The tension grows in anticipation of the Supreme Court's ruling on the Affordable Care Act, which could come as early as Monday. The waiting has led to endless speculation and theorizing about what might or should or could happen. But for the working poor and the uninsured, this is no mere abstraction. Whatever the court decides will directly affect them. Tampa Bay Times photojournalists sampled a small anecdotal and unscientific slice of that demographic that includes 50 million Americans by interviewing patients, a nurse practitioner and the director of the health center at the St. Petersburg Free Clinic, which provides free basic medical care for those who lack health insurance and don't have Medicare or Medicaid. The question: What would you tell policymakers is wrong with our health care system?
RICHARD LONG, 46, of St. Petersburg works odd jobs to pay the bills. Long, who is suspicious of bureaucrats, says he has high cholesterol and blood pressure and is borderline diabetic. "A lot of places won't even take people with no insurance. I'd ask them (the politicians), why they don't want to help people out? Of course, that's the government for you because they can sit up there on their high pedestal, their high suits on, they can afford it. But us low-income people who don't have jobs or insurance, it's kind of hard for us. The government doesn't want to do right. The only thing they're thinking of is themselves. And that's bad."
DANIELLE FORSYTHE, 33, of St. Petersburg, far left, has diabetes and is unemployed. "The health care issue for Americans is definitely the amount of time you get to spend with a doctor. What I think they really need is a more thorough initial interview with the patient, and make sure that that time is available. I think so many things could be solved with a little bit more communication one-on-one with the patient, and not this conveyer belt of rush, rush, rush, let's hurry, we have more people. Medicine has become about money, and not about care."
EMMA DAVIS, 58, of St. Petersburg, immediate left, works in a cafeteria and cannot afford the health insurance premiums. "I think every middle-class working person should have health insurance provided by their jobs. Well, I'm not into politics. Bring it down a notch and provide for the people that have provided for the United States. My priorities. I have rent to pay, I have food to buy, you know, just the essentials. And a lot of times I don't have enough to pay those."
TRUDY GROSSMAN, 55, works as a nurse practitioner at the St. Petersburg Free Clinic. "I don't know what the answer is. I just know that we see more and more people all the time. Our society in general eats too much, drinks too much, doesn't exercise enough. The problem is that the people that we see are very poor. Poor people don't make enough money to buy the best ingredients to eat what they should. And that starts the cascade of things. If we could change that aspect, and allow people to have affordable coverage, that would be the best thing."
RONDA RUSSICK, 67, is the director of the Health Center at the St. Petersburg Free Clinic. "It's not so much about politics, but more about being uninsured and finding the solutions for fixing it. Our patients have no insurance no Medicare, Medicaid, commercial insurance. They have no personal resources. And they've tried all the other services around and they have truly no place else to go. What does that translate into in terms of numbers for the health center, last month was our busiest month in our whole 42 year history and we processed 726 patient visits. And the numbers just continue to increase. We know that about 45 percent of the people that come to us have lost their jobs within the last year. In fact a lot of them are within the last 6 months."
CLIFFORD JESTER, 36, of St. Petersburg has been looking for a full-time job for about two years since his last job at a car wash. His only income now comes from day labor. "I'd just have to say that, finding the right plan that fits everybody because I'm starting to see that different people have different needs. I think that'd be the biggest issue, is trying to find something that is going to fit everybody. What they pay, what kind of benefits are they going to get out of it, and where they can actually go for help. The situation that I see, as I'm traveling the streets looking for a job, people need this health care. You can't just let people walk around being sick. I don't understand why at this day and age, 2012, that we haven't got it together yet in the health care system."
JATADRE AND SUSAN BIKAJLE, 52 and 42 respectively, at left, live in Pinellas Park. Jatadre lost his health insurance when his employer went out of business. "One big issue is that I cannot pay, I cannot go to other hospitals to have my health checkup, because I don't have any money, too expensive. (He gestures to his wife.) She's been sick, and I told her many times that we cannot go because we don't have any money. We've been trying to find places like the St. Petersburg Free Clinic to help us. We stopped going to see our primary care doctor because we cannot afford to pay. We've been trying to apply to Medicaid, but we don't know where to go."
ESTELL WASHINGTON, a 51-year-old diabetic, of St. Petersburg, makes about $1,200 a month as a day care worker. "So it's kind of hard when you're budgeting your money. I gotta pay my light bill, I gotta pay my water bill, so it's been kind of hard, you know. We need help. We need to lower the cost down or something before we are able to afford it. I tried to go for Medicaid. They were saying I was rich. I was making too much money. There are people out here that are sick, and they need the help."
SHERRY MORALES, 64, of St. Petersburg is one year shy of qualifying for Medicare. Morales and her husband, who is retired, rely on a fixed income, and Morales was diagnosed as a diabetic two years ago. "The cost is outrageous. I think for people living on low incomes, or fixed incomes, the cost is very high. And that is one of the reasons that I am without health insurance. Luckily, next year I will go to 65 and be able to pick out a medical plan that I can afford. I don't draw too much Social Security, so what I do draw, it would all have to go for medical health coverage. I'm just hoping that my health holds up for the next year, and that we don't have any big catastrophes, health issues."
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See more of the patients' views in a video at links.tampabay.com