Improving health care is the second biggest issue for Keith Goodenough, Democratic candidate for the U.S. Senate, right behind doing away with special interest money in Washington, D.C.

"People are dying because of the health care in this country, and probably at a higher rate than we think," said Goodenough, a utility line locator from Casper.

Medicare and Medicaid reimbursements to physicians need to be increased, because doctors are choosing not to see those patients, which include the elderly and disabled, Goodenough said.

He said he has seen this recently happen in his community.

Goodenough's opponent in Tuesday's primary, Nick Carter, an attorney from Gillette, agrees that Medicare and Medicaid need to be funded better and doctors need incentives to take care of these patients.

The Democratic winner between Goodenough and Carter will face incumbent Republican Sen. John Barrasso, a physician from Casper, in the general election in November.

Covering the uninsured should be left up to the states with some federal government guidance and support, Goodenough said.

Wyoming needs to create its own insurance pool, perhaps with energy money, to cover the state's uninsured, Goodenough said.

"The nation has to promote solutions at the local level," Goodenough said. "Wyoming needs to look out for its own citizens."

He said health care is similar to education in the sense it is difficult to govern at the national level. The No Child Left Behind Act didn't really work, he said, and neither would a nationalized health care system.

Carter said the federal government should at least provide catastrophic insurance for every citizen. This would prevent people from having to declare bankruptcy after serious car accidents.

Health care "is the number one cause of bankruptcy in the country," Carter said. Then, people could choose to buy health insurance for the day-to-day maladies.

Carter, like his opponent, thinks special interest money in Washington, D.C., is a problem.

To fix the health care system, Carter said, the country needs legislation that is not written by the special interests of the health care industry or pharmaceutical companies.

"In the Bush administration, it was a free for all," Carter said. "It was profiteering for health care organizations."

Contact reporter Allison Rupp at (307) 266-0534 or allison.rupp@trib.com.