A lot of South Carolinians going to the polls Tuesday will be thinking about their health. A growing number of people in the state, and the country, are feeling the pain of the nation's rising health- care bill, and they're citing it as a top concern when they vote.

Health insurance premium increases were lower than expected last year, and South Carolina's premiums rose 7.2 percent, much lower than they did nationally. But that was only because employers bought plans for their workers with higher deductibles and co-payments.

In other words: The typical South Carolinian still pays more for health care today than ever.

Some employers have abandoned health benefits altogether, leaving more people without coverage. About 500,000 South Carolinians are uninsured today, and an estimated 981,000 have been without coverage at some point in the last two years. Nationally, nearly 44 million Americans lack insurance.

The contenders for president have all seen the numbers. And they all have something to say about them. Repeated voter polls show that health care has trumped the economy and Iraq as the top issue in the coming election.

Each of the Democrats running is pushing a health-care plan that is more far-reaching than President Bush's relatively modest proposals.

The Democrats' ideas include covering many more of the uninsured through tax credits and the expansions of government entitlements, while the president's plan relies strictly on the private sector.

Democrats' plans also are more costly, and each of the leading candidates would pay for their proposals by repealing all or part of Bush's tax cuts.

A decade ago, a similar combination of rising costs and rising numbers of people without insurance made health care a major election issue.

That year, 1992, Bill Clinton beat Bush's father, in part because he had an ambitious health-care reform plan. While that plan collapsed under intense criticism two years later, the issue has become only more pressing.

Here's a rundown of where the candidates, including the incumbent, stand on health care.

PRESIDENT BUSH

The centerpiece of Bush's health-care plan would provide tax credits to help low-income Americans buy individual insurance.

Coming at a time when deficits are running high, the cost of the plan is a fraction of what Democrats are pushing: $89 billion over 10 years, according to an analysis by the Commonwealth Fund, a New York-based, nonpartisan, health-care think-tank.

It also would cover the fewest number of people: 4 million, just one-tenth of the uninsured.

Bush also is pushing a proposal to allow small employers to pool together to buy coverage. And he's been promoting a provision of the Medicare prescription drug benefit approved last year establishing health savings accounts.

With these account, enrollees buy a high-deductible insurance plan and can set aside tax-free dollars for their health-care expenditures. Bush now wants to make the premium on these plans tax-deductible, too.

What else he's proposing: The president's health-care proposals include limits on medical malpractice awards to reduce the premiums doctors pay.

WESLEY CLARK

Gen. Clark's proposal opens up the health plan that covers federal workers and members of Congress, the Federal Employees Health Benefits Program, to individuals who otherwise can't get insurance.

The plan would expand Medicaid programs to cover adults who earn up to 150 percent of the federal poverty level, or $13,470 a year. It also would provide tax subsidies to help the uninsured who make between $13,470 and $24,695 a year to pay for premiums.

Clark would require parents to cover their children until they're 22. Lower-income families could get coverage for their children through Medicaid and other federal programs. His plan also would provide tax credits to families with incomes of up to $92,000 a year (for a family of four) to buy coverage for their children.

Clark's plan would cost $772 billion over 10 years, according to the Commonwealth Fund. It would cover 32 million people now without coverage.

What else he's proposing: Clark would provide incentives to encourage providers to use technology like electronic medical records and computer-aided decision tools. He also would establish a commission to come up with recommendations aimed at saving $125 billion over 10 years.

HOWARD DEAN

The former governor of Vermont, a physician, would provide coverage to children and adults up to age 25 in families with incomes up to 300 percent of the poverty line, or up to $54,000 a year for a family of four. Dean also would open the plan to adults who make up to 185 percent of poverty, or $16,613.

Dean would allow small businesses and individuals to buy into new group coverage offered through the federal health plan, while providing tax credits for those whose premiums in that plan exceed 7.5 percent of their income.

The plan would subsidize premiums for people who lose their jobs. And it would restrict nonhealth tax deductions and government contracts for large businesses that don't provide insurance.

Meantime, the plan would use the income-tax system to determine whether people don't have insurance, then automatically enroll them in a plan for which they are eligible. The plan would cover 31 million people and cost $932 billion over 10 years, according to Commonwealth.

What else he's proposing: Dean would create a new agency within the National Institutes of Health to provide patients with the latest health information and would work with states to find new ways to pay for care. He also proposes various efforts to lower drug costs, and another effort to use technology in medical records, billing and prescriptions.

