INDIANAPOLIS — Dorothy Brower's husband died two years ago. She's 79, and in order to afford her $143-a-month medicine costs, she's working at a McDonald's.
"How else could I pay for my prescriptions?" she asked.
LeRoy Munger, 51, who runs an Indianapolis home remodeling service, simply goes without health coverage. He estimates that he earned $12,000 last year.
"I haven't had health care in 20 years," he said. "I've been lucky."
Travel around Indiana — or for that matter, any state — and it's easy to find similar stories of how inadequate, expensive health care is causing people pain — and becoming an important part of how they choose presidential candidates. Ask voters their top domestic concern, and most name the economy, then quickly mention health care.
Andrew Kohut, president of the Pew Research Center, sees the issue becoming more visible as fall approaches, since there are sharp differences on the issue between Democrats and Republicans.
"The economy overall is the most important issue," said Kohut, "and to a certain extent, health care is a component of that."
The issue also has affected the Democratic race, as Hillary Clinton and Barack Obama use it to demonstrate their sensitivity to voter concerns.
Their plans are similar. Each would require private insurers to offer plans to everyone, though Clinton would require all consumers to have coverage, and Obama wouldn't.
Republican John McCain offers a plan that includes encouraging states to provide coverage to high-risk consumers and offer tax credits to families to buy insurance. Clinton and Obama offer more comprehensive, government-supervised plans.
Clinton pushed the issue this week as she stumped in West Virginia, site of Tuesday's primary. Her pitch in Shepherdstown, W.Va., on Wednesday was similar to what she said last week at an Indiana campaign stop.
In Brownsburg, Ind., Clinton's daughter and mother sat on a makeshift stage in comfortable armchairs as the candidate explained gently how "we need universal health insurance, so you don't worry about losing your health insurance when you lose your job."
It was, she mused, one more worry at a time when many money problems are piling up. "When you go to the supermarket," the New York senator said, "when you go to the gas pump, you want a president who feels what you do."
Obama also gets personal, describing how his mother died of ovarian cancer at 53. Preventive care is crucial, he told an audience at the CMW specialty metals plant in Indianapolis.
"We don't have a health care system," Obama said as factory workers gathered around. "We have a disease care system."
The candidates find it easy to get voters' attention; as John Windle, an Indianapolis bulk mail technician, put it, health care is "an incredibly big issue. It affects everyone."
But convincing a voter that your plan can help ease his or her specific problem is a more difficult matter.
And because the solutions are so complex — involving affordability, better care, access to care and so on — it's hard to judge just what motivates people to support one candidate over another.
Brower, who says she does "everything" at McDonald's, is a Clinton fan. "She's a woman," Brower said. "She knows what I'm going through."
Debra Yockey, a physician's assistant from St. Clairsville, Ohio, pays hundreds of dollars each month for coverage. "I think it costs so much because companies really don't want you to have it," she said.
Clinton, she figured, has the right idea, because "we need to give it to everyone, just like Social Security. That will help bring down costs."
Munger liked Obama's idea because it wouldn't force people to buy certain coverage.
Windle also liked not only Obama's blueprint, but also his style. If the senator's call for change becomes a mandate, he said, "I'm sure he can get this done. The moment is right; people are demanding this."