Sen. John McCain and Sen. Barack Obama went face to face on potential health care policies at the second presidential debate. Both the candidates said health care was a priority for them in their first year in office, with McCain saying health care was “one of the major challenges America faces," and Obama said handling the health care crisis was both a "moral commitment" and an "economic imperative."

Though the commitment they say is the same there are some differences in the policies the two would adopt. McCain is in favor of more people being in an individual health care plan while Obama is for employer based health care plans.

Under McCain’s health policy, health benefits would be taxed similar to a salary while individual health plan would get a tax break. He’s in favor of eliminating tax breaks on employer-sponsored health care policies and replacing them with health care tax credits of $2,500 for individuals and $5,000 for families. Increasing competition by doing away with restrictions on buying health policies across state lines is another idea he has.

Obama is in favor of the employers of medium and large companies choosing between providing health care coverage regardless of medical history or paying a tax that will fund the uninsured. He wants to mandate health care coverage for children and create a national health-insurance exchange with the goal of providing private or public health insurance coverage for everyone.

McCain said the plans showed "a fundamental difference between myself and Sen. Obama." He added, "He will impose mandates. If you are a small-business person and you don't insure your employees, Sen. Obama will fine you. I want to give every American [family] a $5,000 refundable tax credit they can take anywhere across state lines. Why not? ... In Arizona they may offer a better plan than the one [you can buy] here in Tennessee."

Obama countered by saying, "That is a fundamental difference I have with Sen. McCain. He believes in deregulation in every circumstance. That is what we have been going through for the last eight years and it hasn't worked."

Karen Davis, who is president of the nonprofit Commonwealth Fund, which supports research on health care policy, said both were guilty of misrepresenting some aspects of the other's plan. "Obama could start with children," she says. "The Children's Health Insurance Plan (SCHIP) is up for renewal in March and expansion is certainly possible. And McCain could start by allowing people to buy insurance across state lines."

Robert Laszewski, who writes the health policy blog Health Care Policy and Marketplace Review, faults both candidates for their failure to acknowledge this economic reality.

"They were asked about it last night and they were asked at the first debate, and neither one would admit that major reform is off the table," he says. "They need to be made to answer the question, 'If you can't have major reform, what will you do?' By letting them off the hook, we have no idea what the answer is."