Washington  – Edward “Ted” Kennedy has grown old, his age etched on his face, his hair faded white. The brain tumour found last year keeps the storied senator from his usual forceful rounds of the nation’s capital.

But the 77-year-old – the only survivor of four famous brothers and one of the country’s most popular politicians – is fighting not just for his life, but for his political legacy.

For half of his life, the political icon of liberal, progressive America has led the battle for better and more thorough health coverage for all of the US.

An estimated 45 to 49 million Americans lack health insurance of any kind, a shortfall fraught with severe consequences that Kennedy wants to fix.

The chances are better than ever that it will happen this year.

Varying, competing proposals were formally circulated this week in the Senate and House of Representatives that would ensure all Americans access to affordable, high quality health care. President Barack Obama, backing the reform idea with the full power of the White House, travelled Thursday to Green Bay, Wisconsin, to demonstrate how that community manages to produce top quality care for some of the country’s lowest per patient cost.

The tragic question is this: Does Kennedy have the time to see it through?

“The future shape of the US health care system could hang on the uncertain health of one very prominent American,” wrote the Wall Street Journal.

The patriarch of the centre-left Democratic Party, with 47 years in the Senate, is the key player in shepherding a final draft bill over all its legislative obstacles – an art at which Kennedy excels. Since the brain tumour was removed little over a year ago, Kennedy conducts business from his house in Hyannis Port, Massachusetts.

Despite his illness, age and physical absence, no one gets around him on serious issues.

“He is gung-ho, ready to go. Had a whole range of ideas in terms of how he’d like to see this move,” Obama was quoted as saying by the Journal after talking to Kennedy on the phone. Obama was meeting with key senators on the health reform issue at the time.

How much strength Kennedy has left, how far the cancer has progressed, this is “one of the most highly sensitive issues in the Senate,” the New York Times wrote.

No one doubts that nothing short of revolution will fix the system. Medical care eats up 17 per cent of the country’s gross domestic product, yet Americans’ state of health does not reflect that.

“We have the most expensive health care system in the world, bar none. But … we’re not any healthier for it,” Obama said Thursday.

In the early 1990s, former president Bill Clinton and first lady Hillary Rodham Clinton (now Obama’s secretary of state) failed miserably in their attempt to fix the problem. Health insurance reform was a rallying cry of Obama’s election campaign last year, as he told how his own mother died of cancer even as she struggled to negotiate and pay for huge medical bills.

Kennedy’s ideas are the cornerstone of the Democratic proposals: Every American must have access to basic, quality medical care. Employers must help pay the costs. Individuals who aren’t insured face penalties. Those who lack the money would receive government help. Pre-existing conditions must be covered.

As an alternative to the expensive, exclusive private insurance plans, where costs balloon beyond the inflation rate, Kennedy proposes a government-run insurance plan – an idea that causes centre-right Republicans, ardent supporters of the free market and limitless economic freedoms, to see red.

There’s little doubt that Kennedy’s ideas are the most radical in the current debate. Several Democratic legislators have circulated compromise drafts that would set up insurance cooperatives to market better coverage, and there are calls for employers’ contributions to be taxed as income.

Obama has wisely made clear that he will not get involved in the pull-and-tug within Congress – a lesson learned from the Clintons.

Behind the scenes, the battle has already been joined. Insiders believe the varying proposals will be bundled into draft legislation in the near future.

Will it be called the “Kennedy health reform” bill?

Kennedy has already called health care reform his life work – now, it’s a question of his political legacy. (dpa)