An estimated 46.6 million Americans have no health insurance coverage and, since 2000, premiums have gone up 78 percent and wages just 20 percent, one report says. Many believe employment-based benefits are unraveling.

Steve Comstock had health insurance for his family when their lives were upended. His son, Steve Jr., was diagnosed in 2000 with Hodgkin's lymphoma.

"Doctors were giving him everything they could think of, and his oncologist threw the kitchen sink at him and then threw it out and bought a new kitchen sink," he recalled. His son's medical bills topped $1 million, about $70,000 of which the family was responsible for.

"The long-term trend is very clear, and it's the slow unraveling of coverage in the employment-based system," said Dr. Drew Altman, president and chief executive officer of the Kaiser Family Foundation, a healthcare research organization that tracks the cost of health insurance.

The foundation's annual report found that health insurance premiums are rising at twice the rate of inflation. Since 2000, health insurance premiums have gone up 78 percent, wages just 20 percent.

Although employers pay an average of 84 percent of medical costs for the individual, the number of businesses that offer health benefits has fallen from 69 percent in 2000 to 61 percent now because of the rising costs.

Comstock has joined the estimated 46.6 million Americans who have no coverage at all. One in every nine children is uninsured, and California is home to more of those than any other state, according to the Campaign for Children's Health Care.

Comstock sold some property he inherited partly to pay the pile of outstanding bills. On Sunday, the Thousand Oaks family held a fundraiser in hopes of catching up on the rest of the bills.

State Sen. Sheila Kuehl, D-Santa Monica, wrote a bill that would have established universal healthcare for all Californians. That passed the Legislature, but Gov. Arnold Schwarzenegger vetoed it, saying that "socialized medicine" was not the answer.

The bill would have provided every California resident with health insurance through a program administered by a new entity, the California Health Insurance Agency. It would have been partially financed by the state's current spending on healthcare and partly by consumers and their employers in place of private insurance payments.

The Bush administration has aggressively pushed for high-deductible insurance plans with health saving accounts, but Altman said only a small number of people participate in them.

After 84 community meetings and thousands of Internet polls, more than 35,000 people were surveyed, Hughes said. The group's report was given to President Bush last week.

"There was an overwhelming consensus that people believe that health and healthcare are fundamental to the well-being of the nation, and it's a shared social responsibility," said Hughes, a legislative analyst for the Venice Family Clinic, the largest free clinic in the U.S. "People felt that we have the capacity inside our nation to make it work somehow."

All over the country, people would say they were afraid of losing their jobs because they would lose their healthcare, even if their healthcare was increasingly unaffordable.

"Coverage doesn't mean you have access," Hughes said. "The system is in need of some serious change. ... There was a groundswell that something needs to happen."

The 5,200 Ventura County employees who have insurance under the county's plan have not seen large increases in healthcare premium costs, but changes could be coming, said Barry Zimmerman, head of Human Resources for the county.

This year, for example, employees will be sharing the 12 percent rise in premium costs. While last year the county gave them a cash allocation of about $80 per month toward their insurance, this year it was reduced to about $25 per month, Zimmerman said.

"We can't ignore it," he said. "Everyone is reacting to a reality associated with benefits for employees. How do we come to terms with it and who shares in what costs?"

Rising healthcare costs eat away at any potential cost-of-living raises, said Stan Mantooth, associate superintendent of administration services for the Ventura County Superintendent of Schools Office.

"The employees lose ground in salary because we have to dedicate new money toward meeting the increasing costs of healthcare and benefits," Mantooth said. "It's a problem greater than what a local school system can overcome."

Cherryl Connally, general manager of Island Packers, which runs trips to the Channel Islands, said the company wants to offer health insurance to its 25 full-time employees in order to attract the best possible talent, but the costs are rising annually.

Peter Means, CEO of the Simi Valley software company NovaStor Corp., said the cost of insurance premiums went up about 11 percent this year. The company pays for all health benefits.

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