Last week, Starbucks Corp. announced that it planned to close 600 coffee shops that aren't performing up to expectations and lay off 12,000 full- and part-time employees. The lost Starbucks jobs differ from those provided by most retailers: They came with health-care benefits for full-and part-time workers. Starbucks, whose founder grew up in a family that couldn't afford coverage, pays more for health insurance than for coffee.

The sinking economy and high energy prices have pushed health care down to fourth on the list of voter concerns. But the economy and health care can't be separated. Starbucks, like the nation's auto makers, has a harder time competing in the marketplace because it is hobbled by health insurance costs.

The day after the Starbucks announcement, former Monitor reporter Lisa Wangsness, writing in The Boston Globe, revealed that while he was still in the hospital recuperating from brain cancer surgery, Massachusetts Sen. Ted Kennedy began organizing colleagues in Congress to make universal health care a reality early in the first term of the next presidency. For that to happen, of course, Sen. Barack Obama, whom Kennedy endorsed in the primary, would have to defeat Sen. John McCain, whose plan relies on competition to control health care costs.

For decades, health care reform efforts have been stymied by massive, well-financed campaigns by insurers, pharmaceutical companies, physicians' groups and other industry stakeholders. Any new effort will face the same array of forces. Kennedy plans to move reform through Congress quickly to minimize the amount of time opponents have to attack. There's no person in Congress better-equipped to lead that effort than Kennedy, who is second in seniority in the Senate behind 90-year-old fellow Democrat Robert Byrd of West Virginia.

To minimize conflicts between rival plans, Kennedy has senior staff members from all major players working together to find common ground. It's too soon to say what kind of reform plan could result from the collaboration. Kennedy had a big hand in creating the Massachusetts plan, which includes the mandatory purchase of health insurance at rates set by regulators. It's also too soon to say how well that plan will work. So far, it has put several hundred thousand uninsured Massachusetts residents on the rolls but cost the state much more than expected. It has not resulted in universal coverage.

Kennedy has worked on the health care issue for decades, and in the past, he has called for expanding the federal Medicare system to cover all Americans. Presumably, that is among the choices those that will be on the table.

The nation's so-called health care system continues to slip out of the reach of more and more people. Health care expenses are putting American employers at a disadvantage in the global marketplace. They have become the leading cause of personal bankruptcy and the need for insurance is affecting the ability of people to move between jobs.

Last year, the nation's biggest union began working with corporations like Safeway and Wal-Mart to lobby for a national system of universal health care. Last month, the U.S. Conference of Mayors voted to endorse a House bill that would assure everyone coverage under a single payer system that preserves choice and the doctor-patient relationship. Those cities are being hit with average annual increases in health insurance costs of 11 percent

November's election could open a path leading out of the health care morass. Kennedy's efforts could guarantee that Congress is ready to take that path at the first opportunity.