THURSDAY, Oct. 2 (HealthDay News) -- Both presidential candidates want to make health insurance available to more Americans, but each has proposed a vastly different route to reform, a new report shows.

Health-care reform is high on the national agenda, with 116 million adults either uninsured, underinsured, experiencing a problem with medical bills, or denying themselves needed care due to cost considerations.

"As we face a crisis in the financial system, we must remember we are also facing a crisis in the health system," Karen Davis, president of The Commonwealth Fund, said during a Wednesday teleconference announcing the results of a new report entitled, The Presidential Candidates' Health Reform Proposals: Choices for America.

The Commonwealth Fund is a private, independent foundation that supports research into health-care issues.

"Rising health-care costs and the decreasing quality of health-care coverage are contributing to the economic insecurity of American families," Davis continued.

Currently, some 82 percent of Americans think the health-care system either has to be rebuilt completely or needs to undergo a massive overhaul.

"As we examine the health-care proposals of the presidential candidates, we need to pay particular attention to whether these plans will ensure affordable coverage to all Americans," Davis said.

Sen. John McCain (R-Ariz.) would use tax credits to encourage consumers to buy coverage in the individual insurance market, including removing barriers to purchasing insurance in other states. This might eventually lead to erosions in consumer protections, said Sara Collins, an assistant vice president for The Commonwealth Fund's Program on the Future of Health Insurance.

Sen. Barack Obama (D-Ill.), on the other hand, would require all employers except those running small businesses to either provide coverage or contribute to the cost. His plan would also expand eligibility for Medicaid/SCHIP (State Children's Health Insurance Program).

Obama has stated that universal coverage is an eventual goal. McCain has not made this statement, instead preferring to focus on expanded access to insurance.

McCain's plan would reduce the number of uninsured Americans by 1.3 million over the coming decade at a total cost of $1.3 billion. Obama's plan would reduce the ranks of the uninsured by 34 million at a cost of $1.63 billion. During the first year of implementation, McCain's proposed plan would dent the federal budget to the tune of $185 billion, while Obama's plan would require $86 billion.

The report concluded that "Senator Obama's plan shows greater potential for making care more affordable, accessible, efficient and higher quality, though it will likely fall short of covering everyone."

McCain's plan is likely to increase insurance administration costs, the report stated, and would not likely lead to universal coverage.

"In 2009, we need a president and Congress who will work together and take action needed to transform the health system," Davis said. "We must realize that investing in the health-care system will pay dividends in terms of a healthy workforce and economic stability."

More information

Get more on the report from The Commonwealth Fund.