Health Insurance reform for '08

More Americans without health insurance coverage and higher costs have thrust the health care issue into the 2008 U.S. presidential campaign but candidates this time are far less ambitious with their plans than in the past.

The problems confronting the U.S. health care system have only worsened since the early 1990s, when President Bill Clinton and the Democratic-controlled Congress failed to pass a sweeping overhaul.

People who have health insurance have seen double-digit increases each year for much of the past decade. The average annual premium for an employer sponsored health plan for a family of four has risen to nearly $11,500, according to the National Coalition on Health Care. The number of people without health insurance has grown to nearly 45 million

People without health insurance spend roughly $125 billion on health care annually, with about a third of that amount -- $40 billion -- going unpaid, a debt largely covered by the government, according to a 2004 Kaiser Family Foundation study.