Health care ranks are among the leading topic for voters according to recent polls, and both Republican John McCain and Democrat Barack Obama have offered reform plans. Nevertheless their ideas on reorganizing health insurance have striking differences.

Obama wants to dramatically increase the number of insured in part by offering them federal health care, while McCain wants to replace employer-based insurance with a system based on individual responsibility. Yet the two candidates don’t offer full prescriptions for Medicare, the sick elephant in America’s health care waiting room.

Actually in comparing the two candidates' health care plans, the Kaiser Family Foundation, which conducts health research, also makes no mention of McCain calling for benefit cuts to reduce Medicare costs. It does say that he would support the establishment of a commission to make recommendations on how to sustain the program for the future.

Obama wants to create a new group of insurance plans, including one sponsored by the government, to offer health care to 34 million of the 45 million But While Obama’s plan builds on America’s traditional employer- based health care program by pushing employers to offer insurance, McCain’s breaks from it. His plan would tax company-provided health care benefits while giving individuals tax breaks to pay for insurance. His goal is to cut costs by making health care an individual responsibility. The $1.3 trillion plan which is to be paid for largely by Medicare and Medicaid cuts to be named later, would cut the number of uninsured by 2 million, the Tax Policy Center said.

In fact the Obama campaign’s new television advertisement asserts that the McCain plan would require “cuts in benefits, eligibility or both.” In his speech Friday, Mr. Obama added that “it would mean a cut of more than 20 percent in Medicare benefits next year.” Moreover analysts did not evaluate whether the health care savings proposed by Mr. McCain would be sufficient to fill the gap.