This is the second installment for 2008 of the Commonwealth Fund/Modern Healthcare Opinion Leaders Survey. More survey results can be found at the Commonwealth Fund’s Web site, cmwf.org.

A vast majority of surveyed healthcare leaders say healthcare quality and efficiency will improve only with fundamental change, and among their priorities are strengthening the primary-care system, encouraging greater coordination of care and moving away from fee-for-service payment.

As the political debate over the nation’s healthcare crisis becomes increasingly polarized, it is tempting to believe that there are only two mutually exclusive paths before us. One proposal argues broadly for greater government involvement in order to ensure “universal” coverage. The other depends on market forces or a “consumer-driven” approach. But neither addresses the core challenge facing our healthcare system: providing quality and value. And that challenge won’t be met solely by enrolling us all in an insurance program or by sending us shopping in the medical marketplace.

The “medical home,” a practice-based structure to facilitate the delivery of comprehensive care and to promote strong relationships between patients and their primary-care physician-led teams, has real momentum in healthcare today. Channeling and focusing this initial progress, however, presents a series of challenges if this promising movement is to bear fruit.

Modern Healthcare asked the presidential candidates to write about their plans for reforming the U.S. healthcare system. Read what they have to say by clicking on their images below. Candidates in black and white have withdrawn from the race.