Individuals face hurdles in insurance quest

John Craig, a 46-year-old software consultant in Orem, plays racquetball twice a week, doesn't smoke or drink and isn't overweight. But when he tried to get an individual health-insurance policy three years ago, he was rejected.

The insurance company cited sinus infections and depression, two conditions that Craig felt were well under control. The sinus infections stopped when he quit eating wheat in 1992, and medication has kept depression at bay for years. Frustrated, he ended up pursuing coverage through various state programs. For people with health problems in the private market, he says, "if you have a job with health coverage, then you get health coverage. If you don't, you're simply out of luck."

Craig has gotten an unwelcome education in the vagaries of individual insurance — the private option of last resort for many of the roughly 60 million Americans who don't get health insurance from their jobs or the government. About 17 million people, or 10 percent of Americans under age 65, buy individual policies in a market that even proponents agree has a big problem: Sick people often can't get insurance, or if they can, it's prohibitively expensive.

Now, the individual insurance market is at the center of a debate about how to extend health coverage to more people, a crucial point of disagreement among the politicians who are pushing to solve the issue of the uninsured in the next few years. President Bush and other prominent Republicans want to expand the market to cover more of the 45 million people who are currently uninsured and to provide an alternative to employer-based and government programs. But it's not clear how they would help people whose health isn't perfect and who, arguably, are most in need of help with medical costs.

Bush officials say simply broadening the pool of people who are buying individual policies — through tax incentives — will go a long way toward improving the market. Some of the uninsured, such as college students, are undeniably attractive to insurers and might be more likely to purchase coverage with such help. In addition, Bush wants to create a national market by allowing people to buy individual policies anywhere in the country — not just from insurers in their own state, as required by current law.

The focus on individual policies fits with Bush's vision of an "ownership society," in which Americans would save and invest for items now supported by government programs, such as retirement expenses, homeownership, college education and job training. In Bush's vision of individual health insurance, more people would own their medical coverage and take it from job to job.