U.S. Sen. John McCain, R-Ariz., sees cost as the key problem with healthcare, while Sens. Hillary Clinton, D-N.Y., and Barack Obama, D-Ill., see a lack of broad-based coverage as plaguing the system.

The Kaiser Family Foundation, a non-profit examining the healthcare industry, said insurance premiums jumped 78 percent since 2002 as the number of employers offering insurance coverage shrank.

Tommy Thompson, who served as U.S. Health and Human Services secretary during the first Bush term, told USA Today those concerns makes this "the first presidential election that will have a good share of the campaign fought around healthcare."

Apart from cost and coverage, Democrats oppose McCain by advocating near-mandatory health insurance, the newspaper said.

McCain's plan could leave millions of people without health insurance, while the Democratic plan could wind up costing more than intended, the newspaper concluded.

The different plans amount to who gets insured and who pays for it but, at the end of the day, not everyone will get covered, the report noted.

Presidential administrations since Harry Truman in the 1940s tried to overhaul the healthcare system, but ultimately, analysts say, tougher reform is needed to curb healthcare spending, which accounted for $2.1 trillion in 2006, USA Today said.