By Judith Graham
Tribune staff reporter
Published October 17, 2004
BETHLEHEM, Pa. -- Until this year, Ken Kopecki and his family were
solidly middle class. Now their savings are gone, the family budget is
wrecked and Kopecki struggles with financial anxiety day in and out.
The reason: soaring costs for medical care.
Last year, the Kopecki family, which has health insurance through Ken's
employer, a small security company, paid $2,300 for medical expenses.
This year, with higher bills for health insurance and drugs, they expect
to spend well over $6,000.
"The increase has essentially killed us," said Ken, 38, an electronics
technician who has a degenerative autoimmune disease ("not AIDS," he
explains).
In this swing state, the Kopeckis represent the kind of voters political
strategists are watching closely as the presidential election draws
near: middle-class families worried about the economy and pocketbook
issues--especially health care, a subject frequently discussed by
President Bush and Sen. John Kerry in the past month.
While the war in Iraq, terrorism and national security have dominated
voters' concerns for months, medical costs are surfacing as a priority.
Working families across the country are facing sticker shock as they
sign up for next year's benefits. Underscoring this issue's volatility,
voters in Iowa, Minnesota and Wisconsin named health care as their top
concern in a recent Chicago Tribune poll.
For women, who tend to be medical decision-makers in families, and
senior citizens, who are prone to illness and among the most reliable
voters, health issues have special resonance and could influence votes
in key states.
"In a close election, everything at the margins is important," said
Terry Madonna, director of Pennsylvania's Keystone Poll, which
identified health care as the No. 1 personal concern on the minds of
Pennsylvania voters.
If voters are split on the state of the economy, the war in Iraq and
America's response to terrorism, "what they think about health care
could become critical," said Robert Blendon, professor of health policy
and management at the Harvard School of Public Health.
*Basic problems*
Though Bush and Kerry stress their differences in campaign speeches,
when it comes to defining the central problems with America's $1.6
trillion health-care system, there is little argument. Where they differ
markedly is in the size and scope of their proposals: Bush's is
relatively modest, Kerry's is far-reaching and expensive.
Both acknowledge that escalating medical costs are aggravating a crisis
of affordability for families and businesses. Every statistic speaks to
the extent of increases: Medical spending is projected to outpace
inflation fourfold next year. Health insurance premiums have climbed 59
percent since 2000.
One in seven Americans under 65 now spends more than one-quarter of his
or her income on medical expenses. As many as half of personal
bankruptcies, which have sharply increased in the past several years,
are prompted by medical bills, experts say.
Linda Clark, 54, a union official from Reading, Pa., and her husband,
Brad, are among those being squeezed. Brad, 56, is severely diabetic and
may not be able to work much longer. Already, the Clarks are paying more
than $400 a month for drugs, and Linda worries that expenses could rise
dramatically if Brad develops medical complications.
In her work, when she negotiates contracts for public employees, she
said, "It's always health care or a raise. We'll do almost anything to
keep health care, so salaries are suffering."
"But the cost keeps going up. ... It's getting to the point where health
care isn't going to be affordable for the common man," added Clark,
preparing to work at a get-out-the-vote phone bank on a recent rainy
Saturday.
Meanwhile, the number of Americans without any insurance continues to
expand as fewer employers offer coverage, largely because of escalating
costs. Some 45 million people had no health insurance last year, up 1.4
million from 2002. Five million fewer jobs now provide insurance than in
2000.
On a warm, end-of-summer morning in Norristown, a Philadelphia suburb,
Mark Ng'elu, 21, was sitting in a public health clinic, wrapped in a
fleece jacket. Unemployed and uninsured, he wasn't feeling well. "I have
chest problems; it's very hard to breathe," he said. He learned a year
ago that he probably has asthma, but he hasn't been to a doctor or taken
medication since then "because it's really expensive for people like
me," said Ng'elu, who said he has about $50 in his bank account.
The National Academies' Institute of Medicine estimates that 18,000
Americans die prematurely every year because they are uninsured and fail
to get proper treatment.
While public hospitals, community clinics and physicians routinely serve
people with no insurance, this safety net of providers is fraying under
the strain of growing demand for services and restricted budgets.
It's no wonder, then, that the Bush and Kerry health plans target the
same two basic objectives: making medical