"I'm scared that I'm going to die from cancer because I'm not taking my medications," says Houston janitor Lugarda Mejia, "but what scares me more is that if something happens to me my kids won't have anywhere to live."

A widowed mother of five, Lugarda spent 18 months in the hospital recovering from breast and ovarian cancer. At the time of her diagnosis, Lugarda qualified for health insurance from the state, but now the state says she earns too much money and has stopped paying for her medications. She currently owes $1,000 for her prescriptions, and has stopped taking her medicine altogether because she can't afford to pay for it.

With a family to support, she is forced to work two jobs to pay the bills. She works as a janitor in an office building from 5:30 to 9:30 p.m., then rushes off to her second job as a janitor at a university from 10 p.m. to 6 a.m. Despite juggling two jobs, she only brings home about $970 a month. She often goes to work sick because if she doesn't, she'll get fired and won't be able to pay her bills and care for her family.

Houston's health care crisis is everybody's problem. Texas has the highest percentage of uninsured individuals in the United States. About 1.1 million of those people live in Houston. Without insurance, many workers simply skip anything but the most serious emergency care. Several years ago, janitor Aurora Luna was hospitalized for 15 days with an ulcer. Now, she struggles under the burden of $26,000 in hospital bills. That leaves her always wondering if the electricity will still be on when she gets home, or whether the landlord will lock her out of her apartment because she hasn't been able to pay the rent.

While it's the families without insurance who face the most immediate and devastating consequences, everyone in Houston feels the effects of the health care crisis. Taxpayers pick up hundreds of millions of dollars in costs as low-wage employers shift the responsibility for providing health care onto the already-overburdened public safety net. Those with insurance -- as well as responsible employers who do offer health insurance -- see their premiums rise to make up for the uncompensated care that hospitals provide to the uninsured. Everyone feels the effects of overcrowded emergency rooms -- often the last resort for families without other ways to get needed medical care.

Houston's Health Care Crisis

1.1 million The number of people in Harris County who have no health insurance. That translates to 31% of the population. An additional half million people are underinsured.

24.6% The percentage of Texans with no health insurance coverage in 2003, last among all U.S. states. That means that 5.3 million people lack health insurance.

978,000 The number of low-income Texas children who lacked health insurance in 2003. That means 15.1% of low-income children in Texas are uninsured, the highest percentage in the nation.

$1.8 billion The amount that Harris County acute care hospitals spent in 2003 on uncompensated care, including bad debt and charity care. Much of this uncompensated care is a result of uninsured workers who cannot pay hospital bills.

$797 million The amount of uncompensated care provided in 2003 by six public hospitals in the Houston area, 44% of all such care provided in the Houston area. About $554 million (70% of the public hospital total) was provided by the three Harris County Hospital District hospitals alone.  

Video: Houston's Health Care Crisis

Follow the experience of Houston janitors who struggle day-to-day without health insurance, a nurse who works at a free clinic who cares for Houston's uninsured, and elected officials and community leaders who see Houston's health care crisis close up, everyday. Watch the video in Real Player format.