WASHINGTON - Democratic presidential front-runner Hillary Clinton says the impact of North American free trade is mixed and Americans are losing jobs to Canadians because Canada has lower health-care costs.

Clinton used a forum of Democratic contenders for the 2008 nomination Tuesday to make a pitch for distributing the burden of health care more widely.

There are some positive effects from the North American Free Trade Agreement, said Clinton, but jobs are going south to Mexico and beyond.

"Now we are seeing it with the loss of jobs going north,'' she told the American Federation of State, County and Municipal Employees.

She said she spoke recently to a United Auto Workers member from the auto plant in Wicom, Mich., who told her it's shutting down and some of the work is going to Mexico.

"But some of the high-value work is going to Canada because of lower health care costs. So some of what has happened with NAFTA is because of NAFTA, but some of what is attributed or blamed on NAFTA has other contributing causes as well.''

Clinton, who failed during her husband's two-term presidency to push through universal health care in country where 45 million people don't have coverage, is raising new proposals for reform.

It was Bill Clinton who signed off on NAFTA.

"There's a lot we could do that we are not doing but we got to get those health care costs under control because that's one of the excuses people use for moving jobs,'' said Clinton.

"They say, `Well, we can't afford to continue to pay health care. Go to Canada, everybody pays. Go to Mexico or China, we don't have to worry about it'.''

Some observers chalked up Clinton's remarks to the heat of a presidential race, not an anti-trade rant.

"A lot of things will be said in the middle of campaigning,'' said Paul Frazer, a former top Canadian diplomat who is now a consultant.

"That won't reflect what ends up happening.''

"She is not anti-NAFTA,'' said Scotty Greenwood, executive director of the Canadian American Business Council.

"She's not at all suggesting we need to undo it.''

But her remarks highlight the fact that it's a tumultuous political period for the Canada-U.S. relationship, said Greenwood.

"All the candidates will focus on the domestic agenda in the U.S. and not necessarily take into consideration the intricacies of the bilateral dynamic.''

"I would not expect the NAFTA to attract any cheerleaders from either political party between now and November of next year.''