JOHN EDWARDS

The North Carolina senator would require parents to cover their children until they turn 21, while offering tax breaks to families with incomes up to 500 percent of poverty to buy coverage for their children through their employer or the government.

People making less than $22,450 a year would get help paying for coverage when they're between jobs. Edwards also would help states create purchasing pools for small businesses, then provide tax credits to help those companies participate in those pools.

People below the poverty level would be eligible for free insurance, while people with incomes up to 250 percent of poverty could qualify for subsidized insurance through Medicaid or the federal Children's Health Insurance Program, or CHIP. And Edwards would allow people 55 to 64 to enroll in Medicare.

The least ambitious of the Democratic proposals, his plan would cover 22 million people who don't have health coverage, according to Commonwealth. It also would cost less, an estimated $590 billion over 10 years.

What else he's proposing: Edwards would push for a single medical records and billing system; he would bring doctors and patients together to develop a system for reporting and assessing health-care quality and would seek to reform medical malpractice by punishing lawyers that file frivolous lawsuits.

JOHN KERRY

The Massachusetts senator who enters this week as the Democratic frontrunner would, like other Democrats, create a new group insurance under the federal health plan. The plan would be open to companies and individuals. Small employers would receive tax credits of up to 50 percent of premium costs. Retirees age 55 to 64 could get tax credits to enroll in the plan. So would people whose premiums are higher than 6 percent of their income.

Kerry would expand CHIP to include all children in families with incomes less than 300 percent of poverty, or $55,200 for a family of four. Parents would be eligible, too, if that family of four earns less than $36,800.

Kerry's plan, according to Commonwealth, would cost $895 billion over a decade, and would provide coverage to 27 million Americans.

What else he's proposing: Kerry wants to establish a universal medical records system and wants to reimburse companies for 75 percent of claims that exceed $50,000, so long as those savings get passed on to workers. It's a plan he hopes could hold down premiums for the vast majority of the population who do have insurance.

DENNIS KUCINICH

The Ohio congressman has the simplest health plan.

It's also the most ambitious, and by far the most expensive.

Considered a long-shot candidate, Kucinich's plan would overhaul health care, replacing the current structure of employer-based coverage with a single-payer health care system.

Phased in over 10 years, Kucinich would add a Medicare "Part E" that would cover everybody, beginning with children and older adults. The program, which the Commonwealth Fund estimates will cost $6.1 trillion over a decade, would be funded with a 7.7 percent payroll tax on businesses.

Backers of a single-payer system say that it would provide health care to everybody and would actually save the health-care industry $286 billion a year in administrative costs. Though some in the industry say they believe a single-payer system is inevitable, getting such a plan through Congress would be a monumental struggle.

JOSEPH LIEBERMAN

The former vice presidential candidate would cover an estimated 32 million uninsured through a complex system of tax credits and program expansions that would cost $747 billion over 10 years, according to Commonwealth.

Lieberman would establish two new group plans, both based on the federal health plan. One, MediKids, would cover children. People under 25 would automatically be eligible. The plan would be free for children in families earning less than $27,600 a year for a family of four. It also would provide tax credits to help families with incomes between $27,600 and $55,200 pay premiums.

Those with incomes more than 300 percent of the federal poverty line would get tax credits if premiums exceed 7.5 percent of income.

The other plan, called MediChoice, would help small businesses and individuals without access to employer-based coverage. Adults without access making between 150 and 185 percent of poverty (or between $13,470 and $16,613 for an individual) would not have to pay premiums. Those between $16,613 and $22,450 could get tax credits.

The plan also expands Medicaid to cover adults making less than $13,470 a year.

What else he's proposing: Lieberman would prevent drug companies from keeping generics off the market; encourage drug re-imports from Canada; and encourage better reporting of medical errors that lead to injury.

AL SHARPTON

The Rev. Sharpton, like Kucinich, is proposing a relatively simple solution. He supports an amendment to the Constitution saying that Americans have a right to "health care of equal high quality," and that "the Congress shall have the power to implement this article by appropriate legislation."

Details of Sharpton's plans, cost estimates and how it would be funded are unavailable. But any such plan would undoubtedly cost a lot.

Jonathan Maze covers health care and nonprofits. Reach him at jmaze@postandcourier.com or 937-5719.