By Tim Bonfield
The Cincinnati Enquirer

Don't expect the next Ohio governor to be the "health care governor."

In the race for governor between Republican incumbent Bob Taft and the Democratic challenger Tim Hagan, health care issues are taking a back seat to sparking a weak economy, coping with a state budget crunch and finding money to rebuild schools.

WHERE THEY STAND

The Enquirer looks at some of the key issues in the race for governor and how each major-party candidate for governor would address them.   Senior prescription drugs • Taft: Supported a 15 to 40 percent discount for Golden Buckeye Card holders. • Hagan: Calls for state Medicaid to bargain down prices, as other states do, and for a pharmacy assistance program for seniors and the disabled.   Medicaid spending • Taft: Fought to protect the Medicaid budget from cuts in 2003, expanded the PASSPORT program, which provides in-home nursing care. Calls for reforming how the state pays nursing homes. • Hagan: Calls for reforming how the state pays nursing homes, for sharper increases in PASSPORT, and for re-directing Medicaid spending toward preventive care.   Medical malpractice reform • Taft: Supports legislation that would limit awards for pain and suffering in medical malpractice cases to $300,000. • Hagan: Opposes malpractice reform, but would create a medical liability risk pool to help doctors control insurance costs.   Mental health parity • Taft: Does not support. Says another mandate might cause employers to drop health coverage. • Hagan: Supports legislation to require similar levels of coverage for mental and physical illness.

Mr. Taft has made few health care promises since taking office in 1999. And, except for the hot-button issue of prescription drugs for seniors, he doesn't emphasize health care in his campaign now.

"When my time as governor is done, and I'm asked what we accomplished, I hope to answer: `excellent schools and high-paying jobs for Ohioans.' These are my highest priorities," he said in February during his most recent State of the State address.

While Mr. Hagan has a more detailed and ambitious set of health reform ideas, he would face an uphill battle enacting them through a GOP-controlled legislature. Mr. Hagan himself says it is unrealistic to expect swift action on health issues during a state budget crunch.

"Obviously, the budget is the top priority. Anything else is intellectual gymnastics," Mr. Hagan said.

Even so, health issues are a constant, high-interest part of politics. Whoever becomes governor will likely spend much of the next four years dealing with several thorny issues, each with far-reaching impact for millions of Ohioans.

Prescription drugs for seniors. Medical malpractice reform. Medicaid spending. Mental health parity. Covering the uninsured. Even what to do about shortages of nurses, specialist physicians and other health care workers.

Mr. Taft may not be viewed as a passionate cheerleader for health care, but he also isn't seen as unaware or hostile to health concerns. In recent months, Mr. Taft won praise for helping protect the Medicaid and mental health budgets.

"That may not sound like a lot, but that was important," said Lynn Olman, president of the Greater Cincinnati Health Council. "I firmly believe he would do more for health care if he could."

This year, Mr. Taft pushed lawmakers to approve a discount program for prescription drugs through the Golden Buckeye Card that promises discounts of 15 percent and more. The program is expected to begin early next year.

"It just doesn't go far enough," said Cathy Levine, executive director for the Universal Health Care Action Network of Ohio.

In addition to medication coverage for seniors, Mr. Taft claims credit for adding 92,000 uninsured children to Ohio's version of the federal Children's Health Insurance Program. Consumer advocates have not been impressed.

"A lot of states have done more than Ohio has," Ms. Levine said.

Mr. Hagan's health care platform is more aggressive, and potentially more expensive, than Mr. Taft's.

He calls for the state to use its Medicaid purchasing power to win concessions on prescription drug prices.

"There is no reason why prescription medication should cost almost twice as much in Ohio as it does in Canada or Europe," he says.

Onnursing homes - a key driver of Medicaid spending - Mr. Hagan contends the state has too many nursing home beds. He supports changing a funding formula to pressure nursing homes to close unused beds and calls for expanding PASSPORT, the state's home-based nursing care program.

Mr. Taft agrees that Medicaid spending, especially for nursing home care, needs to be controlled.

E-mail tbonfield@enquirer.com