Health is now a topic of great concern to the American public due to the sharp rise in costs and the decline in health risk cover resulting in glaring inequalities in access to health care. This situation speaks in favor of an ambitious reform of the health system, initiated by certain states, but still highly controversial at federal level. During the 2008 presidential campaign, health has become one of the major challenges of US domestic policy. This article describes and analyzes the visions and strategic orientations of the Democrat and Republican programs currently vying with each other on the topic of the health system.