DECATUR - Democrat Tim Bagwell of Olney is fighting an uphill battle in his campaign against U.S. Rep. John Shimkus, R-Collinsville, for the 19th Congressional District seat in the Nov. 2 general election.

Little-known and underfunded, Bagwell claims he has stumped the district seeking votes. But Shimkus said he has not noticed Bagwell at major events such as parades and festivals where candidates normally converge to be seen by large crowds.

The two agree on some issues facing the district, though not necessarily in the same order of priority. Job creation, medical liability insurance and health care financing are among the issues being debated.

"Medical liability is by far the biggest crisis facing the 19th District and the state of Illinois," Shimkus said. "If we lose one more OB/GYN physician, we're hurting. In the Metro East area of St. Louis, 160 physicians have left in the last several years. There is no neurosurgeon south of Springfield."

Shimkus said he has cast numerous votes to cap pain and suffering damages in medical malpractice lawsuits, though he does not favor capping economic damages.

The issue should be handled by the states, but the Illinois legislature says the state Supreme Court has ruled caps violate the state constitution, so the federal government must act, Shimkus said. While the House has passed caps, their fate in the Senate is uncertain because of a filibuster, he said.

Bagwell does not view dealing with malpractice caps as a leading issue. He said he does not favor caps on pain and suffering awards but rather would like to see administrative procedures put in place to curtail filing of frivolous lawsuits and penalties for lawyers who do so.

"Downstate Illinois is always short of physicians," Bagwell said. "Hospitals in this area act as triage centers to prepare patients for shipment to larger hospitals in St. Louis or Springfield."

Improving the economy and creating jobs are at the top of Bagwell's priority list.

Bagwell proposes creating jobs by obtaining more federal funding for highway construction on projects such as widening U.S. 50 to four lanes from Lebanon to Lawrenceville and U.S. 51 from Pana south to connect with Interstate 64.

Broadband infrastructure in Southern Illinois would be helpful as well, Bagwell said, noting Bombay, India, and Shanghai, China, have such technology and used it to bolster job growth.

"If we had that infrastructure in Southern Illinois, we could offer lower wages to companies in our rural area, but they would be higher wages relative to those that are being paid now," Bagwell said.

Shimkus said the national economy is improving, but the Midwest lags behind, and Illinois has its own problems with lack of industrial growth.

"Our worker compensation laws are not comparable to surrounding states with higher premiums," Shimkus said. "Illinois also is a litigious state. There also is uncertainty for businesses on fees and regulations. I hope as the national economy improves, it drags us in a positive direction."

Debate rages on the benefit of international trade agreements, Shimkus said. In the next round of trade negotiations, the United States will address the concerns of opponents of the agreements, he said.

"A lot of trade agreements we passed are not creating an outcry," Shimkus said. "We got major benefits from agreements with Morocco, Australia and Thailand. As other countries become more developed, they will buy more of our goods."

Bagwell said a consensus must be developed on dealing with health care, then a decision can be reached on how to fund the program.

"Every advanced industrial country has universal health care except the United States," Bagwell said. "We might have an economic boom in health care. Those jobs don't go overseas."

Shimkus said while Republicans have pushed association health plans, which allow small businesses to band together to buy health insurance coverage, he believes a better plan is health savings accounts.

Such accounts are part of the Medicare prescription drug bill Congress passed and the president signed into law, Shimkus said.

"I hope they work," he said. "They allow individuals to save $5,500 in tax-free dollars to pay for doctor's visits. The money can be rolled over to the next year and earns interest, too."

That plan starts bringing competition back to health care, which should lower costs, Shimkus said.

Ron Ingram can be reached at ringram@;herald-review.com or 421-7973.