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TESS VIGELAND: It’s been more than a dozen years since the Clinton Administration’s healthcare reform efforts went down in flames. Apparently that scared everybody, ’cause since then the system’s problems have just gotten worse.

But now there are signs of a comeback. Businesses are feeling the competitive pinch. Because foreign-based companies don’t have to pay health benefits, workers get them from the government.

From Washington, John Dimsdale reports the political stars may be aligning for some big changes in the national healthcare system.

JOHN DIMSDALE: The non-partisan National Coalition on Health Care has been plowing some fallow fields on health reform for 10 years. President Henry Simmons sees signs the political gridlock may be breaking.

HENRY SIMMONS: We are now dealing with a massive national economic problem that’s affecting jobs, our international competitiveness, middle class economic security. We’ve never faced this range of forces at work at one time.

The forces for change got stronger this week. A coalition of business and advocacy groups came together to endorse an expansion of tax breaks and government spending on insurance for children. Reed Tuckson of UnitedHealth Group says the organization hopes to spur Congress to cut costs and insure every American.

REED TUCKSON: Sixteen of the most powerful, important diverse politically and highly principled organizations in our nation have all recognized that it is in everyone’s interest to find a solution.

But differences over the cost of insuring children prompted some unions and businesses to drop out of the coalition. Health economist Marilyn Moon thinks it’ll take a presidential campaign to sort it all out.

MARILYN MOON: These states and this business coalition is setting the stage for pushing candidates into coming up with a plan and having to take it face on rather than ignoring it.

This time, the politics of healthcare reform will look much different with Hillary Clinton playing the role of candidate instead of First Lady.

In Washington, I’m John Dimsdale for Marketplace.