US President George W Bush charged that Democratic rival Mr John Kerry fails to recognize reality on key domestic issues from jobs and education to health care and Social Security.
In a broadside against the Massachusetts senator delivered as the neck-and-neck White House race enters the home stretch, Mr Bush used campaign stops in Iowa and Wisconsin to lambaste the Democrat as a tax-and-spend liberal out of touch with the modern world.
"The next president must recognize the need for reforms and must be able to lead to achieve them," Mr Bush told supporters in Cedar Rapids, Iowa.
"On issue after issue from jobs to health care to the need to strengthen Social Security, Senator Kerry's policies fail to recognize the changing realities of today's world and the need for fundamental reforms."
The president's remarks echoed a charge that Mr Kerry has repeatedly leveled at the Republican incumbent on Iraq and the war on terrorism - that Mr Bush's policies appear to ignore fact.
A suggestion by Mr Bush that Mr Kerry did not understand the link between education and jobs during the last TV debate of the campaign last Wednesday seemed calculated to deflect Democratic criticism about the loss of 1.63 million private sector jobs since Mr Bush took office.
"The senator didn't seem to get it. He said I switched away from jobs and started talking about education. No. Good jobs start with good education," Mr Bush said.
Mr Phil Singer, spokesman for Mr Kerry, retorted that Mr Bush should focus on fixing his own mistakes "[then] he might be able to create some jobs. But unfortunately, he's chosen politics over governing".
With 18 days to go before the election, both men charged through the Midwest in hopes of developing a definitive lead in a region that could determine the outcome of the race.
Polls continue to show the campaign in a dead heat after three televised presidential debates though a key poll, the Reuters/Zogby tracking poll, shows Mr Bush with a narrow lead.