Diner Exchange Underlines Voters' Health-Care Concerns

Generally, the debate on the campaign trail resembles that in Washington, where congressional Democrats are trying to push through a major expansion of the State Children's Health Insurance Program, which provides coverage for low-income children, but President Bush is threatening a veto in part because he opposes increasing the number of people who receive health care through the federal government.

Democrats, particularly Sen. Barack Obama (Ill.) and former senator John Edwards (N.C.), are calling for higher taxes for people who make more than $250,000 a year, to pay for tax subsidies and increase the number of people on public programs.

Former New York mayor Rudolph W. Giuliani and other Republicans are touting approaches that would be less costly and would cover fewer people. This week Giuliani released a plan, similar to an initiative that Bush has adopted, that would exclude up to $15,000 of a family's income from taxes if it was spent to purchase health insurance.

Both parties have been wary of calling for radical changes in health care, something that polls show makes voters nervous. None of the leading Democrats have offered plans that would create government-run health care as in many countries in Europe, nor have any Republicans sought to break down a system in which most individuals purchase insurance through their employers. Recognizing GOP nervousness about massive health-care plans, Romney has not advocated turning his Massachusetts model into a national system.

And neither party is afraid of demagoguing the issue. When voters tell the Democratic candidates about chronic illnesses, the candidates are eager to respond by attacking Bush's restrictions on stem cell research. Giuliani spent much of his health-care speech this week denouncing filmmaker Michael Moore, who in his movie "Sicko" castigates the U.S. health-care system and praises Cuba's.

Giuliani's aides, unlike those in other campaigns, say that while people ask the former mayor about health care, the topic comes up less frequently than terrorism or illegal immigration. And evidence from past campaigns does not suggest that talking about health care is the key to the White House.

In 2004, former congressman Richard A. Gephardt (Mo.) talked the most about health care and had the most expansive plans of the Democratic candidates, but lost his party's nomination to Sen. John F. Kerry (Mass.). Kerry was defeated by Bush, who rarely spoke about the issue. And although Bill Clinton campaigned in 1992 on creating universal health care, he and his wife were not able to accomplish that goal after he was elected.

Griffin remembered, as she complained to Romney at the Red Arrow Diner, that Hillary Clinton "had a plan and she never followed through. Now, she wants to be president."

"They all talk about health care till they get in there," Griffin said. "But they all have health care, don't they? Do they have to pay outrageous co-pays? No."

Bacon reported from Washington.