More than a year from the presidential election, health care pushes ahead as an important domestic priority. Americans must decipher what is right for health care reform, but some pundits appeal more to the heart than the mind. This year alone, one film and three books take on this important topic, with mixed results.

Michael Moore’s latest film Sicko introduces the American victims of unreformed insurance, bad incentives, and soaring costs, but after a skillful pulling of heartstrings, his movie lurches into a series of bewildering solutions to our problems. For example, Sicko portrays golden, government-run health care in other countries, but two years ago, the Canadian Supreme Court found that government monopoly health care violates basic human rights. The plaintiff in this case was prohibited from paying privately for a hip operation. He didn’t want to wait for years in the public line, so he went to court, and he won.

Cuba’s health care system, another recommendation from Moore, treats Cuban party officials and a group of American patients in the film pretty well. Some 11 million Cuban civilians, however, use dirty facilities, receive dated prescription drugs, and are even required to bring their own sheets, food, and soap to the hospital.

The textual equivalent of Moore’s shockumentary is Sick, by Jonathan Cohn, a senior editor at The New Republic. Like Moore, Cohn focuses on our worst health care failings, and blames the disorder of our modern health care system on “corporate debauchery and free market hysteria.” Cohn’s best evidence for government-run health care success are monopoly health systems abroad, and our very own Medicare system.

In The Diagnosis & Treatment of Medicare, Dr. Thomas Saving of Texas A&M University and Andrew J. Rettenmaier, senior fellow at the National Center for Policy Analysis (NCPA) examine the true impact of our imminent Medicare costs.They estimate thatMedicare will consume almost a quarter of all federal income taxes by 2020, three-eighths of all federal income taxes by 2030, and 11 percent of the GDP by 2080.

We cannot expect to place the price of benefits on the shoulders of younger generations forever, but we can anticipate a more equal distribution of health care payments, and we must foster personal savings for future sustainability to make it happen. Saving and Rettenmaier offer a new approach– prepayment for retiree health benefits and a structural reform of Medicare insurance coverage.

Harvard Business School professor Regina Herzlinger paints a picture of the U.S. health care system as a “battle ground" in her book, Who Killed Health Care?

She notes the philosophical difference between the “villains” and the “heroes” in American health care: those who believe “big [government] is beautiful” will promote government cost controls and health care rationing. Fundamentally different is the “small [government] is beautiful” crowd that entrusts the choice to individual Americans to utilize a free market, and to shop for even complex products.

Herzlinger argues that consumers need more information, and here she welcomes a role for government, to standardize and report health care information for consumers to use at their own discretion. This still means abandoning the “big government” ideal, and it means a total modification of the existing health care villains.

And so we compare two representatives of each camp, “big is beautiful” and “small is beautiful.” The makers of Sicko and Sick believe that the federal government will provide everything for everybody: technology, choice, and a free, efficient economy. Authors Savings, Rettenmaier, and Herzlinger recognize that we cannot scrap growth and innovation as we repair our health care system, or more lives will be lost in the end. The better solution is competitive reform, not big-government bureaucracy.

Read the full review at the Pacific Research Institute web site.