By way of beginning, a disclosure: Dave Roberts is vice president of government relations at HIMSS, part owner of Government Health IT. Take this not as an endorsement, rather it is part of our ongoing Political Malpractice coverage that involves interviewing politicians and healthcare experts of Democrat, Republican, and Tea Party nature – and backing none. And for the record, Government Health IT staffers are not legally able to vote in the San Diego election regardless, by virtue of 3,000 miles worth of geography.

Roberts, an eight-year veteran of HIMSS, who previously served as a corporate officer for a Fortune 500 company and the CEO of a small business, is currently Deputy Mayor of Solana Beach in San Diego and running for the County Board of Supervisors in what is the first time in 20 years the ballot holds no incumbent. That’s just the first twist. Republican Supervisor Pam Slater-Price crossed party lines to endorse Roberts, despite the four Republicans opposing him. And San Diego County is quite a bit larger than it might sound. Approximately 3.2 million residents live in the 18 cities comprising the 20th largest American county, land-wise, roughly the size of Delaware and Rhode Island taken together.

Government Health IT Editor Tom Sullivan interviewed Roberts about the delicate nature of discussing healthcare while campaigning, the non-partisan election in which he’s running, and the impressions his prospective constituents share about President Obama’s health reform law.

Q: You said during a panel discussion at the Government Health IT Conference last week that your political strategist sternly warned against speaking about healthcare on the campaign trail. Is that because people don't want to hear about it, it's too thorny for many citizens to understand, or another reason entirely?
A: The economy is the top issue on voters’ minds right now. Voters are concerned about their jobs and ensuring that the economy recovers. From both my private sector and public service experience, I know that voters are concerned about paying their mortgages, funding their children’s college education, and ensuring that their quality of life is protected. Healthcare is a concern to both residents and business owners – but only after the economy and jobs.

Q: So how does a career healthcare expert actually campaign without talking about healthcare?
A: During the primary election, I listened to my voters first and asked them what was on their minds. We talked about the economy, quality of life, and sensible growth. I shared the fact that San Diego County has worked hard to earn and maintain a AAA bond rating and a healthy financial reserve. My conversations with voters included issues across the gamut from jobs, economy, quality of life, healthcare, arts and culture, environmental sustainability, and public transportation.

Q: What sense do you have for how well the citizens of San Diego County understand that some aspects of the ACA may already be benefitting them? Lower prescription pill costs, for instance…
A: I found that the voters of the Third Supervisorial District in San Diego County are very astute and could see through the vague generalities put up by some candidates. Voters told me they want leaders who can work in a bipartisan fashion and that they are fed up with partisan bickering. Voters told me specifically that they liked certain aspects of healthcare reform such as the annual senior wellness physical, the closing of the prescription donut hole, and allowing students to stay on policies until age 26. Voters did not like the perception of the government taking too strong a role in healthcare, which could better be implemented by private industry.

Q: Given the contentious nature of the ACA some of the most vehemently opposed people — indeed I'm talking about Tea Party leaders — point time and again to federal overreach as the chief argument against it. And of course even some left-leaning citizens oppose that overreach, particularly in terms of health insurance exchanges. What is the sentiment in San Diego County?
A: San Diego County has a large military and veterans population. And one fourth of San Diego County’s almost $5 billion budget is spent on healthcare and folks recognize that the current delivery of healthcare is costly and inefficient and a number of individuals and organizations are working to improve healthcare. I am pleased to serve on the Community Advisory Board for Scripps Memorial Hospital Encinitas and have seen the progress that not only Scripps, but also Sharp, Palomar, Tri-City and others are making in the county to improve healthcare delivery.

Q: It might seem that simply explaining some of the ACA benefits – lower prescription costs again, for one – would go a long way toward clearing the confusion about health reform. So why aren't more centrist and Democrat candidates doing just that on the campaign trail?
A: I cannot speak for other candidates, but my campaign for Third District County Supervisor is a non-partisan race. There are no political party designations and I have strong support from Republicans, Democrats and Independents. As a federal appointee in both the George W. Bush and current Presidential Administration as the Co-Chair of the National Advisory Panel on Outreach & Education at the Department of Health and Human Services, I know that healthcare reform has local implications in San Diego County and our next Supervisor must understand how it could affect our county’s budget and its residents. Voters tell me this, too.

[Political Malpractice: How politics distort Americans' perception of health reform.]

Seniors tell me they are concerned about their Medicare and Social Security benefits. Low-income residents are concerned about MediCal benefits. Parents like that their children can stay on their health policies through age 26. All voters tell me that they like the abolishment of health coverage denial for pre-existing conditions. What folks don’t like is the perceived overreach of the federal government into our healthcare system. Most voters don’t recognize that over 50 percent of all healthcare in the United States is funded by government (Medicare, Medicaid, Children’s Health Insurance, Public Health, TRICARE, and Veterans).

Related Political Malpractice coverage:

Health costs highest on Americans' top 10 issues list

Are politics extinguishing state health insurance exchanges?

They all chant 'ACA repeal' but what could a GOP president actually do?

Podcast: The uncertain future of health insurance exchanges

Podcast: SCOTUS and ACA, what we know, what we don't, why each matters

Newt Gingrich on health IT: Then, now, and the days between

For more of our politics coverage, visit Political Malpractice: Healthcare in the 2012 Election.