CANDIDATES WITH THE RIGHT STUFF WILL TALK ABOUT THE REAL STUFF

It will matter less what candidates seeking to be the next U.S. president
think about NATO and China policy than that they be well versed on the ins
and outs of a host of tricky medical debates.

Does he or she favor assisted suicide?

How about the medical use of marijuana?

What about the problem of the high cost of prescription drugs?

How do you handle the thorny issue of donor organs harvested in one state
going to another state? Should the national registry decide?

Should states be forced to use money from lawsuits against tobacco companies
for health care or can they use it for anything they wish?

The American people are far more savvy about such controversies, HMOs and
denial of care than they have ever been. And unless the economy tanks, which
would lead to other problems, they want answers.

They will quiz the burgeoning field of presidential candidates more intently
than ever about prospects for change in burdensome insurance regulations,
improvements in health care delivery and access to costly treatments.

And they don't want to be pushed aside. Social Security, at the top of the
political agenda, needs a long-term solution, but it will not run out of
money, according to projections, for 30 more years. But a 68-year-old woman
who has to choose between buying groceries or paying for her medicine
doesn't have the luxury of waiting for blue- ribbon commissions, studies,
legislative conferences and sound-bite wars.

President Clinton came to office pledging to do something about the 40
million people without health insurance, and failed. He admittedly muffed
his opportunity so badly that he has since said little about the problems of
the uninsured.

While he talks about the need for "saving" Social Security and shoring up
the Medicare fund, few people now expect he will be able to do much to
improve health care before he leaves office in January 2001.

The medical marijuana debate is increasingly divisive. It heated up this
past week when the National Institute of Medicine said marijuana can ease
the pain, vomiting and nausea of cancer and AIDS patients. But Congress has
prohibited legalizing the smoking of marijuana, fearing it could get out of
hand.

Citizens in Alaska, Arizona, California, Nevada, Oregon and Washington feel
differently and have voted to legalize marijuana for certain patients. But
as long as federal law prohibits it, patients even in those states have
trouble getting permission to smoke pot.

Voters in Oregon have legalized assisted suicide, and the information on how
it's working so far indicates it is not being abused. But it is highly
controversial and certain to be an issue in the 2000 campaign.

No two doctors agree exactly how it should work, if at all. Thus politicians
are grappling with an issue that many people feel is murder and others think
is inevitable and humane. Not an easy issue for a candidate for national
political office to deal with, but one that will be hard to duck.

Many think Congress and the White House should get together to take action
to make prescription drugs more affordable. But, once again, there is no
consensus on the best way to do this.

The only real debate about drugs in 1996 was when Bob Dole's campaign let
loose broadsides against Clinton, blaming him for the doubling of illegal
drug use among teenagers since he took office and castigating him for joking
about not inhaling when he was young.

Dole kept urging teenagers, "Just don't do it." But his major point was that
more money should be spent on keeping drugs out of the country, not on
prevention and treatment.

Clinton wanted to talk about a patients' bill of rights in dealing with
health maintenance organizations.

But even now there is no agreement on how to pass such legislation, despite
horror stories such as the one from a Chicago man whose wife died after her
HMO forced her to travel from Hawaii to Chicago for a transplant although
doctors ready to operate in Hawaii said she was too weak to travel. "It's
just obvious the HMO (was) more interested in saving money than in saving my
wife's life," he said at a conference last year.

If the candidates want people to listen, they'll talk about the man from
Chicago, the woman who has to choose between food and pills, the dying
cancer patient wracked with pain, the family of the hopelessly comatose
patient and the patient in need of a kidney whose neighbor's kidney went to
another state.