Image: John and DeLynn Gibel
Matt Ford  /  AP
With no health insurance offered through their jobs and no money to purchase coverage on their own, John and DeLynn Gibel of Senecaville, Ohio, faced $30,000 in medical bills. The only option, DeLynn Gibel said, was to declare bankruptcy.
updated 10/23/2008 4:02:38 PM ET 2008-10-23T20:02:38

Even if the issue doesn't often get star billing on the campaign trail, health care remains a huge issue for voters. It seems like everyone's got a story to tell about their medical challenges and how they do — or don't — get insurance coverage.

An Associated Press-Yahoo News survey taken last month shows that 78 percent of voters say health care is a very important or extremely important issue.

Both presidential candidates have promised that, if elected, they'll propose significant changes to the way Americans purchase health insurance, a process that is often cumbersome, confusing, and that has left 47 million people in the Unites States uninsured.

Republican presidential nominee John McCain is proposing a tax credit of up to $2,500 for individuals and $5,000 for families so people can buy the insurance of their choice. That credit would replace the tax break that people currently get when they obtain health coverage through their employer.

Democrat Barack Obama's plan calls for the government to subsidize health coverage for millions of Americans who otherwise could not afford it. He has also proposed a government-run plan that couldn't turn away people with certain pre-existing health problems.

A look at how three American households grapple with finding and paying for health care:

Kristopher Yglesias, 34, Keller, Texas
Kristopher Yglesias doesn't consider himself a gambler, but he knows he's taking a risk by going without health insurance.

The father of three used to pay about $1,000 a month to buy coverage through his employer, but concluded it wasn't worth it.

"I decided I simply can't afford to put that much money out when I don't use it," Yglesias said.

Yglesias now pays for everything from routine doctor's visits to prescriptions in cash. When his third child was born, he arranged a payment plan with the hospital and doctors.

Yglesias said his medical costs are lower now that he pays his own way than they were when his family was covered by insurance. But the family has never had to face the costs of treating a catastrophic accident or illness.

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"If something terrible were to happen, we would have a very serious problem," he acknowledges. "We would be exposed to huge financial burden that we wouldn't be prepared to handle."

Yglesias doesn't see himself purchasing conventional insurance again, unless significant changes are made. However, the registered Republican likes McCain's plan to give families a tax credit to use toward the purchase of health insurance.

"That would be a solution I would jump on without any question," said Yglesias, who plans to vote for McCain.

Tina Lawrence, 48, Toledo, Ohio
Tina Lawrence's job as a software programmer has taken her to three different universities in the past two years. Each time she switched employers, she also had to switch insurance companies.

That meant spending hours reading the fine print for each plan. One didn't offer vision coverage. Another raised her co-pays.

"The plans vary greatly," Lawrence said. "It can really be a hassle."

Lawrence's husband and daughter, a college student with diabetes, also are covered under her plans. Fortunately, she said, she hasn't experienced any gaps in coverage as she's moved between jobs, but she's faced frequent worries about what her newest plan will offer.

Lawrence said she would support a plan that allowed individuals to keep their existing insurance when they switch employers, as long as it meets certain coverage standards. However, she's wary of any proposals that could cause employers to stop offering insurance.

"With some of the costs that we incur, there's just no way we could do that," said Lawrence, a Democrat who is voting for Obama.

DeLynn Gibel, 58, Senecaville, Ohio
It took doctors more than a year to diagnose DeLynn Gibel's husband with multiple sclerosis.

With no health insurance offered through their jobs, and no money to purchase coverage on their own, the Gibels' year's worth of tests and treatments left the family with $30,000 in medical bills.

The only option, Gibel said, was to declare bankruptcy.

"You don't have enough money to make ends meet on a fixed income," she said. "You always hear that, but until you actually experience that, it's completely different."

Because of his illness, John Gibel is now covered under Medicare. His wife stays home to take care of him.

But the couple is facing a new problem. DeLynn Gibel was recently diagnosed with Type 2 diabetes. The medical bills are starting to pile up again, including a $15,000 bill for a three-day hospital stay.

Gibel, a Republican, is voting for McCain. She hopes health-care reform will be part of the next president's agenda, but is worried that her needs won't be a top priority.

"We're so busy taking care of other places, and other countries and rebuilding for them, that the American people are just lost in the picture somewhere," Gibel said.

Copyright 2008 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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