One of my colleagues has a daughter who's about to graduate from the U of O. As she casts around for an early-20s game plan, what she's most worried about is finding a job that'll give her health insurance.

My own daughter's preschool teacher doesn't receive health insurance. She doesn't make enough money to buy it on her own, and has to pay cash up front whenever she sees the doctor.

When I was in my early 20s, I was thinking about how to survive as a struggling writer and where to go on my Eurail pass, not about how to pay for a doctor's visit or how to protect my parent's assets and my future credit rating if I ever got really sick.

Welcome to the brave new world of 21st century health care.

Our Input online reader survey finds that nearly half of business leaders think rising costs pose a major financial threat to their companies. In our 100 Best Companies to Work For in Oregon survey, employees rate the cost and quality of health care as more important to their job satisfaction than virtually every other workplace benefit, including retirement and profit-sharing plans, opportunities for higher pay and promotion, and access to information technology.

What can we do about this crisis? I put the question to members of the Oregon Business Council's Healthcare Task Force in a recent Oregon Business roundtable.

The answers included: Make consumers more responsible for their own medical costs; Make health care delivery more efficient using information technology; Fully fund Medicare and Medicaid to stop the cost-shift onto employer-sponsored health plans.

All this will help. But it probably won't stop double-digit annual increases in insurance premiums, or halt the persistent rise in the number of Oregonians who are uninsured.

People are working hard to solve these seemingly intractable problems. They include benefit consultant

Roderick Cruickshank of The Partners Group in Portland. With the help of Providence Health Plans, The Partners Group has devised a new health plan called Dependent Solutions that could assist the uninsured famlies of insured workers.

Cruickshank and a colleague thought up the idea after meeting with a client -- a health clinic in Bend -- that faced an increasingly common problem: It couldn't afford to cover employees' dependents. Many were simply going uninsured, or obtaining cheaper (but less comprehensive and reliable) insurance on the individual market. Dependents with preexisting conditions were sticking with the company plan (at $300-$800/month out-of-pocket), raising the risk and cost to the employer.

Cruickshank's team invented a multi-tiered offering that allows employees to purchase affordable, stripped-down coverage for dependents. Plans for employees, spouses and children can have different deductibles, benefits and co-pays, allowing more choice and flexibility for the employee. And the cost -- approximately $160/month for a spouse, $70/month for a child -- is highly competitive with that of plans available on the individual market.

Since implementation of Dependent Solutions, the Bend employer has seen a 30% increase in participation by spouses and children. Uninsuredness among this working population has gone down -- good for workers, families, the employer and the community. Oregon is ripe for more good ideas like this one.

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Copyright 2005 Oregon Business magazine