Experts and practitioners active in health care every day came to a business and labor forum in Albany and found some common ground in coping with the myriad changes in the health care system.

BALCONY — the Business and Labor Coalition of New York — packed the house in May for panelists who told stories from the front lines of hospitals, dental care, finance and politics in health care in New York.

Questions probed included: What is the financial impact of providing health care for the 2.8 million uninsured New Yorkers? What effect will reform of health care have on the economy?

All agreed, and most presented evidence: People who go without insurance become much sicker and it costs more to cure them. Lives are lost unnecessarily due to gaps in health care. Medical costs — even for the insured — have led to family bankruptcy.

Some problems start out deceptively simple: A person has high blood pressure, but they can't afford a doctor or medicine.

"I'm seeing them in the ER having a heart attack or a stroke," said Dr. Barbie Gatton, a Bronx emergency room physician.

With hospitals taking on the cost of caring for the uninsured, along with cuts in Medicaid; with employees and employers paying more for health care; and with so many people unable to afford any health care, "Who is making the money?" asked Alan Lubin, executive vice president for NYSUT, a partner in BALCONY.

Steven Boyle, CEO of St. Peter's Hospital in Albany, said the three big money-makers in health care are:

• Health care equipment manufacturers;

• Insurance companies; and

• The pharmaceutical industry.

Jeffrey Lewis, president of Heinz Family Philanthropies, added pharmacy benefit managers to that list.

He advocated for community health centers across the state, where every child is charged $30 a visit and the rest of the cost comes from a pool. With the child comes the mother, he said, so the mother can be examined and treated also.

"If the mother isn't healthy, the family won't be healthy," he said.

Choices

"The solution is the problem," according to Richard Kirsch, executive director of Citizens Action of New York.

The first thing people ask, he said, is: "How does it affect me, my family, my costs?" Even the strongest supporters of universal health care balk at Medicaid for all, he said.

"People want to make their own choice of doctors and second opinions. Their choices are being reduced," Kirsch said.

He outlined a universal coverage plan where employers pay into a plan and employees contribute based on a percentage of their income. Individuals would pay for care on a sliding scale. This public plan could use purchasing power to set drug prices, he said.

Gatton said the state Berger Commission's recommendation last year to close hospitals is going to make access to health care even more difficult.

"ER overcrowding is a nationwide problem, and it's more severe in New York," she said, pointing out that this state is 49th out of 50 for access to health care.

She told the story of an uninsured man diagnosed in the ER with appendicitis. When staff came to take him to surgery, he was getting dressed. He said he could not afford hospital care or to go without earning money for his family.

According to Dr. Mara Rosenberg of County Dental, one-quarter of all children entering kindergarten have never seen a dentist.

Mark Blum, managing director of America's Agenda: Health Care for All, said, "We can't contain costs without covering the uninsured." People, he said, are being driven away from prevention, early intervention and early diagnosis.

— Liza Frenette