SEATTLE - It may be as good a method as any to measure the stress in the region's economy: whether families can pay their medical bills.
Uncompensated care is when hospitals step in to help families who either don't have health insurance, or don't have enough health insurance.
Seattle Children's Hospital serves a four-state region, including Washington, Idaho, Montana and Alaska. Its level of uncompensated care has grown dramatically in just a few years.
The hospital's fiscal year begins in September. In FY 2006, uncompensated care totaled $41.7 million. By 2008 that had more than doubled to $86.2 million. Now half way through FY 2009, the projection is for $100 million.
Thirteen-year-old Dylan Halverson is no stranger to Children's Hospital. Like a lot of kids, he's had surgery there. But because his latest expensive surgery was part of a clinical study, his family's insurance didn't cover it.
"Children's assured us they would find a way to make it happen," his father Steve Halverson said.
Children's does a lot of research, but situations like Dylan's make up only a small part of uncompensated care. Most of the money goes to kids whose parents don't have insurance or whose insurance doesn't cover all of their medical expenses.
Forty-four percent of the young patients go on Medicaid, which only covers three fourths of the cost of treatment.
"The payment we get from Medicaid compared to commercial insurance is quite a bit lower," said Dr. Sanford Melzer, pediatric hospital specialist and senior vice president for strategic planning.
"Because of job losses, we're anticipating a growth in the number of children covered by Medicaid."
Children's has a lot of friends who donate money. A multi-year fundraising campaign that wrapped up in September bought in $350 million, but that's dedicated mostly to cover building costs and research.
Melzer says the amount of donations coming in to cover uncompensated care is dropping. The hospital says it will never turn any child away, but it is worried about the new state budget and if Medicaid reimbursements go lower.
Children's says current donations are down almost 25 percent.