Bill Clinton said he would do something about it, but he and his wife Hillary were beaten back in the first year of his first term when they tried. John Kerry made it a major platform issue in his recent ill-fated campaign and with his defeat any real hope for national reform might have evaporated.

The issue is health insurance - the soaring costs and the increasing unavailability for millions of Americans. In a political era defined notably by phantom issues like "homeland security" and polarizing debates over "moral issues," the political evasion over finding a way to deliver affordable health care to poor and working class citizens continues to be a true American scandal.

The need for health benefits has been a divisive part of recent labor negotiations. Boston's police and fire unions, telephone workers and other labor organizations have made employer-supported health insurance a priority. For their part, the ever-rising cost of insurance strikes fear in most corporations, and the firms are forever trying to limit the employer's share of providing health insurance.

A recent New York Times report revealed that WalMart, this country's leading retailer, keeps its costs low and its profits high in large part by holding back on health benefits for its "associates." It is a typical big business strategy: convert from full time to part time staff, outsource many jobs, and don't worry about how employees get their health care.

In this divided country, health insurance is far more than a red state/blue state issue; it is an employer/employee divide, and one that worsens with each passing year. So it is encouraging this week to learn that Democrats in Massachusetts have signalled their intention to put health insurance on the priority list. State Senate president Robert Travaglini said Tuesday he plans to support several new meaasures intended to reduce the numbers of residents who are uninsured.

The State House News Service reports Travaglini said most Bay State residents have access to the best health care in the world; the Senate president's own life was saved twice when he faced bypass surgery and cancer - but he cautioned that 460,000 uninsured residents are "paying too much for their care."

"This is both an economic and moral failing," Travaglini said. "The cost in dollar terms to take care of the uninsured is high and unnecessarily wasteful."

His comments came just hours after the release of a new report on the cost of treating the state's uninsured residents. Hospitals, community health centers and physicians provided $1.1 billion worth of medical care to uninsured patients between July 1, 2003 and June 30, 2004, and it would cost somewhere between $374 million and $539 million to insure those patients, according to the report.

Authored by the Urban Institute for the Blue Cross Blue Shield of Massachusetts Foundation, the report is being billed as the first analysis of its kind and is intended to help Beacon Hill policy makers draft a "practical roadmap" to insure the uninsured. The latest official state estimate of the uninsured puts that population at 450,000, while the US Census Bureau in 2003 reported there may be 650,000 uninsured Massachusetts residents.

In addition to quantifying the cost of insuring the uninsured, the report says the new costs of expanding insurance would be dwarfed by between $1.2 billion and $1.7 billion worth of "economic and social benefits from improved health" that would be anticipated with more people having health insurance. On Monday, Travaglini told reporters that the uninsured and the issue of "free care" are among his top priorities. The cost of care delivered to the uninsured is borne by a combination of taxpayers and payers of hospital bills and insurance premiums.

Government action on these pressing matters cannot come too soon, and we applaud the Senate president for taking the lead.

- Ed Forry