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If you want health insurance, try moving to Iraq

Kim Guericke is 30 years old and she radiates the kind of health you see in Caribbean vacation brochures. Her skin is flawless and her body looks like it was made to sprint around and bruise on a soccer field.

You wouldn't know from looking at her that she suffers from Lupus, a chronic and occasionally fatal inflammatory disease that targets the skin and blood, and various organs -- especially the kidneys.

Guericke's body lacks the ability to distinguish between foreign agents that cause illnesses and her body's own cells and tissues, so it produces excess antibodies to fight against itself. "Every day you wake up, and you feel like an old woman," she says of living with the disease.

Guericke is one of at least 500,000 Americans living with the illness, but she also belongs to a larger and more diverse extended family, one that keeps getting bigger and reaching deeper into the middle class. She's one of the 44 million people performing the daily high wire act of living without health insurance.

You're going to be hearing a lot more about people like Guericke in the year and a half leading up to the 2004 presidential election, as Democrats try to whack President Bush in a pretty obvious weak spot.

Stories similar to hers -- thousands spent on a single trip to an emergency room, the financial Russian roulette of living with a chronic illness and without health coverage -- won't be hard to find. Indeed, new people join her clan every day as medical costs and health insurance premiums continue to increase at a double-digit rate. Meanwhile, wages for the lower and middle classes stagnate, more people lose their jobs, and states, caught in a budget squeeze, cut back programs such as Medicaid.

The uninsured population rose by 1.4 million between 2000 and 2001, according to the most recent data available, and "if you're not insured, the likelihood that you can afford getting health care is much lower than it was years ago," says Ron Pollack, executive director of the health care advocacy group Families USA.

Of course, there was a time when Guericke's plight was the cause celebre of the left. Giving everyone a more equal chance at good health -- and therefore good economic health -- through universal, government-funded health insurance was the American thing to do. It's been in the Democratic platform for decades, but since President Clinton's massively complicated health care proposal flamed out in the early 1990s, it's become rare for mainstream candidates to mention single-payer health insurance.

If you look at the numbers objectively, however, health care for all shouldn't be a political football. The crisis of the uninsured, which continues to dig into the middle class, is becoming an economic issue that represents a drag on the U.S. economy.

America currently spends as much or more per capita for health care than any other country in the world. Total health bills were about $1.4 trillion in 2001. Meanwhile, people who have insurance are paying higher deductibles and higher co-pays, and worrying whether their employer will keep their coverage.

Stranger still, the failure to cover people like Guericke increases the very medical costs that drive premiums higher for people who are covered and sometimes force hospitals to cut back services or close altogether.

There are signs that politicians are finally starting to pay attention to the crisis. At every stop the nine Democratic 2004 presidential hopefuls make, they stump on health care. So far, three of the top-tier candidates have released their own universal or near-universal insurance plans.

And President Bush has done the same. The only problem? It's for Iraq. Part of the $74.7 billion initial allocation for the war in, and reconstruction of, Iraq contains a provision for "rapid, universal health service delivery to the Iraqi population," according to the Washington Post.

For Americans, Bush has offered slightly less visionary proposals for medical savings accounts and market-based Band-Aids.

One thing's for sure, with almost 75 million Americans who, based on census data, went without health insurance for part or all of a two-year period spanning 2001-2002, more people than ever have a stake in the debate. And if Bush continues down an economic path that reduces revenues in the form of tax cuts, the tens of millions of luckless, insurance-less people will be offered a stark choice: a chance at the country's first real health care plan, or a steady increase in the have-nots of health care.

"Being uninsured represents triple jeopady: You receive less medical care than the insured, you pay about as much out-of-pocket, and what you pay represents a bigger burden on your family's resources," noted Jack Hadley, a principal research associate at The Urban Institute in testimony before Congress in May.

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