As health care becomes more expensive, even Americans who have health insurance are struggling to get the medical care that they need.

In this report, the NewsHour's Betty Ann Bowser interviews people who have health insurance but decide to forego preventative treatment because their share of the cost is too expensive. She also talks to health care experts and doctors about the effect of the rising cost of health care on the entire system.

David Osborn, a health care expert at Vanderbilt University, tells Bowser that while people are personally saving money skipping screenings and other preventative care, those decisions are costing the system more money in the long term when patients come to the emergency room with a serious health problem.

"Nationwide, the rise in annual premiums is outpacing average wage increases. According to a September 2008 Kaiser Family Foundation report, the average employee contribution for family health coverage increased 117 percent over the past eight years. Out-of-pocket costs for deductibles, co-payments for medications, and fees for physician and hospital visits are also higher." - Betty Ann Bowser, NewsHour

"It's absolutely frustrating, but to have to sit there and think, 'Let's see, should I take care of my wife's gallbladder that bothers her every day, or do I need to take care of my asthma? Can I do my best to suck it up a little longer?'" - Allen Orozco

"We see patients in our emergency room, and it costs five or six times what it does to see them in a primary care physician's office. So we save money in the short term, but it ends up costing us money and having worse health outcomes for individuals." - David Osborn, Vanderbilt University Medical Center

1. What is health insurance?

2. What is a deductible? What is a co-pay?

3. Why doesn't everyone have health insurance?

1. Why aren't patients signing up for preventative care?

2. How is the bad economy affecting patient's decisions on health care?

3. Why have health insurance if you can't afford even regular doctor visits?

4. Does a story like this make you more inclined to support some type of universal health care, where everyone is covered but everyone shares the costs via taxes? Why or why not?