One woman was having chest pains but refused to get into an ambulance. She couldn't afford another $1,000 ambulance bill, so she waited patiently for a friend to give her a ride to the hospital.

Another patient wanted an abortion but couldn't afford it. She ended up having the baby.

In the past year, things have been hairier than usual at the Community-University Health Care Center -- known fondly by its acronym CUHCC (pronounced Kook), on Franklin Avenue in south Minneapolis.

It's the oldest community clinic in the metro area, and when the rest of the system has failed people, this is where they show up.

They are showing up in growing numbers, according to clinic manager Amy Shellabarger, and by every measure they are showing up with greater needs.

It used to be that clinic staff called an ambulance once or twice a month because someone turned up in such bad shape they needed to be rushed to a hospital. Now, it's once or twice a week.

The clinic has noticed a rise in white patients and patients from the suburbs. They have lost their jobs and health insurance and can no longer go to their regular clinics. Recently, a patient drove in from Monticello, 50 miles away.

In 2006, 10 percent of CUHCC's patients were uninsured. In 2007 and 2008 the share was about 28 percent.

Busy afternoon

On a recent afternoon, the waiting area is full. Patients shuffle in and out of small private rooms, where they huddle with financial counselors to see whether they qualify for financial assistance.

Roxana Ionita, one of several financial counselors, says she helped about 80 patients apply for Medical Assistance, MinnesotaCare or the clinic's sliding-scale fee in January. That was up from 56 in December.

Many patients are working -- making too much money to qualify for government programs, but not enough to buy private health insurance.

A patient who wants to be known only as Gray works part time in retail. She's 21, makes $18,000 a year and can't afford health insurance. She's waiting to see a doctor because she needs asthma medication. "I tried to stretch it," she said. Instead of using her inhaler two or three times a day, as prescribed, she puffed on it once a day. A month ago, she ran out completely. She finally came into the clinic after she got so winded she missed a day and a half of work.

Another young woman comes in to see a dentist. She has been rejected by three health insurers because she is overweight. She's working part time in marketing and looking for full-time work.

She has come in with four cavities. She finds out that even the discounted rate will be $400.

She leaves with four cavities.

Chen May Yee • 612-673-7434