivation (North Carolina holds its Democratic primary May 6), Obama picks the Tar Heels to beat UCLA's Bruins in the national championship game.

No teams from Obama's home state of Illinois are playing in the tournament. His alma mater, Columbia University, hasn't sent a team to an NCAA tournament since 1968, according to a report from Bloomberg News.

Hillary Clinton declined to divulge her NCAA selections this week, saying that she'd leave that up to her "basketball advisor," husband Bill Clinton. (The former president has not disclosed his picks. His alma mater, Georgetown, is a No. 2 seed in the Midwest Regional, where Kansas is the top seed.)

As for supporting teams from her home state of New York, Senator Clinton could look to Cornell or Siena. Cornell, the No. 14 seed in the South Regional, plays No. 3 seed Stanford. Siena, the No. 13 seed in the Midwest Regional plays No. 4 seed Vanderbilt. She got her undergraduate degree at all-women Wellesley College, which, naturally, has never participated in the men's tournament.

John McCain encouraged people to compare their tournament brackets to his, posted on his official Web site. I tried to access the Arizona senator's bracket this morning, but the Web site hung after I submitted information on a sign-in sheet. So I don't know his Final Four -- but I've already gotten two e-mails asking for campaign support.

McCain's home-state team, Arizona, is the No. 10 seed in the West Regional, taking on No. 7 seed West Virginia. His alma mater, the U.S. Naval Academy, last made the field of 64 teams 10 years ago.

If you answered yes, you're among a strong coalition, according to survey results released Feb. 19 by Computer Sciences Corporation (CSC). Seventy percent of respondents said they would vote for a NHIN supporter, according to CSC, which commissioned Kelton Research to survey 1,000 Americans aged 18 and older between Jan. 31 and Feb. 5.

The survey, which explores people's voting tendencies and attitudes related to health IT (HIT) during a presidential election year, has a margin of error of +/- 3.1 percent.

Candidates should note that enabling electronic access to medical records is especially important among young, tech-savvy voters. Survey results indicate that 84 percent of those aged 18-24 would be more likely to vote for a candidate who supports creation of a NHIN, compared to 68 percent of Americans over the age of 25.

However, candidates have not yet capitalized on gaining mindshare among NHIN proponents. More than two-thirds (67 percent) of those surveyed have never heard presidential candidates discuss HIT or electronic health records (EHRs).

Robert Wah, MD, chief medical officer for CSC's North American Public Sector business unit, told ADVANCE during a phone interview that he expects candidates to be more explicit about their proposed HIT initiatives as the campaign progresses: "It will be interesting to see how they address this issue. Particularly, will they be able to talk about how they would push for national standards in the IT world? How would they increase or enhance adoption of HIT? And how would they establish a nationwide health information network, where information could flow securely from place to place to improve patient care, decrease duplication, lower expenses, reduce medical errors and enhance quality?"

Dr. Wah, a practicing physician specializing in reproductive endocrinology and fertility, devoted more than 23 years to public service in the military health system and the Department of Health and Human Services (HHS). Prior to joining CSC, Dr. Wah served as acting deputy national coordinator for HIT under Dr. David Brailer at HHS.

"By providing better information that enables patients, doctors, health care institutions and the government to make better decisions, health IT can dramatically improve the quality of patient care, saving lives and money," Dr. Wah commented. "To address the problems of our health care system, the next president will have to look to IT for sustainable solutions."

The CSC survey results concur with some findings from a 2005 Rand study, which showed that the U.S. health care system could save more than $81 billion annually and improve the quality of care if electronic records were adopted. EHR benefits cited in the CSC survey include the following:

• sixty percent of survey respondents believe that patient care can be improved with rapid, secure access to individual health records, especially in the event of an unexpected crisis such as a biological or chemical attack;
• thirty-six percent believe EHRs lead to fewer hospital errors; and
• forty-eight percent believe EHRs will lead to decreased costs and hassle.

