ATLANTA --- Gubernatorial candidates Nathan Deal and Roy Barnes have long records dealing with health issues that illustrate their differing philosophies.
Deal's final act of his 18-year career in Congress was to vote against the Democrats' health care reform legislation.
Barnes, the Democratic nominee, has said he likes parts of the reform legislation, just not all of it. He approves of the funding for states to create insurance pools for people who can't get coverage until a provision takes effect in 2014 requiring companies to provide insurance to everyone regardless of their health. He faults President Obama for not securing broader public support.
"I consider it to be the greatest failure ... of political leadership in my lifetime," he said. "Everybody recognized, 'We've got to do something here,' but there was such partisanship on it."
Barnes and Deal share a concern about the effect of expanding Medicaid eligibility.
However, as governor, Barnes expanded eligibility under the PeachCare for Kids program, a similar federal-state initiative for the poor. Deal once introduced legislation that would provide vouchers to Medicaid and PeachCare recipients to buy private insurance.
Barnes and Deal part ways when it comes to one of the most controversial aspects of the new reform law -- the requirement that individuals and companies buy coverage.
"I think the individual mandate is purely unconstitutional," Deal has said. "(It's) the first example I have ever seen of the federal government saying that somebody had to buy something just because they exist."
Barnes says that government can make people buy car insurance, so it can require health insurance.
Deal's prescription for health reform includes electronic medical records, healthier school lunches and exercise programs, clinics for routine care of Medicaid patients and financial penalties for those who go to emergency rooms instead.
He favors reinstating limits on jury awards in medical-malpractice lawsuits, amending the constitution to do it after the state Supreme Court unanimously struck the limits down in March.
That position was a major reason the independent insurance agents and the political-action committee of the Medical Association of Georgia endorsed him, said PAC chairman Dr. Jack Chapman.
Barnes opposes jury-award caps, saying his experience as a trial lawyer has given him faith in juries.
"Generally, the jury does the right thing," he said at a debate sponsored by the medical association. "Occasionally, they get cranked up and don't. And in those cases we give judges the right to correct that."
Barnes' successful 1998 campaign for governor centered on health. He railed against health-maintenance organizations at the time, even after it was disclosed that his law firm only offered a form of HMO coverage to its employees.
Once in office, he changed the law to allow employees to sue their HMOs and to see doctors outside of their physician networks. He also created a consumer advocate in the governor's office to challenge company requests before the insurance commissioner, a position Republicans removed when they came to power.
He consolidated all the state medical agencies into the Department of Community Health with the promise that its larger bargaining power and specialized skills would result in lower costs to taxpayers.
As governor, Barnes won praise for creating the Georgia Cancer Coalition for targeted research and treatment in centers across the state. His education-reform law put nurses in every school, another program cut by the GOP.
Barnes drew criticism for cutting health and physical-education classes to make more time for academics. He angered health advocates for allocating much of the state's share of the national tobacco settlement to compensate tobacco farmers instead of devoting it to prevention and treatment.
While Deal was in office, his health-related legislation reflected his more-conservative philosophy. One bill he introduced would have eliminated Medicare and Medicaid coverage for drugs to treat erectile dysfunction.
Among the bills he authored were those that would have limited pre-existing-condition exclusions for individual health insurance and provided more options for unemployed individuals.
Other bills would have allowed employers to contribute to the premiums of certain employees and authorized states to cooperate in the marketing of insurance across borders.