Who'll pay the tab when you're ill?

How to ensure that health care is affordable and accessible to all Americans is one of the major concerns on voters' minds this election year.

Even if you have medical insurance, like Maureen McMullen of Clayton, you can find yourself facing huge medical costs that can take years to pay off. Others put off medical treatment or make the emergency room their doctor's office.

As for employers, they are rethinking their traditional role as the link between most Americans and their health insurance.

Since 2000, the percentage of businesses that offer coverage has fallen nine percentage points to 60 percent. As new businesses start up, more are choosing not to offer coverage, according to the Kaiser Family Foundation.

Today's section outlines the candidates' proposals and their track records on health care. We're focusing on the major races in our state -- the presidential, gubernatorial and U.S. Senate primary contests.

Here's a closer look at the health issues facing North Carolina and the nation.

The insured

51 percent--Percentage of North Carolina residents who get health insurance through an employer.

Even though about half of North Carolinians have company-sponsored health insurance, they are paying more for that care than they used to. Last year, families paid an average of $12,106 for health insurance, and the cost of such benefits has nearly doubled since 2000.

At smaller companies with fewer than 200 employees, workers often pay nearly half or more of premiums. Even still, employers picked up 75 percent of the cost of coverage.

The uninsured

$1,100--Average cost of an emergency room visit in Wake County, based on pooled data from the county's three hospital systems.

About 20 percent of the uninsured say their usual source of care is the emergency room. It's the most expensive place to seek care, and it means emergency departments are clogged with visitors.

As the number of uninsured patients rises -- in 2006, there were 1.8 million North Carolinians without health insurance -- the situation is expected to get worse.

$269.3 billion

Amount U.S. consumers spent out-of-pocket on health care in 2007.

People are paying more to see a doctor or go to the hospital. As employers shift more costs onto workers, the out-of-pocket health care expenditure is expected to rise to $464.3 billion by 2017.

For many people, that means postponing care because they can't afford their share of the bill, according to a recent study by Consumer Reports.

If they do seek care they can't afford, it can drive them into bankruptcy. A study by the Harvard School of Public Health found that 50 percent of personal bankruptcies were linked to medical problems and bills.

--Kaiser Family Foundation; U.S. Census Bureau; Consumer Reports; Harvard School of Public Health

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