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In the midst of the presidential primaries, voters may wonder how to distinguish among the contenders on the critical health-care issue.All the top-tier candidates favor selling more private insurance, which misses the crisis faced by millions. Just ask Gina Dooley of Albuquerque.“I found out when I was 36 weeks pregnant that my unborn daughter had a lung tumor,” she said. “With this advance knowledge of the care and attention we would need, we did a lot of research and had a lot of contact with our insurance company. I was working for a pharmaceutical company and had the best medical coverage available.“After several second opinions, we were told by our insurance company that only one hospital in town would be covered. We went to that hospital and had a month of treatment, surgery and bills. Months later we learned that the NICU (neo-natal intensive care unit) team was not part of our insurance network, although they were the only doctors available in the hospital we had no choice but to go to.“Because the doctors were out-of-network, we paid 90 percent of all our bills after meeting our $1,200 hospital deductable. Five days after my daughter was born, she had major surgery resulting in a $100,000 bill. We paid $90,000 of that, despite paying $1,200 a month for insurance to cover everything.”Dooley is one of hundreds who responded to a California Nurses Association/ National Nurses Organizing Committee ad describing the disparity of care available to Vice President Cheney and members of Congress and the rest of us (www.cheneycare.org).The stories are disturbingly similar, people with insurance who have been ill-treated in their hour of need. One in six insured adults have substantial problems paying their medical bills, one report noted last year, and 42 percent told Zogby-UPI pollsters that their insurer had refused to pay a medical bill. Healthcare proposals that focus on more insurance – without ending insurance industry price-gouging or the all too routine denials of care – don’t help families like Dooley’s.The top Republicans, including Sen. John McCain, as well as former governors Mitt Romney and Mike Huckabee, endorse tax incentives to enable the uninsured to buy insurance, and more deregulation to limit rising costs.While tax credits will help some, in a declining economy many will still be unable to afford policies which now average more than $12,000 per family just for the premiums, not including skyrocketing deductibles, co-pays and other costs that have made medical bills the leading cause of personal bankruptcy.There’s also no evidence that deregulation will constrain costs. Premiums alone have jumped 87 percent over the past decade, far outpacing inflation and wage increase rates, despite increased deregulation by many states and the last two administrations in Washington.The leading Democrats favor a more comprehensive approach with expanded public programs for children and the poor. Sen. Hillary Clinton pushes an “individual mandate,” the requirement for everyone to buy insurance. Sen. Barack Obama disagrees, saying those who don’t have insurance want it, but can’t afford it. Clinton’s argument that Obama is thus “leaving out” people and is not supporting “universal health-care” is disingenuous.“Having” insurance is not the same as being able to use it. You’re only being mandated to purchase the premiums; they’re not mandating the insurance companies to make sure you get the care you need. There is an alternative: expanding and improving Medicare to cover everyone, and eliminating the costly and wasteful role of the insurance industry and its built-in incentive to limit care to increase revenues. It’s a system essentially in place in every other Western country, and it works. A January 2008 study by the London School of Hygiene and Tropical Medicine, for example, found the U.S. ranked worst among 19 industrial nations in preventable deaths. Obama says he’d take that approach “if I were designing a system from scratch.”We are starting from scratch. Our present system has hit rock bottom, as Dooley and so many others can attest. Rose Ann DeMoro is executive director of the 80,000-member California Nurses Association/National Nurses Organizing Committee and a national vice president of the AFL-CIO.