But corporate America isn't buying.

As neither candidate seems to be aware, healthcare is increasingly available only to those who can pay.

This article represents Trudy Lieberman's personal views, not those of Consumers Union.

As crises go, medical insurance is not a very sexy one.

The Medicare "reform" legislation just passed by Congress sends the program on a path to destruction.

Twelve years ago, Harris Wofford made healthcare an issue. Promising to
fight for coverage for all, Wofford scored a surprise victory in a
Pennsylvania Senate race--inspiring speculation that a President named
Bush could be beaten in 1992. Wofford handed the issue to Bill Clinton,
who won the election but lost the war by proposing a plan that offered
more in the way of bureaucracy than a clean break with the existing
for-profit system. Since the Clinton crackup, Democrats have struggled
to reassert the healthcare issue. While the 2004 campaign has yet to
experience a "Wofford moment," Dr. Norman Daniels of the Harvard School
of Public Health says rising numbers of uninsured and underinsured
should move healthcare to the fore as an issue. "The question," he says,
"is whether the new crop of candidates will address it effectively."

Enter Representative Jim McDermott, a physician and the new president of
Americans for Democratic Action, who has taken it on himself to sort
through candidate proposals (www.adaction.org). As McDermott sees it,
the plans of Howard Dean, John Edwards, John Kerry and Dick Gephardt
"are all quite similar--they each combine modest expansions of public
sector programs such as Medicaid and [children's health programs] with
private sector initiatives to encourage employers to provide health
insurance for their employees." While under each of these plans the
government becomes an even greater purchaser of healthcare, McDermott
says that "because most of the new expenditures are through the
fragmented private insurance market, the government will continue to
waste its considerable market power." He's still reviewing Lieberman's
plan, which looks to resemble the others.

In contrast, McDermott notes, Representative Dennis Kucinich offers a
single-payer national healthcare plan based on a bill by Representative
John Conyers, of which McDermott is a co-sponsor. While he sees value in
incremental reforms, McDermott says, "I continue to believe that a
national health care plan, with a government-guaranteed revenue stream
for providers, would be most effective in providing universal coverage
and controlling costs while guaranteeing high quality care." A separate
study of the candidate proposals, done by The Commonwealth Fund
(www.cmwf.org), says Kucinich's plan would cover all Americans, while
those of Lieberman, Dean, Gephardt, Kerry and Edwards would leave 9
million to 19 million uninsured. Single-payer backers Al Sharpton and
Carol Moseley Braun have not offered details; Gen. Wesley Clark has yet
to make his views clear.

While McDermott's analysis will please Kucinich backers, his candidate
choice won't. The Congressman just endorsed Dean. Two reasons, he says.
First, "as governor of Vermont, Dean implemented reforms. He got people
covered. One of the problems the Clintons had is that they were starting
without ever having done it. For them, it was theoretical. Experience
helps you avoid big mistakes." Second, "Electability. Dean isn't my
perfect candidate, but I think he can beat Bush. Beating Bush is the
first step toward healthcare reform."

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Hawaii recently became the fifth state to make emergency contraception,
also known as the morning-after pill, available directly from
pharmacists. This is far from a small regulatory change.

It seems clear that one of the keys to public health is establishing public patents.

While fighting givebacks, unions can't lose sight of the big healthcare
picture.