EVERY day, about 200,000 Americans are sickened by contaminated food. Every year, about 325,000 are hospitalized by a food-borne illness. And the number who are killed annually by something they ate is roughly the same as the number of Americans who’ve been killed in Iraq and Afghanistan since 2003.

Those estimates, from the Centers for Disease Control and Prevention, suggest the scale of the problem. But they fail to convey the human toll. The elderly and people with compromised immune systems face an elevated risk from food-borne pathogens like listeria, campylobacter and salmonella. By far the most vulnerable group, however, are children under the age of 4. Our food will never be perfectly safe — and yet if the Senate fails to pass the food safety legislation now awaiting a vote, tens of thousands of American children will become needlessly and sometimes fatally ill.

Almost one year ago, the House of Representatives passed the Food Safety Enhancement Act with bipartisan support. A similar bill, the F.D.A. Food Safety Modernization Act, was unanimously approved by the Senate Health, Education, Labor and Pensions Committee in November. This legislation would grant the Food and Drug Administration, which has oversight over 80 percent of the nation’s food, the authority to test widely for dangerous pathogens and improve the agency’s ability to trace outbreaks back to their source. Most important, it would finally give the agency the power to order the recall of contaminated foods — and to punish companies that knowingly sell them.

This bill is supported by an unusual set of advocacy groups: the American Public Health Association, Consumers Union, the Center for Science in the Public Interest, the United States Chamber of Commerce and the Grocery Manufacturers Association, among others. Last week, a poll for Consumers Union found that 80 percent of Americans want Congress to empower the F.D.A. to recall tainted foods.

You’d think that a bill with such broad support, on a public health issue of such fundamental importance, would easily reach the floor of the Senate for a vote. But it has been languishing, stuck in some legislative limbo. If it fails to gain passage by the end of this session, Congress will have to start from scratch again next year.

Food processors reluctant to oppose the bill openly will be delighted if it dies a quiet death. That’s because, right now, very few cases of food poisoning are ever actually linked to what the person ate, and companies that sell contaminated products routinely avoid liability. The economic cost is instead imposed on society. And it’s a huge cost. According to a recent study sponsored by the Pew Charitable Trusts, the annual health-related cost of food-borne illness in the United States is about $152 billion.

Without tough food safety rules, a perverse economic incentive guides the marketplace. Adulterated food is cheaper to produce than safe food. Since consumers cannot tell the difference between the two, companies that try to do the right thing are forced to compete with companies that couldn’t care less.

So the law of the jungle prevails, as Upton Sinclair noted more than a century ago. In those days, many companies had no qualms about selling children’s candy colored with lethal heavy metals and rancid food laced with toxic chemicals to disguise the stench; such abuses were widespread. And some of the strongest support for President Theodore Roosevelt’s food safety crusade came from processors (like the H. J. Heinz Company) that were outraged by the unfair advantage their competitors gained by selling cheap, dangerous, adulterated food.

The Pure Food and Drug Act of 1906 helped to eliminate many unsafe practices. But the recent centralization and industrialization of the American food system poses new kinds of threats.

Today, a problem at a single factory can swiftly lead to an outbreak that extends nationwide. Last year’s peanut butter recall illustrates what can go wrong. Executives at the Peanut Corporation of America knew that peanut butter from their filthy, rodent-infested plant was testing positive for salmonella — but shipped it anyway, for months.

Thousands of different products, manufactured by more than 200 companies, including candies and cookies marketed to children, were potentially tainted thanks to that one plant. And in the end, roughly 20,000 Americans got salmonella; about half of them were under the age of 16 and one-fifth were younger than 5.

The enormous rise in imported food also exposes American consumers to food safety lapses overseas. In recent years, China has been responsible for food scandals that bring to mind the United States in the days of Upton Sinclair: Chinese companies have been caught adding lead-based whiteners to pasta and selling beverages made with industrial alcohol. Two years ago, almost 300,000 Chinese infants were sickened by baby formula that had been adulterated with melamine, a cheap but toxic chemical. The overuse of antibiotics and pesticides in Chinese agriculture is rampant.

Despite those food safety problems, China has become the largest exporter of food to the United States after Canada and Mexico. About 60 percent of the apple juice in America — like peanut butter, a product consumed largely by children — now comes from China. This is yet another reason that passage of the F.D.A. modernization act is so urgent; it would, for the first time, subject foods from overseas to the same standards as those produced in the United States.

Last year, President Obama called for measures that would “upgrade our food safety laws for the 21st century,” and this bill is a good first step. The president has asked lawmakers to pass the legislation, saying that it would provide “the federal government with the appropriate tools to accomplish its core food safety goals.”

For months, however, the Internet has been rife with wild rumors and accusations: that the bill is really a subterfuge cleverly designed to eliminate small farms and strengthen the grip of industrial agriculture; that it would outlaw organic production; that it would hand over the nation’s food supply to Monsanto.

Those arguments may be sincere. But the bill very clearly instructs the Food and Drug Administration to focus its enforcement efforts on plants that pose the greatest risk of causing large-scale outbreaks. And the bill’s wording can still be clarified so that mom-and-pop producers aren’t threatened by heavy-handed government regulations.

What the legislation actually seeks is some restraint on unchecked corporate power. We’ve seen what happens when Wall Street is allowed to regulate itself and when the oil industry is allowed to regulate itself. How could it possibly make sense to let the food industry continue to write its own rules?

I’ve come to know families that were devastated by a food-borne illness. A great deal of harm, inflicted on some of the weakest members of society, can be avoided with a few simple reforms. Nobody should lose a child because the Senate lacks the will and the leadership to act.