And the value of HIT doesn't stop with EHRs, according to the survey. In fact, three out of four (77 percent) respondents recognize that a national system can address some of the United States' most critical health issues, such as improving the quality of patient care (60 percent); facilitating faster and better medical research (43 percent); ensuring a quicker response during a national crisis, such as epidemics or biological and chemical attacks (39 percent); ensuring that government health care programs deliver the highest quality at the lowest costs (29 percent); and decreasing fraud (28 percent).

Dr. Wah declined to comment on individual candidates' HIT plans and proposals, but remarked that voters should watch for how they differentiate themselves as we head into the decisive stages of the election process. "If we have a leader who can address national standards and adoption of interoperable health IT, and establish a nationwide health information network, that candidate will further the ability of  health IT to really start helping people."

He concluded, "That's what I've been advocating for a long time...getting health IT out there to provide better information for better decisions for better health care."

According to Hillary Clinton's official Web site, no candidate has won the Democratic nomination without winning Pennsylvania since 1972.

The site also notes that no Democrat has won the presidency without winning Pennsylvania since 1948.

With 40 days to go before the April 22 Pennsylvania primary, Clinton holds a 16 percent lead over Barack Obama. (Source: RealClearPolitics average of four Pennsylvania polls conducted between March 5 and 12.)

However, as we've seen continually over the course of the campaign for the Democratic nomination, nothing is certain.

According to CNN.com's Election Center 2008, Obama leads Clinton in delegates by a margin of 1,611 to 1,480. With 2,025 delegates needed to secure the nomination, political observers have questioned whether either candidate will be able to clinch victory prior to the Democratic convention in August.

So McCain's off and running as the presumptive nominee with his sights now on November's general election. He spent four hours yesterday in Washington, picking up President Bush's endorsement and meeting with Republican National Committee officials.

But even McCain admitted today during a fundraising stop in Florida that it will be difficult for him to remain visible in the national news. Most media coverage will be fixed on the tight race for the Democratic nomination for at least the next six weeks leading up to the April 22 Pennsylvania primary.

So what's next for the Arizona senator?

In an article filed for Bloomberg News, Edwin Chen and Hans Nichols reported that McCain plans to "define himself to voters before Democrats do with a cross-country ‘biography tour' and overseas travel that underscores his foreign policy credentials."

Chen and Nichols said McCain "plans to soon embark on a week-long tour of places that marked turning points in his life, with stops at the Naval Academy in Annapolis, where he finished sixth from the bottom in the class of 1958, to Pensacola, where he led a flight squadron, to his family's ancestral home in Mississippi."

In addition, McCain will visit Europe and the Middle East later this month as part of a congressional delegation, according to the Bloomberg report.

The report also noted that, behind the scenes, "McCain and his strategists are working to bolster his economic, health care and environmental stances because they want him to project a stronger command of [those] topics."

McCain plans to give a series of speeches over the next several months to give more details on those subjects.

*photo courtesy: JohnMcCain.com

Nurse Bonnie Britton grew up in a rural area of North Carolina, not thinking that she'd return to her hometown years later to help her fellow low-income community members link to a telehealth program for improving their lives. Called the Patient Provider Community Telehealth Network, the computer-based program is working for the residents of Ahoskie, N.C.

Not only have lives been extended with the telehealth program, but Britton has crunched the numbers since the program began two years ago and presented the health care community with striking financials that show cost justification for telehealth equipment. With the use of telehealth kiosks placed in senior centers, schools and the use of in-home monitors and in-home vital signs monitoring equipment Roanoke Chowan Community Health Center, Britton's employer, saved an average of $53,095 a year per patient participating in the remote disease management program. When Britton delivered that figure at the 2008 Healthcare Information and Management Systems Society meeting last week in Orlando, her audience clapped loud and strong since it places a monetary value on telehealth services, justifying the technology.

Britton shared more statistics: Her poverty-stricken county ranks number one in the state for cardiovascular disease, diabetes and HIV infection. She recounted dramatic patient stories where IT technology and services made a measurable health impact. One man suffering from heart failure gained months of life by interacting remotely with caregivers; others gained years of life since the program began in 2006. The program is relatively low-tech and makes use of e-mail and the telephone for patient interactions.

