The increasing number of people without insurance -- an estimated 47 million in 2008 -- and growing health care costs are fostering more interest in and movement toward overhaul of the health care system. At the national level and state levels, dozens of proposals are on the table, offered by candidates, businesses, consumer advocates and many others. The proposals range from national health insurance modeled on Medicare to private market options based on tax breaks. Many policy analysts expect substantial movement on the issue in 2009. At the state level, Massachusetts is leading the way, along with less-advanced initiatives in Pennsylvania, Hawaii, Vermont and Maine.