Health Care in the Heartland

LYNCHBURG, Va., June 24, 2009— -- As President Barack Obama gets set to launch his health care reform initiative, the people in this central Virginia town have their doubts he'll be able to deliver what he promises.

"He might try, but I don't think he'll be successful," Debora Peters said. "Nobody else has been."

"The economy's so bad, it'll take a long while to fix it -- if we fix it," Bertie Cunningham said.

"But at least he's getting started," countered Betsy Flowers. "I don't know if he'll get everything he wants, but at least it's a start."

This town of 72,000 has battle scars. It is home to Jerry Falwell's Liberty University. The local Civil War monument honors "our Confederate soldiers."

Obama campaigned here last August, holding a town hall meeting at a local high school. Obama did unexpectedly well here, but he ended up losing this part of Virginia to John McCain.

As the health care reform debate begins, expectations are low. But the need is clear. At the local Free Clinic, the waiting room is full. The caseload has doubled during the recession, as more and more lose their jobs and their insurance.

"We used to get 50 new clients a month, but at the start of this year we started getting 100," said Bob Barlow, the clinic's administrator.

Patients who qualify for the program, based on need, pay only a $2 co-pay. Local doctors offer their services for free.

According to Barlow the clinic, which has an annual operating budget of $600,000, was able to give more than $6 million in medical services last year. This year, the tab is expected to be even higher.

Kimberly Gambolati, a stay-at-home mom, is typical of the newly uninsured. Since her husband got laid off a few months ago, the family of three has no safety net to fall back on.

Gambolati's mother had been helping them until she was diagnosed with cancer. Now the mother is going to need to save her money for her own treatments.

"My biggest fear is my [5-year-old] daughter," Gambolati said. "It's a worry every day, every night before I go to sleep."

Gambolati's doctor recently prescribed anti-anxiety medication to keep her stress level down. He gives her free samples because she can't afford the pills.

The people we met in Lynchburg were mostly content to leave the details of reform to the experts.

Many like their doctors, but they don't think their insurance plan offers an adequate safety net.

Dr. Thomas Eppes, who practices family medicine, said many of his patients worry that health reform will force them to find different doctors or that any benefits that come out of reform will go to special interest groups, not to them.

"I think it's the government in general they don't trust to do a good job," he said.

Many people ABC News spoke with worry that health care reform will create a new government bureaucracy and add to their tax bills.

"The government is going to try to micromanage Chrysler and health care?" joked Biff Johnson, president of a local small business.

Johnson, who runs a civil engineering firm called Hurt and Proffitt that employs 85 people, says business has dropped off sharply during the recession but health premiums haven't.

"We've seen double-digit increases for the past four years, and those have ranged from 11 percent to 19 percent," he said.

The company now pays just half of the health care premiums and the company has been forced to cut benefits from the plan. Workers are paying more for less.

But even that is better than having no coverage at all, which for Gambolati, is a nightmare that can't end soon enough.

"I don't have the answers, but I hope somebody will," she said.

And, she said, a solution can't come fast enough for her family.