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In North Carolina, Recession Breeds a Health-Care Crisis

Job Losses Leave State With Highest Percentage of Uninsured

North Carolina's rise in unemployment, the highest in the country, coincides with a surge in patients at HealthServe Community Clinic in Greensboro.
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Washington Post Staff Writer
Monday, April 20, 2009

GREENSBORO, N.C. -- It's right there on the wall, hectoring David Talbot as he races from one exam room to another.

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"You want to see the recession? There it is," Talbot says, pointing to a row of multicolored graphs. "We began to spike in October 2008, and we're losing the battle now. We just can't keep up."

Recessions are tallied in numbers -- jobless claims, home foreclosures, plant closings and bailout dollars. Here at the HealthServe community clinic, Talbot, the medical director, tracks the recession in days -- the number of days that patients wait to see a doctor.

Just six months ago, the clinic delivered same-day care to most callers, the gold standard from a health perspective. But in October the delays crept to four days, then 19 in November and 25 in December. In January, HealthServe temporarily stopped accepting new patients, and almost immediately 380 people put their names on a waiting list for when the crunch eases.

In North Carolina, more than any other state, the recession has triggered a burgeoning medical crisis. A steep rise in unemployment has fueled a commensurate increase in the number of people who do not have health insurance, including many middle-income families.

"I used to be upper middle class," said Amy, who called HealthServe every morning for weeks before getting in to see Talbot. "I've paid my taxes for 30 years."

Last fall, when she moved here from Florida to care for her parents, she got trapped in the economic tailspin. The former resort manager who bought jewelry in tony Palm Beach now does temp work and sits in the clinic's crowded waiting room with dozens of others who cannot afford insurance.

"I haven't told anyone I'm coming here," she said, asking that her last name be withheld because she is embarrassed to be seeking discounted medical care.

Though in relatively good health, Amy, 54, needs a doctor to monitor her allergies and high cholesterol. "It's kind of depressing," she said. "But thank God it's here."

In the past two years, North Carolina's number of uninsured has climbed 22.5 percent, the biggest jump in the nation, according to an analysis by the North Carolina Institute of Medicine, a quasi-state agency. Nationwide, about 22 percent of adults do not have health insurance. Here in North Carolina, 25 percent of adults -- or 1.8 million people -- have no coverage. An additional 9 percent are underinsured.

For most Americans, health insurance and employment are linked. Every 1 percent increase in the jobless rate translates into 1.1 million people losing coverage nationally, according to the independent Kaiser Family Foundation. North Carolina's unemployment rate has doubled in the past year to 10.7 percent, making it the fourth-highest in the country.

"Relative to other states, North Carolina is still a manufacturing state," said North Carolina State University economist Michael Walden. "And manufacturing takes it on the chin during a recession."


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