Dick Gephardt: first with health care plan
The Democrats who want to challenge George W Bush for the White House in the 2004 presidential election are racing to produce plans for health care reform which they hope will prove their fitness for office.
Over 40 million Americans lack any health insurance and many only have access to health care through hospital emergency rooms.
The Democrats are hoping that this issue - which was last raised by President Clinton in 1994 - could provide them the key to the White House.
The United States has fallen 50 years behind the social standards of what we consider the civilised world
Howard Dean, former Vermont governor
Two weeks ago, one of the leading democratic hopefuls, former House Minority leader Richard Gephardt, proposed a $210bn plan to ensure health insurance for all.
Now the other Democrats in the presidential race are scrambling to produce rival health care plans
Former Vermont governor Howard Dean made his proposal public on Tuesday, while Senator John Kerry is expected to announce his plan on Thursday.
But the approach contains considerable risks: Republicans captured control of the House of Representatives in 1994 by attacking Democratic health care plans, and the cost of the proposals could revive charges that Democrats are big spenders who want to raise taxes.
President George W Bush, who has also proposed health care reform, has been pushing for a big tax cut to boost the economy.
Congressman Gephardt wants to fund his health care package by repealing all these tax cuts.
DEMOCRATIC PRESIDENTIAL CANDIDATES
Reverend Al Sharpton
Mr Gephardt said it was a "moral imperative" to help those without health care.
Under his proposal, the government would subsidise private companies to expand health care coverage for all those in work.
Howard Dean, who said that Mr Gephardt's plan was "pie in the sky" because of its expense, proposed a different approach.
He wants to expand the government-funded Child Health Insurance Programme to include families, young adults under 25 and low-income older people.
And he would provide a federal tax credit to ensure that individuals pay no more than 7.5% of their income to buy individual health insurance.
The cost, at $88bn, would be considerably less than Mr Gephardt's plan.
Mr Gephardt attacked his proposal as not comprehensive, and said "we can no longer afford incremental steps or policies that nibble around the edges".
On Thursday, Senator John Kerry is expected to propose his own $80bn health care plan which unlike the others, will include an element of cost control, including measures to encourage the use of generic drugs.
"It's paid for by cancelling only the Bush tax cuts for the wealthy, while keeping tax cuts for the middle class," Mr Kerry was expected to tell an audience in Des Moines, Iowa.
And Senator Joe Lieberman is expected to lay out his vision of health care reform on 21 May.
None of the plans so far would provide prescription drug benefits, which President Bush has proposed at a cost of $400bn over ten years.
However, Mr Bush's plan, which also includes a radical reform of Medicare, the government health insurance plan for the elderly, is in some trouble in Congress.
The only candidate talking about a government-run health care system is Dennis Kucinich, the former Cleveland mayor who has been running on an anti-war platform.
Mr Bush is also pushing for the reform of medical malpractice suits, something doctors say is driving many specialities to leave the profession.
Health care is an issue that appeals even more strongly to the Democratic base of voters than to the electorate as a whole.
KEY DEMOCRATIC PRIMARIES 2004
19 Jan: Iowa caucuses
27 Jan: New Hampshire
3 Feb: South Carolina
3 Feb: Arizona
7 Feb: Michigan
10 Feb: Virginia
2 March: California
This will make it particularly important in the coming year when all the Democrat rivals face an intense series of primaries in a short time, accelerating the pace of previous campaigns.
A number of big states, hoping to seek more influence in the electoral process, have moved up the date of their own primary election much earlier this time around.
With fewer than 40% of the electorate even recognising the names of any of the Democratic candidates, health care might be the one issue that will allow them to make their mark on the public's consciousness.