Ah, the middle-class scramble. Tracy Ashford teaches special education, is working on her second master's degree, is pregnant with her third child -- and, together with her husband, a barber, earns about $60,000 a year. That is enough for the Ashfords, who live in Yorktown, Va., to own their two-bedroom condo and two cars of early-1990s vintage.

Overall, Ashford said, "We can't complain."

Except when it comes to health care. The cost always seems to be headed upward, especially the co-payments that are required on doctor visits. And at the same time, the quality of service her family gets is clearly deteriorating.

The doctor who delivered her first two children has stopped practicing obstetrics because of rising malpractice insurance costs. Worse, some of the other physicians she has used in the past won't accept her insurance, obtained through the school system, which is from Trigon/Blue Cross Blue Shield.

So Ashford, who has a thyroid condition, has had a lot of trouble finding affordable care. "The only specialist in the area who takes Trigon is roughly 40 minutes away," she said. "There are several specialists who practice close to my house, but they don't take the insurance. So I have to travel 40 minutes, and that means I have to take a day off from work and use a lot of gas."

Aside from an overhaul of the health care system, Ashford would like to see a rise in the minimum wage. Not that she needs it; she and her husband, Ronald, are able to sock away about $150 a month, which they put partly in mutual funds. They are planning on buying a bigger place to live next year, now that their family will be expanding again. They just bought a second personal computer for their home.

"But there are some very close friends of our family, working several years some places, making the minimum wage, and it's just not enough to sustain their families," Ashford said.

Ashford is also concerned about the debt she has incurred to pay for her master's degrees -- about $40,000 altogether, which will probably take two or three decades to pay off. She plans to teach in an inner-city zone in the next few years, and wishes the government would offer forgiveness on loans like hers as a way of offering an incentive to work in an area where teachers are in short supply. "That," she said, "would be beautiful."

-- Paul Blustein

Tracy Ashford of Yorktown, Va., teaches special education and "can't complain" -- except about health care.