If the 2008 election does not grab the interest of the average American and motivate them to vote, I'm not sure any presidential race ever would.

After all, we have distinctly different candidates to choose from this year and plenty of election issues.

With Wisconsin actually assuming a strategic role in the electoral process, one would think that health care would be one of the key items for Tuesday's primary. However, despite many people feeling like our health care system is desperately in need of an overhaul, it's becoming apparent that health care is not emerging as a pivotal issue right now.

What is clear is that the next president will have to confront some major policy decisions that will affect the lives of all Americans.

First, we are experiencing a dramatic trajectory of health care spending — over $2 trillion a year and 18 percent of our GNP — while ranking only 45th in the world in life expectancy and 37th in a recent World Health Organization study on the performance of national health systems. U.S. health care expenditures, the highest per person in the world, are expected to double to $4 trillion by 2016, 20 percent of our GNP.

Second, while it is easy to point the finger at various culprits regarding costs, more than 75 percent of our health care dollars are spent treating chronic diseases. The harsh reality is that 60 percent of these chronic diseases are caused by preventable factors such as smoking, obesity and physical inactivity. Yet despite these statistics, less than 5 percent of health care spending supports prevention and health education.

Third, much fanfare has been made regarding our 47 million uninsured. However, keep in mind that census data suggests the demographic make-up of this group is not what the media portrays. Surprisingly, 85 percent of the nation's uninsured appear to be employed or have worked in the last year. This group is young, with almost half between the ages of 18 and 34. Nearly three-quarters describe their health as excellent or very good, and more than two-thirds have some college education. About half earn middle-class incomes.

Fourth, the next president will play a major role in our national position on scientific research. How much the U.S. invests in research will have sweeping impacts on medical innovation, both locally and abroad. We are in a period of decline in medical research funding. As a result, our pace of finding cures and developing prevention strategies is diminishing.

So, as you contemplate Tuesday's primary, I encourage you to use the following four guidelines to help you focus on a candidate.

First, don't pay too much attention to differences among each party's individual candidates at this point. Clinton and Obama have more in common than you might think and the eventual candidate platforms will be shaped by who is combined on the November tickets.

Second, there are profound differences between the Democratic and Republican approaches to health care reform. Republicans favor an open market solution while the Dems have different versions of a universal coverage-based design.

Third, don't get too attached to any one candidate's health care agenda at this stage. It's a safe bet their plan will change.

Finally, and most importantly: Vote. Let's make this the year America sheds its voter apathy and gets to the polls for both the primary and general election. If you don't vote, you have nobody to blame but yourself for the outcome.

Larry Sobal is chief executive officer of Appleton Cardiology Associates, a member of the Appleton Heart Institute. He can be reached at 920-731-8900 or at larry.sobal@thedacare.org.