Britton's project was a showcase for HIMSS and its goal to demonstrate the value of an electronic health care system. This year's event was a record-breaking HIMSS conference with more than 28,400 attendees and 900 exhibitors answering the nation's health care IT call.

According to over 600 health care executives polled at HIMSS08 last week in Orlando, Hillary Clinton is the presidential candidate who would most positively impact the health care industry. Yet, when also asked which candidate they'd vote for on Election Day, Clinton ranked third among the four remaining candidates.

John McCain topped Barack Obama as the most likely vote-getter on Election Day.

"We felt it was important to poll this select group of people -- individuals who truly understand the issues and challenges facing the health care industry today -- as to which presidential candidate they feel would have the greatest impact on health care," said Ralph Fargnoli, president and CEO of Beacon Partners, the company that administered the "Beacon Partners 2008 Presidential Healthcare Poll" onsite at HIMSS08.
 
"We find it fascinating that while they think Hillary will have the greatest impact on health care as president, these same individuals wouldn't necessarily vote for her," Fargnoli added.
 
Choosing from the current presidential candidates -- Hillary Clinton (D), Barack Obama (D), John McCain (R), or Mike Huckabee (R) -- here's how health care executives attending HIMSS08 responded to the following four questions via an electronic survey:
 

1) Which candidate do you believe will be the biggest advocate for health care IT adoption?

Clinton -- 43.2%

Obama -- 30.1%

McCain -- 20.7%

Huckabee -- 6.0%

2) Which candidate do you believe will have the most impact on empowering providers to deliver the best possible health care through the use of health care IT?

Clinton -- 34.2%

Obama -- 33.8%

McCain -- 26.4 %

Huckabee -- 5.6%

3) Which candidate do you believe has the best plan to improve health care quality and reduce health care costs?

Obama -- 32.9%

Clinton -- 32.1%

McCain -- 28.7%

Huckabee -- 6.3%

4) If today were Election Day, which candidate would you vote for?

McCain -- 35.6%

Obama -- 34.4%

Clinton -- 23.8%

Huckabee -- 6.3%

According to the "2008 Survey of Health Care Consumers," a poll of more than 3,000 Americans between the ages of 18 and 75 conducted by the Deloitte Center for Health Solutions, 79 percent of consumers believe health care will be an important issue in the 2008 election.

Forty-six percent of consumers surveyed described health care as one of the top three issues affecting their vote.

Deloitte released the survey's findings this week at HIMSS08 in Orlando, Fla.

In an unrelated, unscientific survey -- ADVANCE's online Opinion Poll for the period of Feb. 1 through Feb. 12 -- we asked:

"Do you think the economy has begun to overshadow health care as the domestic issue that will most influence the 2008 presidential election?"

Respondents who said "yes" outnumbered those who said "no" by nearly a 5:1 margin.

The quick takeaway: Health care remains a core issue for consumers. However, nothing resonates more than a hit to the voter's wallet or pocketbook.

Clinton's campaign appears to be in serious trouble, according to some political observers, setting the stage for must-win, big-state primaries in Texas and Ohio on March 4, and then Pennsylvania on April 22.

Ron Fournier, who has covered politics for the Associated Press (AP) for nearly 20 years, included the following passage his "On Deadline" column today...

"The chances of Obama doing something that's going to cause a major problem are about as low as [Clinton] doing something that will turn it around," said Democratic strategist Bill Carrick, who is not tied to either campaign. "When you start pressing to come back, it's usually the person who's behind who makes the mistake."

Tom Raum, who has covered Washington for AP since 1973, including five presidencies, included this in an article titled "Clinton on the Ropes"...

"It's fair to say the race isn't over yet, but I think Senator Clinton must win Ohio, Texas and Pennsylvania to have any shot at getting the nomination," said Democratic strategist and pollster Mark Mellman, who is not affiliated with either candidate. "Obama could lose all three and still get the nomination. So at this point, he's got more ways to win than she does."