LAS VEGAS - The ongoing crisis in the markets was evident yesterday in the hallways and at the podium of The Bond Buyer's annual Nonprofit Hospital Finance Conference here.

"What a difference a year makes, and oh, what a mess the markets are," co-chair Iain Briggs, managing director of FTI Healthcare, said to kick off his opening remarks.

"Last year could be called the end of the best of times," he said. "In summary, it is shaping up to be another good year for consultants and turnaround advisors."

The market meltdown - in which, the new-issue market effectively ground to a halt with a slew of issuers postponing, canceling, or dramatically reducing in size their pending transactions - spilled over into the first panel. It was set up to allow representatives of the presidential campaigns of Sens. Barack Obama and John McCain to talk about their health care proposals.

"Clearly it will have an impact on the agenda of the next president," said Grace-Marie Turner, president of the Galen Institute think tank, representing the McCain campaign. "There's not a lot of new money available."

But the high cost of health care and health insurance is going to keep the issue on the national agenda, she said.

"The next president is not going to want to go to the voters in 2012 without doing something on health care," she said.

"The pendulum has swung back again to have a national conversation of health care," said Deb Mizeur, a representative of Obama's campaign.

Mizeur said Obama's health proposals start with coverage for children.

She said he wants to build on the existing employment-based system, with measures that include having the federal government pick up the tab for the most expensive cases covered by private employers' insurance. Obama would increase regulation of health insurance companies, and limit their ability to decline coverage, she said.

There would also be tax credits for small employers and a national health insurance exchange, and more regulation of health insurance companies.

If the plan lacks specifics, she said, that is in recognition of the reality that reform will require cooperation from Congress.

"It's less about specifics and more about the leadership that is needed to make reform happen," she said.

McCain's health care philosophy is built on four pillars, Turner said - affordability, portability, access, and quality.

Its most significant component is a shift in the tax treatment of health insurance, removing the tax-exempt treatment employees currently receive for their health benefits with a system of tax credits. That would make it much easier for those who currently lack health insurance - and therefore receive no tax benefits - to obtain it, she said.

"For people shut out of the market, it gives them real money to work with," she said.

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