Durham resident Vanessa Hobbs is watching the healthcare debate unfold in Washington when she can. The 23-year-old doesn't have a television.

But she's keeping track of the debate as much as she can. She's only in her early 20s, but she has already racked up thousand in hospital bills.

"I lost count after 10 [thousand]," Hobbs said. "I don't want to rent my whole life. I want to have a home. Hospital bills bring your credit down," she said.

Because of a heredity immune condition, she's had trouble finding insurance coverage. When she has, she hasn't been able to afford it.

"Normally, if you have a pre-existing condition, they normally turn you down or if they do accept you - you're paying, probably, more than rent," she said. "I have a really good doctor. It upsets me that he's not getting paid because he saved my life, basically, and I can't pay him."

Monday night, the Durham Board of County Commissioners signed a resolution that "urges Congress to support public hospitals and other providers in the health care safety net so that those who fall through the cracks of expanded health coverage may still receive care."

The resolution goes on to say 26.6 percent, or more than 50,500 Durham adults, are uninsured "causing safety net providers in Durham to struggle to provide care to a population that has much lower rates of insurance than other counties."

"Our numbers are worse than some of the national numbers," said Gayle Harris, the director of Durham County's Health Department. "We found out our [emergency department] utilization is far higher for the uninsured than in some places. People go to the emergency department for services that could have been taken care of some place else."

Harris believes the economy plays a role.

"We see people who have been uninsured on more of a continuous basis and then there's this new group of people who are uninsured periodically because of the shift in jobs," she said.

Currently, agencies in Durham are working with Duke Health Researchers to come up with a model that could play a role in shaping future health care coverage.

"That's looking at how we can better-manage ten diseases or issue-areas by redefining how healthcare is delivered," Harris said.

It will address cardiovascular disease, diabetes, asthma/pulmonary disorders, obesity, adolescent health, HIV/STDs and other areas that plague the Durham area.

"The hope is that we can come up with a way that is an evidence-based model - something that has been proven to work - that can be delivered in a more cost-effective manner and people will use the service and we'll see a change in our health indicators in our community," Harris said.

SOUND OFF: What's the fix for the nation's health care system? 
MORE INFO: read the resolution

DURHAM COUNTY BOARD OF COMMISSIONERS
Resolution

WHEREAS, Durham County, like counties across the nation struggles with a healthcare crisis in the form of high rates of uninsured, underinsured and rapidly increasing costs affecting residents, employees and businesses; and

WHEREAS, county governments have historically dealt with healthcare issues as their core mission, along with challenges of providing access to care, eliminating racial health disparities, treatment of chronic diseases and planning for emerging issues such as pandemics; and

WHEREAS, in Durham County, 26.6% or more than 50,500 Durham adults are uninsured causing safety net providers in Durham to struggle to provide care to a population that has much lower rates of insurance than other counties; and

WHEREAS, 17.6% of Durham residents reported that they needed to see a doctor in the past, but could not because of the cost while emergency departments in Durham County have seen large increases of uninsured patients over the last five years; and

WHEREAS, in fiscal year 2007, 82% of the patients at Lincoln Community Health Center had no insurance and over 1,000 low-income uninsured Durham residents have been in enrolled in Project Access of Durham County since July 2008 which has allowed them to access donated specialty medical care; and

WHEREAS, any comprehensive reform proposal which seeks to craft a health care delivery system that leaves no one behind must be led by the federal government.

NOW THEREFORE BE IT RESOLVED that we the members of the Durham County Board Commissioners do hereby support the enactment of health care reform legislation this session consistent with the Administration's principles. We agree that comprehensive reform should reduce long-term growth of health care costs for businesses and government; protect families from bankruptcy or debt because of health care costs; guarantee choice of doctors and health plans; invest in prevention and wellness; improve patient safety and quality of care, assure affordability and high quality care, maintain coverage when one changes or loses a job and end barriers to coverage for people with pre-existing medical conditions.

BE IT FURTHER RESOLVED that the Board urges Congress to support public hospitals and other providers in the health care safety net so that those who fall through the cracks of expanded health coverage may still receive care; so that surge capacity is available in case of public health emergencies; and so that the cultural competencies achieved by providers serving diverse populations are preserved and enhanced in a reformed health care system.

This the 20th day of July, 2009.