Rivals' prescriptions for an ailing system Both John McCain and Barack Obama would change the rules on health insurance. But other issues, analysts note, have taken center stage.

Barack Obama and John McCain present voters with starkly different visions of how to change the nation's troubled health-care system.

Obama wants more people to have health insurance. He would require insurance for children, create new options for uninsured adults, and reduce price discrimination against people with health problems.

McCain wants to make insurance more affordable. He would weaken incentives for employer-sponsored insurance - the value of benefits would be taxed as income - while giving people tax credits to help them buy insurance on their own.

But don't expect the election to hinge on health care, political and health-care experts said last week. The Wall Street debacle has grabbed the spotlight for the foreseeable future. More important, it's grabbing billions of dollars, and that likely will constrain reform efforts by either candidate once the election is over.

"The top three issues in the election are the economy, the economy and the economy," said David L. Cohen, a Comcast executive who chairs the board that governs the University of Pennsylvania Health System and who was a top aide to Gov. Rendell when he was Philadelphia's mayor.

"I think everything is past tense now," said Joseph Antos, a health-policy expert with the American Enterprise Institute who has critiqued Obama's proposal. "I don't think any of this is going to happen."

Nonetheless, Jay Khosla, a McCain health-policy adviser, said last week that "health-care reform is going to be a very important priority for McCain."

Obama, whose campaign did not respond to a request for information last week, said he might have to delay some domestic initiatives.

Cohen said he believed health care would continue to resonate with voters. "There's nothing that scares people more," he said, "than losing their health insurance."

And everyone agrees the problems are not going away. Forty-six million people in this country lack insurance, and costs are rising for the people who have it. The Henry J. Kaiser Family Foundation said last week that the average family plan now costs $12,680, up 5 percent from last year.