Congress is committed, if not to act, at least to listen.
The stories in this package illustrate the obstacles encountered, as well as the generous doses of creativity required, as people cobble together health coverage in America's often hit or miss system.
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(BEGIN TEXT OF INFOBOX)
The changing face of coverage
PEDRO BARRERA
WHEN a bundle of cardboard boxes headed for the recycling bin fell off a forklift in February 2001 and hit Pedro Barrera, 50, the blow sent him flat on his back and, ultimately, out of the workforce.
At the time he was insured through his employer, Macy's. "I paid $30 a week," he says. But he couldn't afford to insure his whole family, including three children. "They wanted $150 a week. That's a lot of money," he says. He lost his own coverage when he lost his job.
Since the accident, Barrera, a permanent resident in the United States, has bought insurance through the national health system in Mexico -- paying $175 a year for medical, dental and vision coverage. When Barrera needs care, he heads south. "When I need to go to the doctor, I take a trip to Tijuana," he says.
"I am worried," he says. "Not only for myself, but for the whole community. I come from South Central, and probably 90% of the people there don't have insurance. They don't have access to visit the doctor. It's too expensive. So usually they go to USC hospital."
When they go to the Keck School of Medicine at USC, they are not turned away. The hospital has a contract with the L.A. County health department, and although the public dollars don't cover the full cost of uncompensated care, it makes the hospital the biggest provider of care to uninsured people in the county.
About 50% to 60% of outpatient visits are from people without insurance, says Jeffrey Huffman, dean of clinical affairs at the medical school, and 40% to 45% of emergency visits. "We take care of them, regardless of their ability to pay, as they present themselves," he says. "A patient is a patient."
Some, like Barrera, do what they can outside the healthcare system to avoid illness. He is a volunteer for a project he hopes will help keep members of his community healthy: the South Central Community Garden.
The garden has flourished on 14 acres of land on Alameda Street for a generation of gardeners. Although the land's owner, Ralph Horowitz, recently won a court battle to evict them, a new garden, on 111th Place and Stanford Street, opened for planting March 26. Barrera expects it to thrive not only with carrots, lettuce and tomatoes, but also with herbs and medicinal plants.
