While considering the two main candidates running for President of the U.S., entertain this question: Which will be better for the U.S. economy, or more to the point, best for the medical- device community? To answer that question, it is useful to review the candidates' positions on medical-device development and manufacturing, especially because both candidates profess to be interested in implementing some form of national health care, or in my mind, a one-purchaser program.

Before coming back to the topic of a national health plan, I must mention a recent article that suggests Germany is becoming a primary center of medical innovation, particularly in stent design. Then at a recent medical conference, a presenter made a similar remark and lumped in France with Germany. This sounds a bit unusual because both countries have nationalized healthcare plans, with only one purchaser - the government. The remarks make more sense when you realize those countries are eyeing the most lucrative market on the planet: the U.S., where surgeons are free to choose whatever stent they think will do the best job. In such an atmosphere, device firms are attentive to new design and manufacturing ideas that catch the eyes of innovative surgeons.

At lunch during the conference, there was some discussion about what a national plan would do to the inventiveness of U.S. companies, especially if there should there be only one buyer. If the U.S. plan shapes up similar to Canada's, suggested one guest, expect services to slow. His family story was eye-opening.

When his wife and daughter were living in a town of some 645,000, enough to support a range of GPs and specialists, his daughter developed an eye infection that needed medical attention. The wait to see an eye doctor would be nine months, they were told. (There are no private practices in Canada.) But as shocking as nine months sounds, it is just as impressive that eight-and-a-half months later, the office called (you'd think they'd have forgotten) inquiring as to whether or not the appointment was still needed. Thank you, but no, it would not be needed, the mother told the doctor's attendant, because the daughter's eye had healed on its own. We should all be so fortunate.

This brings us back to the impending election and selecting the most qualified candidate. To get a better feel for where they stand regarding a healthy and vigorous device community, we reviewed their websites and in particular, their positions regarding medical-device manufacturing. You will not be encouraged. Our questions to each camp have been ignored and neither candidate mentions support for device manufacturing. Furthermore, the positions of both main candidates sounds quite similar.

However, if we examine only volume of proposals and number of topics, then Senator Obama may be our man (barackobama.com). The health-care section on his website covers some five-and-a-half pages of topics such as, guaranteed eligibility (no American will be turned away), comprehensive benefits, and affordable premiums. Who can argue with that?

Senator McCain and staff have been slacking by comparison because they provide only two-and-a-half pages of medical subheadings (johnmccain.com). His listings sound a bit less big-government-ish with titles such as cheaper drugs, greater access and convenience (walk-in clinics and retail outlets), and making insurance more portable. Tort reform, a plus for Senator McCain, will protect doctors and by extension, device companies, that follow government guidelines yet still get sued.

The good news is that both candidates talk of affordable insurance rather than a one-payer national system. And if reading between the lines counts, both want to lower costs in part by increasing competition and funding research. However, both speak of change as if anything different will be an improvement. That's worrisome.

Still, may the best man for device makers win.