Health Care Among Top Issues For Voters

How big might the change be? Well, you might be taxed on what your employer pays for your health insurance coverage, for instance. (Right now, you're probably not, if you work for a big company.) Or you might be guaranteed health insurance, with the government picking up the tab.

Indiana and North Carolina Democrats are to take their stabs Tuesday at deciding whether Hillary Clinton or Barack Obama will take on Republican John McCain in November. And health care is among the top issues for voters, not only in those states and Michigan -- where automakers have cited costs as a major obstacle to long-term profitability -- but everywhere.

As health care costs have outpaced inflation in recent years, businesses have had to pay more -- and have asked their employees to contribute more. So dramatic changes in the status quo could potentially free up cash for investment, spending and job creation.

Or, as some critics warn, a sweeping move toward federalized health care could have the opposite effect if it's ultimately subsized by higher taxes.
Big problem everywhere

A national Gallup poll conducted April 25-27 found that 28% of 1,008 American adults polled said rising health care costs constitute a crisis. The poll had a margin of error of plus or minus 3 percentage points.

Only the declining value of the dollar and rising gas prices beat it out as a national economic concern.

"We're probably going to be headed in a better direction on health care, by necessity," said Comerica Bank's chief economist, Dana Johnson. "We're not serving enough people well."

Jeanette Avila, 39, of Bloomfield Hills agrees. She not only writes a check for $1,300 each month to cover insurance for her and her diabetic mom, but also worries about health coverage for her 10 full-time employees at the family-owned El Rancho Restaurant in southwest Detroit.

A Wayne County program picks up about a third of the cost, with the business and the employees splitting the difference. But a more affordable program -- possibly government-sponsored -- would help.

"The problem is greater here in Michigan, especially with all the people who took buyouts," Avila said. "They need more affordable health care. And maybe they could give us some tax credits or insurance incentives."
Cost of having, needing insurance

Sixteen percent of the U.S. economy was spent on health care in 2005 -- about $6,500 a person -- with spending significantly outpacing the rest of the economy, with an average annual growth rate of nearly 10%, according to a report last summer by the Kaiser Family Foundation, a health policy-oriented nonprofit.

Meanwhile, insurance premiums grew 87% from 2000 and 2006, or more than four times the growth in wages.

In all, the nation has about 47 million people who are believed to be uninsured. In Michigan, the number is estimated at 750,000 to 1 million.

People without insurance add to health care costs, experts said, because they don't receive preventive care -- and it can be a lot more expensive to treat people who are significantly ill.

Instead of receiving preventive care or early warnings for treatment from their doctors, uninsured people tend to head to emergency rooms -- which are much more expensive to run -- for health care, and then only when their conditions become serious.

Those costs are passed on to others.
What Clinton, Obama promise

Len Nichols of the Washington-based New America Foundation, a public policy institute, said at a panel discussion on health care in Washington last week: "If we could just agree to cover everyone, we could talk about how."

On the Democratic side, there seems to be general agreement among analysts, researchers and experts that the plans from Obama and Clinton differ little. They diverge, however, on who must be covered.

Clinton said coverage must be mandatory. Obama wants required coverage for children only, under the theory that if you make health care affordable and accessible, you don't have to force it on everyone.

Both are committed to creating public systems available to everyone. Both would allow people to keep their existing coverage or access public or private plans modeled on the generous plan members of Congress get.

Activists and pundits praise the move toward something like universal health care. The question is whether a new president can get it through Congress -- and what it will cost.

"They make promises that simply can't be kept," Joe Antos, with the American Enterprise Institute, said last week.