The movie Groundhog Day was a gentle comedy in which the hero finally makes the right choices and gets the girl in a crowd-pleasing happy ending. But in 2008, Groundhog Day has become a national nightmare in which we, the heroes, may have only one chance to get it right. Each day we wake up hoping to find a leader who has the intelligence to understand how best to navigate our current crises and the discipline to hold a steady course through our economic perfect storm that is wracking Wisconsin and the rest of the nation. But again and again, rational deliberations are drowned out by voices that tell us to fear those who are not like us, because Joe Sixpack and all those hockey moms have what it takes to preserve the freedom and greatness that we inherited from our founding fathers: Washington, Adams, Jefferson, Hamilton, and Madison, just your ordinary kind of guys. On November fourth, the alarm clock will awaken us for what may be our last best shot at preserving Wisconsin's economy and making the twenty-first century an American century. After eight years of shooting ourselves in the foot, how can we avoid shooting ourselves in the head?

Now that McCain and Palin have draped themselves in Obama’s mantle of change, the crucial question has become: change to what? Obama, Biden, McCain and Palin all claim to feel the pain of hard working Americans who seem to be falling behind rather than getting ahead. All envision a bright tomorrow in which every American will be safe and prosperous. But there is a stark contrast between the Obama-Biden and the McCain-Palin vision for America. And nowhere is this contrast starker than in their competing plans for health care reform.

It’s easy for candidates to advocate a “free market” for health insurance, but my background as a cardiologist, the founder of a small but quite successful national consulting firm, a recognized expert on measuring clinical quality and cost-effectiveness, a developer of analytic tools to support coordinated, effective, efficient health care markets, and a Medicare beneficiary who once enjoyed rather good private health insurance permits me to look under the hoods and see how the engines will run, where they will take us, and what they tell us about two very different visions of America’s future.