When Democrat Manan Trivedi offers his credentials for unseating Republican Rep. Jim Gerlach, he talks about his life as a doctor and a veteran.

"My experiences not just tell you who I am, but drive me and form my decision-making and my stances," Trivedi, 38, said at a recent meeting with The Inquirer's Editorial Board.

Trivedi, a former Navy surgeon, was with a Marine Corps unit when it entered Iraq in 2003. As a physician, he has wrestled with questions at the center of the national debate on how much health care Americans can afford and how to pay for it.

Gerlach has plenty of experience of his own: a lawyer, he has been in elected office since 1991, and in Congress since 2003. Perhaps most important for his prospects Nov. 6, he has beaten back challenger after Democratic challenger in a district his opponents have frequently targeted, including defeating Trivedi two years ago.

"They've spent tens of millions of dollars to try to defeat us," Gerlach, 57, said in a phone interview. "We're working hard; we're getting great feedback."

The two are competing for a House seat in a suburban district that centers on Chester and Berks Counties but also stretches into Montgomery and Lebanon Counties. Wielding his medical experience and Democratic talking points, Trivedi has assailed Gerlach over the GOP's Medicare plan, and Gerlach has fired back on the issue and questioned his opponent's residency.

The rematch of their 2010 race puts the candidates on new turf after Republicans redrew legislative maps to reflect the 2010 census. The district is far more Republican than in the past.

Trivedi was buoyed last week by news that his campaign had raised roughly $100,000 more than Gerlach's did last quarter.

But as of Sept. 30, Gerlach had more left for the stretch run ($728,000 to Trivedi's $283,000) and had raised $2 million overall, compared with $1.2 million for Trivedi.

National Democrats once again made Gerlach one of their top targets this year, but signaled recently that the race, and other local contests, may have fallen out of reach when they canceled their Philadelphia TV advertising buys scheduled for the final two weeks of the campaign.

In making their cases, Gerlach and Trivedi largely echo arguments being made this year by fellow Republicans and Democrats in races around the region and the nation.

Gerlach is promoting a message of smaller government and lower taxes, including cutting rates for corporations and individuals at the top of the income scale.

"We're fighting for the taxpayers of our district and across Pennsylvania to rein in government spending that's at an all-time high and also put in place the kind of pro-growth economic policies that are going to lead to more jobs," said Gerlach, a member of the influential House Ways and Means Committee.

Trivedi contends the incumbent has moved out of step with the moderate district, pointing to Gerlach's votes for the GOP budget sponsored by Wisconsin Rep. Paul Ryan, now Mitt Romney's running mate.

"He's not the same guy he was 15 years ago," Trivedi said of Gerlach. "He's really gone to the extremes of the party."

Actually, Gerlach has been rated by several independent publications and think tanks as one of the most moderate Republicans in the House. But Democrats say he has stood with the GOP's base during key votes on issues such as taxes, spending, and President Obama's health-care law - which Gerlach voted to repeal.

In particular, Trivedi hammered Gerlach's votes for Ryan's budget, saying its proposed Medicare overhaul would cost seniors thousands of dollars.

The proposal calls for giving seniors a fixed subsidy to buy health coverage. Democrats call it a voucher program; Republicans call it "premium support."

Gerlach says the plan, which would apply to future seniors who are now younger than 55, would save money, introduce competition, and lower costs for one of the government's most expensive programs. A second version, which he also supported, leaves traditional Medicare intact as an option.

"Through the competition of plans, they'll have better options and therefore bring the costs down," Gerlach said.

Democrats, including Trivedi, contend that if Ryan's plan were adopted, government support for future seniors covered by Medicare wouldn't keep up with costs, leaving those elderly patients to pay the difference themselves.

If plans get too expensive for the government support, Gerlach countered, "then the senior won't pick that plan."

Republicans, at least, offered an idea to curb Medicare's growing costs, he said.

"It's put up or shut up," Gerlach said. "I think it's time for them to shut up if they're not prepared to put a plan on the table."

Trivedi, who talks like a policy wonk when discussing health care and its rising costs, argued that the path toward savings should focus on incentivizing "best practices." Medicare should pay for only those medicines and procedures proved to provide the best outcomes, he said. This would eliminate unnecessary tests and procedures, he argued, and relieve one of the biggest pressure points on the federal budget.

"We have to figure out what works and what doesn't work in medicine and make health care much more efficient," Trivedi said.

He said Obama's health-care plan did not do enough to control costs, but he praised elements of the law, such as barring insurance companies from denying coverage for people with preexisting conditions.

On taxes, Gerlach called for cutting corporate rates and lowering the top individual income tax rate to 25 percent, along with closing loopholes and eliminating some deductions. He would have two tax brackets: 10 percent and 25 percent, down from the current six that range from 10 percent to 35 percent, following a plan backed by the House GOP.

The plan does not specify who would fall into which brackets. The proposal would ensure tax cuts for couples making more than $142,700 and individuals making $85,650 and up; anyone in those ranges currently pays rates of 28 percent or more.

A fairer, simpler tax code would provide economic growth and more revenue, Gerlach said.

Republicans "don't oppose increasing revenues," Gerlach said. "We just don't think increasing the [tax] rates are going to get you there."

Trivedi favors a "balanced" approach to reducing the deficit, which he said would pair spending cuts with increased taxes on high incomes. Rate increases would begin with taxpayers earning $250,000 or higher, he said.

Gerlach has worked to paint Trivedi as an outsider.

A Birdsboro resident, Trivedi no longer lives in the Sixth District after the new legislative map sliced out his home. He can still legally run in the district.

Gerlach has tried to raise questions about Trivedi's residency, pointing out that most of his personal income in the last two years has come from Washington, where the Democrat's wife works.

Trivedi said he had worked primarily in Pennsylvania, taking shifts at hospitals in Reading and Pottstown, but works in Washington when his wife is there.

Washington hospitals pay more, accounting for some of the pay disparity, he said.

"I live in Birdsboro. This is a lie," he said of Gerlach's contentions.

Trivedi and his wife own a townhouse in Washington, but their Berks County house is their home, he said.

The two candidates are scheduled to debate in Lebanon County on Oct. 29 and in West Chester on Nov. 1.

Contact Jonathan Tamari at jtamari@phillynews.com or follow on Twitter @JonathanTamari. Read his blog, "Capitol Inq,"