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Politicians of all stripes have repeatedly pledged to reduce the number of Americans lacking health insurance, but since 2000, the number of uninsured people under age 65 has increased from 39.6 million to 45 million. In his 2000 presidential campaign, George W. Bush told The Associated Press, “I believe every American should have access to quality, affordable health care by giving consumers better information about health care plans, providing more choices such as medical savings accounts, and changing tax laws to help more people, such as the uninsured and the self-employed, afford health insurance.” But political progress on this vexing — and expensive — issue has proven elusive, and the United States remains the only wealthy industrialized nation that does not guarantee universal health insurance coverage for its citizens.

While deep disagreement remains over how best to improve the American health care system, there is widespread consensus that the system is broken. Both 2008 presidential nominees acknowledged the problem and offered major — if very different — plans to reform the system to reduce the numbers of uninsured. According to an October 2008 poll by the Kaiser Family Foundation, 62 percent of registered voters agreed “it is more important than ever to take on health care reform.” A few states — most prominently Massachusetts and California — have taken up the issue of health care for the uninsured on their own, with varying degrees of success. But the failure of the federal government to make progress on this issue not only leaves many Americans without health care, but also costs the nation an estimated $65 billion to $130 billion each year, according to The National Academies’ Institute of Medicine.

Throughout his presidential campaign, Barack Obama promised to enact reform to make health insurance “affordable and accessible to all” Americans. But questions remain about how he will finance his plan, and now some analysts wonder whether the costs and urgency of the financial bailout will push health care reform to the backburner.

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