Health care:Are you covered?

For nearly two years after completing graduate school at Kent State University, Lindsay McVey searched for employment that offered a good health insurance plan.

"The issue of health insurance was a big one for me," McVey said. "I'd already had two surgeries for a degenerative disc in my back. I tried not to worry about it, but I knew that I needed good health insurance."

She found the security she was seeking in a group insurance plan with her employer, Washington State Community College.

Health insurance is an all-pervasive issue that touches every family, every person, young and old, in America.

In the final sprint to the November election, two issues - the economy and health care - have thundered to the forefront. On the street corner, in the office and around the kitchen table, over coffee, and with friends and family, Americans are talking about health insurance.

"My husband had not had health insurance for 10 years, and now he is on mine," McVey said. "Anything could have happened, but the only medical emergency he ever had was dental."

Now her brother, who is too old to be on her parents' health plan, is in the same boat, she said.

"When I was uninsured, I tried not to worry. I had friends studying medicine who told me that exercise would boost my immune system and help," McVey said. "Exercise even helped when I did get sick."

Her best advice to those who are without insurance is that when minor illness, like a cold, strikes, don't panic.

"Don't run to the ER (emergency room)," she said. "It's way more expensive. If you have to see a doctor (and don't have a primary care physician), go to Quick Care or MedExpress. They will work with you on payments."

The U.S. Census Bureau this month released a report on county-level characteristics of residents with and without health insurance coverage. The 2005 estimates cover all states and counties and include people of varying income levels and ages under 65.

Washington County numbers show that 44,386 people, in fact, have some form of health insurance, and 6,567 do not have health insurance, according to the Census Bureau's Small Area Health Insurance Estimates (SAHIE).

Today an average family health insurance plan may cost $1,200. In 1988, the cost of the same plan was less than $200, said Rick Walters, an insurance professional for more than 20 years and vice president of Dietz, Futrell & Walters Insurance Inc., with offices in Beverly and Marietta.

"There has been a huge difference over 20 years," he said. "The driving factor is the cost of medical care."

People need to take more responsibility for their own medical care, Walters said. The first requirement is to have health insurance and the second is to always seek a second opinion if there is a serious medical issue.

"Thirty-seven percent of second opinions result in a change," Walters said. "It should not be taken as an insult of the original opinion."

This expert has studied both health insurance proposals of presidential candidates John McCain and Barack Obama and isn't convinced either one is what America needs now.

"Neither plan will work," he said.

Part of the reason insurance costs are high is because pricey services and procedures are being provided today that never were intended to be part of the health system, according to Walters.

"Medications are (an) area where people may spend thousands of dollars a month and they were not ever part of the insurance years ago," he said.

Many factors drive medical costs and insurance premiums higher. Employers are feeling the pinch every year.

"It's hard for small business," he said. "I spoke with one employer this morning who is seeing his premiums for eight employees rising 29 percent next year. He's not thrilled."

This business owner is looking at his group plan going from $5,600 to $7,400 a year.

To make up for the hike, his options are restructuring benefits, going to a higher deductible, higher co-pays or dropping employee insurance altogether.

There are options for uninsured people, and health insurance plans are customized for individuals.

"We can't go back to the old barter system or of giving the doctor a basket of produce for his services," Walters said. "You cannot have a society without health insurance."

Mark Schwendeman, partner in the Schwendeman Agency Inc. in Marietta, Parkersburg, and St. Clairsville, believes when the issue is health insurance, it is important to get to the root of the problem before it can be solved.

"We are a pretty unhealthy society," he said.

The ultimate solution is to become more healthy, he said.

"To me, it's common sense. We have to become healthier," Schwendeman said. "It's like taking care of your car. You have to do the right things, proper maintenance, to keep it going."

First things first in health care, he said.

"You ought to be going to a primary care physician first," he said. "People are self-referring to specialists and over 40 percent of the time, they go to the wrong one."

He said that most preferred provider option (PPO) plans do not require an insured person to see his or her primary physician first.

When Schwendeman began selling health insurance 30 years ago, the world of insurance was a very different place.

"I've seen a lot of change," he said. "For example, a single plan sold for $40 and a family plan for $120. Costs have continued to rise for a variety of reasons."

One of the major reasons is an aging society, he said.

Another factor is the proliferation of medical technology, advances on every front, along with a wide range of new medications.

"Litigation is a huge issue for doctors and it is another factor," he said.

But prevention is at the core of the problem, Schwendeman said.

"Sixty percent of all medical diseases are preventable and are lifestyle-related," he said. "We've all heard of the $700 billion (bank) bail-out recently, but each year, $700 billion is spent in this country on avoidable and unnecessary medical services."