What's coming out of your pocket these days – for prescription medicine, doctor visits, lab tests, X-rays, physical therapy? It's a question coming up more than ever this year, as millions of Americans and thousands of Delawareans encounter the ripple effects of health care reform and cope with sweeping changes in how their insurance policies cover or shift the cost of care. For some, new plans are producing a surprisingly painful pinch. For years, those who got health insurance from their employer saw the price of medical care as roughly equal to the "co-pay" they gave the receptionist when they left the doctor's office. Twenty dollars to the general practitioner, $50 to the specialist.