JIM LEHRER: Tomorrow the President and Congress will be asked to address the problem of the 40 million Americans without health insurance. The call will come from a coalition of the U.S. Chamber of Commerce and the AFL/CIO.
Susan Dentzer of our health unit has been looking into a clinic that knows the problem all too well. Our unit is a partnership with the Henry J. Kaiser Foundation.
SUSAN DENTZER: Just 20 miles from downtown Los Angeles Venice Beach is the heart of laid-back California funk. That's especially evident in life along the city's famed boardwalk. But just a few blocks from the beach, here at the Venice Family Clinic, it's a far different scene.
On a recent afternoon, pediatrician Norma Rosales showed Marle Comacho how to give asthma medication to her three-year-old son, Stephen. (Counting in Spanish)
SUSAN DENTZER: Young Stephen Camacho is just one of 17,000 patients who frequent the Venice Family Clinic, the largest free medical care clinic in the United States. Founded by two local doctors in 1970 to pride health care for the poor, today it has grown into a $16 million a year operation with four separate sites. The vast majority of the clinic's patients are in working families, most are poor and most are without health insurance, like poet and part-time fencing instructor, Stephen Goldman.
HEALTH PROFESSIONAL: Your good cholesterol is 37, which is a little low, but we can't do much to adjust that; that's just your genetics. And your bad cholesterol is 88, which is great.
STEPHEN GOLDMAN: Really? I've had two hundred and something.
HEALTH PROFESSIONAL: I'm telling you, it's great.
SUSAN DENTZER: Goldman has been coming to the clinic for treatment of diabetes, hypertension, high cholesterol and depression for the past 15 years.
STEPHEN GOLDMAN: This is my health insurance. This is what I call -- Otherwise I would have "die in the street health insurance." And I'm not much of an activist or advocate, but not this... This is literally life and death to lots of people or damn near it.
SUSAN DENTZER: When to comes to the lack of health of health insurance, the events of September 11 and the economic slowdown have made a bad situation worse. There are roughly two million of uninsured people in Los Angeles County, where the clinic is located. That's the highest number of uninsured of any county in the nation and in a state that also has the highest rates of uninsured. Local health experts say that without places like the Venice Family Clinic, tens of thousands of people would go without even basic health care. Elizabeth Benson Forer is the clinic's chief financial officer.
ELIZABETH BENSON FORER, CEO, Venice Family Clinic: September 11 impacted the area surrounding our clinic in many ways. We're very close to the Los Angeles Airport. Many people there lost their jobs. There was no parking on the premises for many months. We have many hotel workers in the neighborhood. We live close to the beach. And they have lost their jobs. Many of them have lost their health insurance, and so they are in the process of coming to us or will be coming to us.
SUSAN DENTZER: One of them is 38- year-old Beatriz Samayoa, a single mother of three who came here 12 years ago from Guatemala. She was working at this elegant beachfront hotel in nearby Santa Monica until shortly after September 11, when tourism plummeted. With the hotel only half full, she was laid off.
BEATRIZ SAMAYOA: They didn't give us notice. They didn't say we're going to cut people. They just call us into the office and... And tell us that there's no more work for us.
SUSAN DENTZER: It was the first and only job Samayoa ever had that came with health insurance.
BEATRIZ SAMAYOA: I didn't know how to pay my bills. That affected me emotionally -- affected my kids.
SUSAN DENTZER: Samayoa seeing a mental health professional at clinic, who is helping her to cope with the stress and to find another job. Samayoa also depends on the clinic for health care for her three children. Two were born here, and as U.S. citizens, they have health insurance through the state's Medicaid program called Medical. But her eldest son, born in Guatemala is not eligible for coverage. So the free clinic is his only option. To Dr. Susan Fleischmann, the clinic's medical director, the situation demonstrates how the clinic fills the many gaps in America's health care system.
DR. SUSAN FLEISCHMAN, Medical Director, Venice Family Clinic: In a single day, I'll see someone who is uninsured because they lost their job. I see someone who has Medicare and they come here because they can't pay for medications. We'll see someone who lost their Medicaid because they didn't fill out the right form, or they moved, or their address changed. We see all the people that fall through all the cracks.
SUSAN DENTZER: Recently Dr. Fleischmann treated another patient who fit that bill-- 30- year-old Eric Moore. A graduate of nearby UCLA, Moore was working for a Web site, lainsider.com until he was laid off after September 11. Not long after, he developed a pain in his leg.
