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Health care has been an important issue in recent elections, and as the 2008 vote approaches, it’s gaining even more steam. With health care premiums doubling over the last six years, and 45 million Americans uninsured, voters are calling for actual change. They are tired of Republican and Democratic administrations and Congresses failing to act.

Candidates are offering a variety of solutions to the health care crisis. Some Republicans, such as Mike Huckabee, want to take it to a consumer–based system. Hillary Clinton is pushing her universal health care plan. And Mitt Romney is suggesting a “federalist” approach, where the federal government would offer incentives to states to bring down the cost of health insurance.

We’ll see who the voters choose come November next year. In the meantime, some cities are taking matters into their own hands. San Francisco announced a new initiative, called Healthy San Francisco, which will offer care for all uninsured city residents. The city is hoping that it can offer sensible care for the roughly the same cost as current uninsured treatment, which often occurs in the emergency rooms. There are obstacles to overcome and problems to work out, but a two month trial in Chinatown went well.

If it is successful, other cities might be tempted to follow suit. But it may be difficult to replicate the system because, as the NY Times put it, “In addition to its unique political culture, San Francisco, with a population of about 750,000, has the advantages of compact geography, a unified city-county government, an extensive network of public and community clinics and a relatively small number of uninsured adults. Virtually all the city’s children are covered by private insurance or government plans.”

So although San Francisco should be praised for being proactive, perhaps its solution won’t work for the areas in the direst need of help, those with large numbers of uninsured. Here is a map taken from GeoCommons, showing the percentage of the population which is uninsured by county. Based on the hot spots, the Southern states will probably be paying closest attention to the candidates’ plans for fixing the health care dilemma.

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