The big question of the campaign yesterday: Was Barack Obama referring to Sarah Palin or the policies of John McCain when he wisecracked about painting lipstick on a pig? Important stuff, right? Speculating on Palin vs. policies makes great copy, and the press could continue doing so until the cows—excuse me, pigs—come home, but there are graver matters to report on. Health care is one of them.

Let’s recall that Elizabeth Edwards used the expression last spring when she spoke to journalists about McCain’s health care proposals. Edwards referred to some of McCain’s lofty-sounding words that pretty up some of his ideas about health reform that could actually hurt ordinary people who didn’t understand what’s going on. The language of his plan sounds good, she said, making it “hard to understand what’s wrong with it.”

Edwards went on to explain what she thought was wrong with McCain’s health proposals. She pointed out that allowing insurers to sell across state lines lets them avoid state regulations and leaves consumers without protections. Edwards also pressed the point about insurers denying coverage to people like her and John McCain who have had cancer. “Coverage for pre-existing conditions is enormously important to people,” she said.

We took Edwards’ points a step further and zeroed in on the word “bias,” a term McCain has used to describe the current employer-based health system. While frequent use of “bias” gussies up McCain’s plan for changing the tax code, such a move could ultimately result in the demise of employer-sponsored health insurance. About 60 percent of the people who have health insurance get it from their employers—so if their bosses suddenly drop coverage, hundreds of thousands may go without.

Last weekend the Financial Times ran a wrap-up story about the Republican convention that explains what’s really going on here. The last graph was the most telling:

Senior Republicans admit they are playing from a weak hand: “We are only going to win this election either by changing the subject or else persuading people that Obama is an old-fashioned tax and spend liberal,” said the former policy adviser to one of the leading Republican opponents of Mr. McCain.

Lipstick on pigs changed the subject, at least for a day. The real question is: Will the media continue to let the politicos change the subject when the need to divert the campaign discourse from more substantive issues surfaces again?

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Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.