As a progressive Democrat, I have a very different view of health-care reform than that of conservative Republicans. The dividing point is this: Do we, as a people, care enough about providing effective, affordable health care for everyone to put citizens' needs ahead of the financial interests of the health care industry?

I have pledged in this campaign not to be negative toward my opponents, but Republican policies cannot escape examination. I do not direct my criticism at Mr. Akin, rather I express concern at the ethos and philosophy of the Republican Party.

Judge them -- and Democrats, as well -- by their actions during the health care debate. Did they offer anything constructive, or did they stand up only to oppose anything offered by their political rivals? Are their arguments and proposals those of a party that cares about individuals and families, or those of a political organization whose allegiance is to corporate interests and lobbyists? Mr. Akin may have some good points. I urge you to seek out the facts and form your opinions based on what you learn.

In the 20 months since President Barack Obama took office, Republicans have opposed any progress toward meaningful health care reform. Why? If the Republican philosophy was one of caring, or "compassionate conservatism," they would have hopped on the health-reform train. Instead, they dragged out the debate, threatened filibusters, pushed back on virtually every proposed change, added poison pills and generally worked to sabotage efforts toward health-care reform. Their "compassion" seemed to rest with corporate interests, whose motivation was not to care for people, but to nurture their own bottom lines.

Republicans loaded down health-care reform legislation with caveats, restrictions, burdens and provisions designed to create failure inside the bill. When "reform" passed, in the Republican-preferred, watered-down version, it faced ongoing criticism from those who opposed it in the first place.

But Republicans were not satisfied with merely undermining health-care reform by weakening it in Congress. They took their anti-reform agenda to the states, where they pushed constitutionally dubious measures onto statewide ballots, calling for states to opt out of congressionally mandated health-care reform. Here in Missouri, they succeeded in hoodwinking voters into passing Proposition C, a mischievous and dangerous act of nullification, cynically designed not to help people but to score political points for a right-wing agenda.

Despite Republicans' efforts to block it, the Health Care Act of 2010 passed, and it's a start in the right direction. It includes significant improvements that will immediately make health care coverage better for many Americans.

Some of the reforms go into effect this fall. Among the most helpful are these:

* A new, national high-risk insurance pool will become available for people who were previously uninsurable because of pre-existing health conditions.

* Dependent children, up to age 26, will be able to keep their coverage under their parents' policies. This is great news for college students and young adults entering the work force, whose employers do not offer health coverage.

* Insurance companies can't put a lifetime limit on the dollar value of your coverage.

* You health-care coverage can't be canceled just because you get sick.

* Insurance companies have to insure children with pre-existing conditions.

These are excellent first steps, but we have a long way to go to fulfill the goal of universal, affordable health care for all Americans. The health-care reforms passed in 2010 still operate under a structure in which for-profit insurance companies benefit from the misfortune of people who are ill or injured. Health-care coverage still is not available to everyone, and I was disappointed that the "public option" didn't make it into the final bill. In addition, with health-care insurance still tied to employment, the cost of American goods is artificially high, compared to goods produced in countries where the government funds health care.

To get the universal, affordable health care that all Americans deserve, the federal government should have the primary responsibility of guaranteeing every citizen access to health care. Medicare for All would do just that, as similar programs do in virtually every other industrialized nation.

For me, the bottom line on health care is this: Does this country truly want its citizens to be able to access the health care they need at a cost they can afford? If we do, we won't get it with a Republican Congress. We might get it from a conventional Democratic Congress. And we will get it with a progressive Democratic Congress.

To read an article on this topic by incumbent Rep. Todd Akin, R-Town & Country, click here . 

Editor's Note: Arthur Lieber has been a donor to the Beacon.