ERIC MOORE: After three days, I realized it wasn't a muscle cramp, but I was too afraid to go to the hospital because I didn't have medical insurance. I was afraid of a very large bill. Ironically, because I didn't go to the hospital, that probably made the situation much worse.
SUSAN DENTZER: Then, while walking outside in early December, Eric collapsed on the pavement.
ERIC MOORE: I collapsed from what I now know is a blood clot which became a pulmonary embolism, where the blood clot moved from the leg to the lung. It knocked me out. I almost died.
SUSAN DENTZER: Taken first to the Venice Clinic, he was then transferred to Daniel Freeman Hospital, where he spent the next several days. The bill for his care there came to $14,000.
ERIC MOORE: My mother put down a down payment for $2,000. I couldn't ask for anything more. But I still have a bill of $12,000 along with... That's more than my school loans.
SUSAN DENTZER: Eric is now receiving free follow-up care at the Venice Clinic. That includes getting advice on losing weight and staying active and receiving blood thinning medication to lower his chances of another clot.
HEALTH CARE PROFESSIONAL: This is your coumadin. You need to take three of them every day. Make sure no aspirin with that, and we'll adjust your dose when we see you.
ERIC MOORE: Thank you very much. Bye.
SUSAN DENTZER: The medications given to patients like Eric are donated to the clinic by large pharmaceutical companies. That's part of $8 million a year the clinic gets from private contributions. The rest of the clinic's annual budget, another $8 million, comes from a patchwork quilt of public sources, city, county, state, and federal governments. The clinic also depends on 500 private physicians. They donate their time alongside the clinic's small paid medical staff.
DOCTOR: My Spanish is terrible, so I'm sorry. 'S why I have Rosa. What brings her here?
SUSAN DENTZER: One is Dr. Ami Oren. An Israeli émigré he's a full- time lung specialist at UCLA's hospital. He donates a number of hours at the clinic. He says part of the motivation is the patients are so appreciative.
DR. AMI OREN, Volunteer Physician, Venice Family Clinic: Patients here are more cooperate active in many ways. They are very grateful. And it's easier for me to have patients do things that are very difficult, such as getting off drugs, smoking cessation-- much easier than I find elsewhere.
SUSAN DENTZER: The clinic's high profile fund-raising efforts include an annual art festival featuring the work of the many prominent artists who live nearby. What's more, the proximity of Hollywood attracts celebrities like Dudley Moore. And recently television personality Larry King came by with his wife, Shawn, to help patients with heart disease.
LARRY KING: We're very impressed, as Shawn said, with this place and we're happy to do this, so here it is. ( Applause )
SUSAN DENTZER: King says that he received care from a free clinic as a child after his father died.
LARRY KING: I had to go to a New York free clinic where they examined my eyes and New York City through this clinic, gave me my first pair of glasses. I never forgot that. I was humiliated, but at the same time, thankful. I don't think anybody is entitled to more health care that another person. That's what a free clinic does; it welcomes you through the door. They did me. We owe it back.
SUSAN DENTZER: For all the support behind it, the clinic is now having to gear up to fight threatened cutbacks in state and federal funding over the next several years. A yawning state budget gives portends possible cuts in Medi-Cal.
ELZIABETH BENSON FORER: At a time when we're not economically stable, with families who are fighting to keep a job or find a job and really need health care, it's the worst time to cut this funding. (Speaking Spanish )
SUSAN DENTZER: As part of campaign the clinic is asking patients to fill out post cards and send them to elected officials to let them know how much the clinic's services are needed. Some experts say that having more places like the clinic would offer a solution to the problem of roughly 40 million Americans without health insurance. But ask clinic officials about that and you'll get a surprising response: No.
ELIZABETH BENSON FORER: We're here because there is no other way to solve this problem right now. We're a band-aid; we're not the solution.
DR. SUSAN FLEISCHMAN, Medical Director, Venice Family Clinic: I would really love to the clinic didn't need to exist. It was started as a stopgap measure. We never dreamt of growing this big. And our goal is not to be so successful that we grow and grow, because I don't want to see that kind of need. If everyone had insurance and everyone had access that went along with that insurance, I would be very happy to shut the doors and go out and find another job.
SUSAN DENTZER: Until that day comes, the doors of the Venice Clinic are likely to stay wide open to serve those who need it.