The candidates for the 2008 presidential election have offered a range of proposals that could bring significant changes in health care. Although few are aimed directly at the nurse and physician workforce, nearly all of the proposals have the potential to affect the health care workforce. Furthermore, the success of the proposed initiatives is dependent on a robust nurse and physician workforce. The purpose of this article is to outline the current needs and challenges for the nurse and physician workforce and highlight how candidates' proposals intersect with the adequacy of the health care workforce. Three general themes are highlighted for their implications on the physician and nurse workforce supply, including (a) expansion of health care coverage, (b) workforce investment, and (c) cost control and quality improvement.
Keywordsnursing; health care workforce issues; regulation of nursing practice; electoral/campaign activity; coverage/access America's workforce of nurses and physicians is the linchpin of its health care system. During the past decade, critical shortages of nurses have developed, and projections suggest that these shortages will progressively worsen (U.S. Department of Health and Human Services, 2002). Inadequacies in the supply of physicians are only a few years away, with the emergence of critical pockets of shortage during the past several years and with projected shortages approximately equal (in percentage terms) to those projected for nurses (Cooper, 2004;Cooper, Getzen, McKee, & Laud, 2002; Council on Graduate Medical Education, 2005). In both cases, shortages vary in geographic distribution and are most severe among inner-city and rural populations, but they are spreading to affect the entire population. It seems certain that these shortages will negatively affect health outcomes across the United States. They also will limit the options for making planned structural changes to the health care system. During the 2008 presidential campaign, candidates have offered a range of proposals that would effect changes in health care. Although few would directly affect the workforce of physicians and nurses, most have implications for the health care workforce. The candidates' proposals have followed three general themes: (a) expansion of health care coverage, (b) workforce investment, and (c) cost control and quality improvement. Although most candidates have ended their campaigns since the start of party primaries in January, the proposals of all candidates remain relevant because they have informed the still-fluid discussion of health carePlease address correspondence to Matthew D. McHugh, Claire M. Fagin Hall,