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RALEIGH — When candidates for governor debate health policy Thursday night, voters such as Dale Metz will be paying close attention.

"I think it's the No. 1 issue," said the former principal who now works for an adult day health program. "The bottom line for me is the children. Not to have children's health care is inexcusable."

Jay Callaham, who has been a fraud investigator for insurance companies and worked in the telecommunications business, will be looking to hear something different.

He says those who want to be the next governor need to talk about how to reduce costs related to treating illegal immigrants.

"They are filling up our hospitals and emergency rooms, and you can see that," Callaham said. "Somebody is paying for it and it's not them."

Reducing the cost of treating illegal aliens, he said, would reduce health-care costs for the rest of us.

Health care is clearly on the minds of voters. But as Metz's and Callaham's perspectives show, what exactly they're thinking about depends on who you talk to.

The Democratic and Republican front-runners will have a chance to sell their health policy ideas to voters during a debate on UNC-TV this week. The event will be the second of three this spring that the public television channel is hosting among those who hope to be governor.

Political observers say the candidates will be expected to talk a lot about health care in advance of May's primaries.

"I think it remains an issue because of the number of uninsured people has stayed up and the people who do have insurance feel vulnerable because it's tied to their employers," said Charles Prysby, a political science professor at UNCG. "All kinds of stories about health care have been in the news....Even people who might not yet have been personally affected can see the potential."

Thomas Ricketts, a professor in health policy at UNC-Chapel Hill, is teaching a graduate class this semester that will analyze the health policy proposals of presidential and North Carolina gubernatorial candidates.

"What I tell the students is the state has more influence on the way you practice medicine," Ricketts said.

But although it makes sense for state candidates to talk about health care and voters are paying attention, candidates — especially those for governor — don't always make health policy a centerpiece of their campaigns.

"I would say not, people don't run on this from my involvement," said Ricketts, who has worked on Democratic and Republican campaigns. "They could make some hay out of it if they were willing to address it."

Lt. Gov. Beverly Perdue and Treasurer Richard Moore, the two Democrats leading the race for their party's nomination, have developed detailed health-care proposals.

Both say they want to expand health coverage to all uninsured children in North Carolina, and both say the state needs to help small businesses afford to provide health insurance to their employees, although their approaches differ on both points.

Perdue emphasizes preventative care in her materials, while Moore has offered a plan to keep the state from paying the costs associated with medical errors.

All four Republicans have made broad statements on health care, although none yet are as detailed as the two Democrats' plans.

Former Supreme Court Justice Bob Orr says that the government needs to work "in concert" with the private sector, and he said Friday he would be issuing a detailed proposal in advance of this week's debates.

Salisbury lawyer Bill Graham has said he wants to leverage the government's buying power to win good rates for uninsured citizens.

State Sen. Fred Smith emphasized the use of personal medical savings accounts and reforming medical liability laws.

When the News & Record asked readers for their thoughts on what candidates for governor ought to be talking about, there was no shortage of ideas.

Some, like many of the Republican candidates, emphasized controlling the cost of health care, suggesting that people ought to be able to "shop around" for services.

Others pointed to needs they thought the government ought to fill.

"I've run into a lot of people who can get no dental care," said Joan Paul, a retired accountant who lives in Graham. "It's crazy because that sort of stuff just breeds other problems."

She said the next governor should work on making dental care available to all residents with payments based on a sliding scale. Dental clinics and other free dental care services, she said, were not enough.

Charles Hook, a vocational specialist who lives in Greensboro, says there needs to be universal health coverage for all. He said that the state should create a "super pool" of uninsured and negotiate with private insurance companies to obtain coverage, an idea not unlike the one espoused by the Republican candidate Graham.

UNC's Ricketts points out that proposals like Hook's stray into a dicey area of the health policy debate.

"Talking about universal coverage is one thing, and talking about government-run health care is another," Ricketts said. Government-run health care, like that offered in Canada, is seen by many conservative politicians and voters as undesirable because it eliminates choices and puts medical care in the hands of the government.

But in political debates, the idea of government-run health care is often conflated with universal coverage as a way to argue against the expansion of public health insurance programs.

Of course, some readers say they wouldn't mind having "Canadian" health care. Jim Galler, an accountant from Stokesdale, says he has relatives in Canada who are satisfied with the services they received.

"There's got to be some way to make affordable health care available to everyone," he said. When asked if North Carolina should strike out on its own with such a program, he said, "We wouldn't be the first."

Contact Mark Binker at(919) 832-5549 or mark.binker@news-record.com