Hopefuls - logical, energetic, battle-ready

J. Patrick Coolican and Michael J. Mishak

Sunday, March 25, 2007 | 7:14 a.m.

One candidate will draw from pain and loss. Another will build consensus. A third will try to out slug the opposition.

Democratic presidential contenders at a Las Vegas health care forum Saturday were in broad agreement about the causes of and potential solutions to the crisis in American health care.

Their presentations, however, reflected the differences in their political style and biographies - and offered predictors of how they would govern.

The aspirants gathered at UNLV for a forum sponsored by the largest health care union, Service Employees International Union. Public opinion polls show that Americans consider health care coverage second to the Iraq war as an important issue in the 2008 election. Although the United States spends more on health care per capita than any other country, Americans don't live as long and more of our infants die than in most of the industrialized world.

Former Sen. John Edwards, the Democrats' 2004 vice presidential candidate, arrived at the forum with his wife , Elizabeth, a breast cancer survivor. She received a diagnosis last week of a treatable but incurable form of bone cancer, and the Edwardses decided to continue the campaign, setting off a national conversation about living with cancer and the wrenching choices families are dealt.

It's unclear how the news will affect the campaign, especially fundraising, as potential donors consider supporting a candidate under family duress. But his wife's condition gives Edwards added credibility on health care.

As he said Saturday: "A lot of women with the same diagnosis had to get up the next morning and go to work."

Edwards is a former trial lawyer, and his remarks reflected how that background shapes his style of politics. He spoke as if building an argument before a jury, supported by evidence.

Thus far, he has the most thorough plan for giving health coverage to all Americans. It would require rolling back some of President Bush's tax cuts in the highest income brackets, a potential political vulnerability in a general election campaign. Defending his proposed tax increase, he said, "I think the president needs to be honest, and that starts here." It was among the biggest applause lines of the day.

Sen. Barack Obama's presentation resembled his candidacy to date: energetic, lacking clear direction and predicated on politics that will break through the current red/blue impasse by building a new coalition.

The Democratic Party's freshest face ran straight into the reality of a tough presidential campaign when an SEIU member told him she was disappointed by the lack of health care specifics on his Web site. He replied that he would have a plan in the coming months, and he laid out its essential principles, which were more or less identical to those of the other leading candidates.

They all agree that: Everyone should be covered ; more should be spent on prevention and managing chronic illness such as diabetes ; the government should create insurance markets to broaden the shared risk and reduce overall costs ; and medical records should be made electronic, which would reduce overhead.

"The most important thing is to build a political consensus ," Obama said. "Everyone is going to have good ideas, but can they bring a majority of people together to support this?"

Obama's chief rival, Sen. Hillary Clinton, took the floor appearing ready for battle, and her presentation reflected her political history and devoted campaign team, which plays smash-mouth politics.

The crucial element of health care reform isn't consensus but steamrolling the opposition, she said. She went after the insurance companies and said she would end "insurance discrimination," whereby insurers refuse to cover people or refuse to pay for certain treatments.

Clinton has a long history of working for health care reform, and said , "I've got the scars to show for it." She led an effort on behalf of her husband, President Clinton, to reform health care. She was beaten badly, and many observers blame that defeat for the Democrats' landslide loss in 1994.

The newly re elected New York senator said her prior effort laid the groundwork for the present debate. Nevertheless, she suggested the coming debate will again be a battle with the insurance industry.

"We need to change the way we finance health care by taking money away from those who are doing well," she said. "So this is going to be a big political battle."

Judging by audience reaction, Clinton was the favorite. Most of the crowd were women, many in the health care industry.

Clinton suggested that the objective will be to secure close to 60 votes in the U.S. Senate, a number needed to overcome attempts to kill legislation through a Republican filibuster.

Underscoring the depth of GOP opposition, Nevada Republican Party Chairman Paul Willis issued the following statement: "Today the Democrat presidential candidates descended upon Nevada to unveil their various positions on health care. Unfortunately, their artfully crafted political rhetoric lacked realistic and feasible proposals for improving our nation's system.

"From Barack Obama's continued failure to highlight specifics to Hillary Clinton's politically motivated plans, it's clear that putting Democrats at the helm of our nation's health care system is not a safe bet - and our health is just too important to take a gamble."

A fourth Democratic candidate at the forum, New Mexico Gov. Bill Richardson, is running a campaign that has a spontaneous feel to match the quick wit and gregarious personality of the former U.N. ambassador.

Richardson said he would expand some government programs, offer tax credits to help people buy coverage and mandate that everyone have some insurance plan.

Richardson also proposed capping credit card interest rates to protect people forced to borrow to pay their health costs, an idea almost certainly unpopular with capital markets. He said he would get the plan passed in his first year.

He pointed to his experience in New Mexico, where he signed a statewide indoor smoking ban and got junk food out of schools.

As a second-tier candidate - and the only one from the West - Richardson needs to do well in the Nevada contest to have a chance at the nomination. After the event, Richardson headed to a block party in downtown Las Vegas.

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