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GREENSBORO — “I woke up. I was on a respirator. It was scary as hell .”

This is Frank Grant.

He gulps down 14 medications a day, many in rapid succession, except for an anticoagulant that he has to inject into his stomach.

He has survived cancer, and he suffers from a bad back.

He has a host of other health issues.

But it was his heart that almost killed him a year ago.

Grant will tell you that his decline had been building for a while, one thing that inexorably led to another.

He lost his business.

Then his health insurance.

Then his health.

And then almost his life.

“I was constantly worried about something happening,” says Grant, 55, a former landscaper. “When you put off your health care, it’s going to hit you all at once.”

A broken system

The fallout from the recession, now going into its fourth year, continues to be shocking, according to government figures.

The 14 million people out of work.

The one in six Americans living in poverty.

The record number of families falling out of the middle class.

A U.S. Census Bureau report released last week shows just how much deeper the recession has cut. Health insurance, which has long been part of the country’s fabric, is no longer affordable for many Americans. As unemployment has risen, so has the number of people living without it.

In 2009, that was 51 million Americans, according to the report.

Among the Census Bureau’s other findings:

* Adults, ages 45-64, without insurance: 13 million.

* Children without insurance: 7 million.

* The number of people receiving Medicaid, a government program that offers medical care for the needy: 48 million, the highest total since 1987.

There was a time when having health care was pretty much taken for granted.

But not anymore. Not in this economy.

“I knew exactly what I was losing,” says Greensboro’s David Phillips, 47, who lost his insurance when he was laid off from a local printing company in 2007. “I had a high level of anxiety. When you go from getting medicine to nothing, you’re at the mercy of your body.”

Many North Carolinians are finding that out the hard way.

From 2007 to 2009, the state had the nation’s highest rate of people without insurance — 22 percent — according to the North Carolina Institute of Medicine, a quasi-state agency charged with studying health issues.

In Guilford County, that amounted to 82,097 adults and children — 19 percent of the population.

It’s a number that many say will only get larger as long as unemployment remains high.

“The plight of the uninsured is not the fault of a doctor or a dentist,” says Brian K. Ellerby, chief executive officer of Triad Adult and Pediatric Medicine. “The fault is with us. Our country will not put systems in place for people to be able to afford health care.”

But in Greensboro, there is help.

You just need to know where to look.

The doctor is in

You wouldn’t know the Guilford Community Care Network existed unless someone told you.

There are no billboards. No radio spots. No TV commercials.

Their office — if you can call it that — is a sliver of space inside a children’s clinic on East Wendover Avenue.

Grants fuel what is an $862,676 operating budget this year.

Word-of-mouth is their calling card.

Hope is their selling point.

Greensboro’s Linda Hildreth, a convenience-store clerk for most of her life, is typical of the network’s many patients.

“If it hadn’t been for them, I wouldn’t be able to get anything done,” says Hildreth, 63. “I didn’t have the income.”

Currently, the network serves 80,393 people, 22,455 uninsured. All are at or below the federal poverty level of roughly $22,000.

Many patients work, but some struggle to afford a co-pay that can be as low as $10. So they pay what they can. If they can.

The network itself is made up of local clinics and any number of dentists, dermatologists, podiatrists and other specialists willing to take on patients.

As more doctors have been added, the network has become very much like what would be offered by traditional health care coverage.

It’s a point that Ellerby doesn’t hesitate to drive home. His Triad Adult and Pediatric Medicine is a provider.

“We are not a poor person’s clinic,” he says. “We are a medical home. All of this is to bring order to a system that lacks it. If the (network) wasn’t here, these people are going to get care — but it might be riding in an ambulance.”

'I’d be dead’

North Carolina realized that as far back as 1998 when it launched a statewide initiative to assist those on Medicaid.

In 2002, under the auspices of the Moses Cone-Wesley Long Community Health Foundation, the Guilford Community Care Network was created to further that mission on a local level.

Through the years, the network typically served those you might expect: the low-income and the indigent.

Then that drastically changed.

No one knows exactly when the middle class started showing up. But once they did, it was in droves.

“I received calls from people who’ve worked their entire life and didn’t know where to go,” says Lisa Duck, executive director of Guilford Adult Health, a nonprofit organization that currently oversees the network. “It wasn’t your typical indigent care. It was anyone and anything.”

Phillips, the printing company employee, started noticing how full the lobby was at his network clinic.

“It used to be a lot of low-income people,” he says. “Now it’s anyone. You can tell a lot of people are humbled.”

Many who enter the network have more than one chronic illness — hypertension and diabetes are prevalent — which have been exacerbated by years of going without health care.

“They make choices that aren’t the best, but for them, it works in the moment,” says Tracey Holyfield, who is charged with the tough task of convincing doctors to take on network patients. “By the time we see them, it’s much more chronic. These are situations, had they been managed, would not have progressed to this point.”

Grant says he feels “blessed” he found out about the network. If his health had continued to stay unchecked, he knows what would’ve happened.

“I’d be dead.”

Tough choices

If you’re Monica Crockett, you pray you don’t get sick.

She contributed to a system she thought would always be there for her.

And it was. Until she couldn’t pay anymore.

Then she was cut loose.

It was two years ago when Crockett, a baker at a local grocery store, wrenched her left shoulder trying to carry a 70-pound bucket.

Disabled and only able to work part-time, she cut expenses to live.

Her health coverage became one of them.

“I chose to eat.”

All those years Crockett had medical care, she never thought she’d need it.

Now, she feels vulnerable without it.

“I was on easy street because I had it,” says Crockett, 41, a single mom whose Medicaid covers her two kids, ages 4 and 8, but not her. “Now that I don’t, it’s real scary. I worry about getting sick. Colds, flu — anything.”

For the poor and uninsured, health becomes a series of choices, usually bad ones.

You put ailments off because it costs.

You want to eat healthfully, but that costs, too.

You prioritize your medications because that costs. A lot.

What keeps you alive comes first. Anything that reduces pain or symptoms can wait.

“There’s a whole lot of medications I should take,” Crockett says, “but I walk around and suffer.”

And if things get bad, really bad, there is one place you can go that won’t turn you away: the emergency room.

A toothache. Back pain. “Female problems.”

These are some of the things that have made Crockett go.

Pride. Shame. Embarrassment.

These are some of the feelings that have made her want to leave.

“When I’m really sick, I go,” she explains. “I can’t afford a doctor.”

Contact Mike Kernels at 373-7120 or mike.kernels@news-record.com