Hazel Partin cannot afford to be sick. She cannot pay for the 22 pills she takes each day for her illnesses.

And if she keeps worrying about paying the bills, she says, her doctor has warned her she may have her ninth heart attack and further aggravate her chronic diabetic condition.

Her coal miner husband, William, is on strike and may not earn a paycheck for three months. During most of the past eight years of his wife's sickness, his United Mine Workers medical card paid every cent of the 100 days' hospitalization costs, al the weekly doctor and laboratory bills, all the drug bills, and the bill for the specialist who recommended that she have a heart operation.

And then Tuesday - following a reduction in payments in July - all the payments stopped when the strike started because the union's medical fund, which gets paid only when miners work, is too short of funds to pay the bills.

"I've got enough insulin stored up for a month, but I'm not sure I can make it three months," says the 47-year-old Mrs. Partin. "It's worrying me to death."

Dr. Kenneth Smith, the internist at the Daniel Boone Clinic who treats her, says he and other physician in the group practice will continue to treat patients whether they can pay or not. But he is worried that ironically ill patients, especially those like diabetics who need daily medication, will not buy medication and will defer other needed medical care.

Clinic supervisor Fred Scraeder pointing to the nearly empty waiting room where normally 300 patients a day are received, predicts, "If the strike lasts three months, there will be hospitals and clinics shutting down all over the region. Since the cut off. The UMW miners and their families haven't been showing up."

White House spokesmen said President Carter is expected to make an announcement Thursday concerning federal help for Appalachian health care facilities when he signs a bill that will aid rural health clinics nationally. He is expected to ask Health, Education and Welfare Secretary Joseph A. Califano Jr. to name a task force to examine the health emergency forming in Appalachia.

According to the Appalachian Regional Commission in Washington, only federal aid could provide shorterm relief that would keep 70 clinics and 61 coal field hospitals in six states from cutting back health services to some degree. The commission said some facilites could lose from 6 to 80 per cent of their revenue this month, depending on the strength of the union in their area.

"It's roughly the equivalent of Blue Cross going out of business in Chicago," says Pat Feming, a Washington consultant for the Appalachian Regional Hospitals, which operate in the heart of the coal field.

That chain's admissions dropped 40 per cent when the union's medical fund cut payments in July, Fleming said. "That clearly shows people are deferring medical care. Nobody knows what's going to happen with the complete cutoff."

No firm figures are available on the cost of keeping health services in the region at adequate levels during the strike, but UMW Health and Retirement Fund Director Martin Danziger says the fund last month paid $12 million to health providers serving 815,000 beneficiaries. [TEXT OMITTED FROM SOURCE] that are seeking jobs there because

Before the fund instituted the 60-40 cost sharing arrangement with beneficiaries in July, the cost was $26 million a month.

The Appalachian Regional Hospitals, a system once owned directly by the UMW, has already reduced working hours for employees, closed a free mail prescription service for persons on maintenance drugs and eliminated all but emergency surgery.

Daniel Boone Clinic supervisor Schraeder sees long-range effects already from the cutoffs. He says he is unable to hire two needed physicians that are seeking jobs there because he lacks funds.

Sen. Walter D. Huddleston (D-Ky.) in an urgent message to President Carter asking for quick aid, said that Appalachian coal field communites have long been "some of the most medically underserved areas of the country." He warned the President that unless immediate aid is made available, some communities may be left entirely without medical care as clinics close and doctors leave town.

The UMW and coal operators are negotiating over full restoration of health benefits, but the operators say they can agree to that only after the union has assured them that it can control the wildcat strikes that deplete the fund's royalties.

Dewey Thompson, a retired miner who remembers the long strikes it took to get the medical fund established in 1950, was hoping today that his wife would not need any more treatment for cancer during the strike.

Patting the $1,000 worth of medical bills in his overalls pocket, he said, "I've seen hard times in this union before . . . [but] I don't know what would happen if she had to go back to the hospital." Thompson says he and his wife live on Social Security and a union pension. The UMW funds say it may be necessary to eliminate or cut that pension in January as the strike's effects continue.