STEVE INSKEEP, host:

It's MORNING EDITION from NPR News. Good morning, I'm Steve Inskeep. Renee Montagne is on assignment.

We're about to meet a man who says it's very simple to get his vote in 2008. He says he will vote for the presidential candidate who promises him health coverage. His story is part of our weekly series on the politics of health care reform. Employees are paying more for their health insurance, more small businesses are dropping health benefits for workers, and more than 10 million Americans are solidly middle income but still uninsured. All of which brings us back to that voter in New York, who spoke with NPR's Patty Neighmond.

PATTY NEIGHMOND: For years, James Calhoun has been enthralled with computers. He loves being able to create something on the keyboard and see it immediately transformed on the screen. When he was a teenager, he used the computer to make videos. Now in his twenties, he focuses on the Web.

Mr. JAMES CALHOUN (Resident, New York): Mainly I lead the development teams for building Web sites, mostly interactive advertising Web sites. I work with the business to make their Web site reflect their print or online or radio campaigns.

NEIGHMOND: In recent years, Calhoun's worked for a number of small companies, none provided health benefits.

Mr. CALHOUN: As soon as dot-com bubble burst, there was sort of a mass exodus of freelancers into the workforce. And suddenly anybody would take any work for any money. I mean we had to survive.

NEIGHMOND: Calhoun describes this new group of workers, people like himself who are expected to act like full-time employees but without the benefits.

Mr. CALHOUN: Perma-lancers are people who work as if they were full-time employees but don't have health insurance, don't get paid vacation days, don't get paid sick days. And, you know, and if the advertising revenue falls off for a quarter, it's no problem to stop an assignment.

NEIGHMOND: In other words, lay off the employee. Calhoun still loves what he does, but that's tainted by a number of worries, whether he can maintain full-time work, for example, and whether he can also maintain his health.

Mr. CALHOUN: Every time I get sick I worry what if this turns into bronchitis. I have to take a couple of days off work, and I'm not paid for the days I take off work. And I'm, you know, I have to pay my doctor full price when I go. And if - when I'm getting prescriptions written I say, hey, is there a generic version of that? You know, I don't want to pay for the name brand meds. Day to day when I'm crossing the street I say, you know, careful, if you get hit by a car, that's five grand.

NEIGHMOND: And then there are those risky sports that lure lots of twenty-somethings like Calhoun, but their activities he now thinks twice about.

Mr. CALHOUN: This January, I wanted to go snowboarding and I said well, you know, I'm going to have to stay off the hard slopes because I cannot afford the few thousand dollars if I was to fall and catch a sprain to my wrist or something like that.

NEIGHMOND: Calhoun has seriously considered buying health insurance, but he'd have to buy it on the open market as an individual.

Mr. CALHOUN: If I had to pay $600 a month for a comprehensive coverage and, you know, maybe a total of almost $2,000 per month for housing and comprehensive health care. Then $24,000 of my post-tax money needs to go to rent and health insurance. And after taxes, not bring home more than $45,000 or $50,000. So 50 percent of my post-tax income is already spent just on my housing and my health insurance.

NEIGHMOND: A situation that seems fruitless, says Calhoun.

Mr. CALHOUN: It almost makes more sense to play it safe and save that much money. I mean it's almost like my new plan is just make sure not to get hospitalized and save as much money as I can between now and the next two years.

NEIGHMOND: And Calhoun says he's hardly alone.

Mr. CALHOUN: Most of the people I know are at least in the same boat, if not worse. A lot of them are working at lower wages and have the same problem. And for them, purchasing or pricing out comprehensive health care isn't even an option.

NEIGHMOND: Public opinion polls show that James Calhoun's experiences and opinions mirror that of millions of Americans. Right now, concerns about health care rank third after taxes and national security.

Mr. CALHOUN: It's an absolute necessity that health care is provided for people who are working day-to-day at the very least, if not everyone. But the people who work a full-time job, who work maybe two jobs and don't have any health care, can't cover prescriptions. And I mean I know plenty of people who actually say: I can't afford to get sick, you know. I can't afford to go to the hospital. I can't afford to go to the doctor. And the sick days are not something that enters the vocabulary.

NEIGHMOND: And come 2008, James Calhoun says he'll cast his vote based in large part on what the presidential candidates have to say about health care and how to reform the system.

Patty Neighmond, NPR News.

INSKEEP: You can hear other stories in this series by going to npr.org, where you can find the issue of health care reform examined from the point of view of doctors and from state lawmakers.

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