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Uninsured rates are spiking as job losses continue

President Obama said this week he wants to reform the U.S. health care system by the end of the year. Before the recession hit, an estimated 45 million Americans were without health insurance. That population is now growing by the day as millions of people lose their jobs. WFAE's Julie Rose has more: When we first visited the Charlotte Volunteers in Medicine Clinic it was October and it was busier than ever, with patients waiting days for an appointment. This week we went back and discovered things have gotten much worse. "We're out three weeks now for new patient appointments - till I think the second or third week in March," says Physician's Assistant Donna Murray Lacey. She and her two full-time nurses see 15 or 16 patients a day at this small, free clinic - one of seven in Charlotte set up to treat people without health insurance who make too much money to qualify for Medicaid. Typically, the clinic's patients earn minimum wage, have been uninsured for long periods of time and live in low-income neighborhoods, "but it's starting to shift a little bit because of the economy," says Lacey. "So we're more likely to see somebody who may have had a job with insurance, but not live within a typically low-income area. The ones that are first timers, you can tell because they're almost embarrassed to have to ask for help." The clinic's phones ring constantly with newly pink-slipped patients desperate to renew their prescriptions for diabetes, high blood pressure or asthma. The North Carolina Institute of Medicine estimates 23 percent of adults in the state are now uninsured. And every 1 percent increase in unemployment generally drives that number up by another 50,000. Job fairs in Charlotte these days are crammed with people who've either joined their ranks, or are on the brink: There's a part-time bus driver willing to take any job that offers benefits. A mother who - along with her self-employed husband and two children - has been uninsured for a year. A laid-off salesman who's taken a job delivering pizza to pay for his diabetes medication. "I've looked into trying to get aid, but they tell you right on the phone it could take months and this and that," he says. "So what are you supposed to do, pass away in between, with out the medication?" The jobless face difficult decisions when the cost of health insurance competes with food and shelter out of a meager unemployment check. Geneva Williams was laid off in October. "My salary dropped with unemployment by 1,000 a month and my expenses went up by 800 because of Cobra insurance," says Williams. "So that decision put me about 2,000 to the negative per month. So we've gone through savings and things like that." COBRA is the government-enabled option that lets you temporarily stay on your former-employer's health plan. But you have to pay the full premium, which can run a thousand dollars a month. The new federal stimulus package will pay 65-percent of that premium for some who've recently been laid off. "But there are still many people who don't have access to COBRA - if I didn't have coverage at my prior job, then COBRA doesn't help me at all," says Mark Holmes, Vice President of the North Carolina Institute of Medicine which tracks health statistics. Middle income earners are the fastest growing segment of the state's uninsured population. But Holmes says North Carolina has one of the better safety-nets for them. There's extensive coverage for children. Many health clinics charge patients on a sliding scale. And there are free clinics like Charlotte Volunteers in Medicine. But Holmes says in this recession, the safety net's not big enough. Nor is it easy to access. "Many people who maybe this is their first time being unemployed - don't really know what is out there and what kind of resources they have available to them," says Holmes. And it's a wicked cycle. Holmes says minor problems are more likely to become serious health issues when people lack insurance. They go to the emergency room more, which drives up insurance premiums across the board. Hospitals with fewer paying customers are forced to cut costs, freeze hiring, postpone building projects . . which means more people out of work. "It's a feedback kind of loop there, where unemployment goes up, uninsured goes up, puts stresses on the health care sector, which can push stresses on the broader economy as well," says Holmes. Some local economists are predicting the Charlotte-area unemployment rate could hit 13 percent within two years. Which will mean thousands of new people on the doorsteps of clinics like Donna Murray Lacey's. So she says it's no wonder that President Obama - in the midst of a massive effort to stimulate new jobs - also plans to start work next week on fixing the nation's health care system. "If people are not healthy, they can't work," says Lacey. "So we need to keep these people healthy enough so they can go out and apply for jobs and stay employed."