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The sluggish economy means fewer people have health insurance and more people are looking for help at public clinics, which are struggling to keep up with demand. Case in point, Harris County, Texas where Houston is located. A new study shows the hospital district there is bursting at the seams. From member station KUHF Carrie Feibel reports.

CARRIE FEIBEL, BYLINE: At the Martin Luther King Jr. Health Center on the south side of Houston patients can fill a prescription, see a podiatrist and get new eyeglasses. They can even buy fresh fruits and vegetables at a farmer's market. But what they can't always get is a doctor's appointment. Monica Smith sees her doctor for diabetes and high blood pressure.

MONICA SMITH: Sometimes you have to wait a long time to get an appointment with him because he has so many patients, and that's just how it is.

FEIBEL: Surveys have repeatedly shown that a third of adults in Harris County have no health insurance. For most of them, the hospital district is the medical safety net. Carolyn Bell is the center's director.

CAROLYN BELL: They're over-booked, over-capacity, over-worked. So, what we do, we screen and we treat the most acute.

FEIBEL: The district includes three hospitals, 44 clinics, and a dialysis center. But every day more than 300 people who call the district are unable get an appointment with a primary care doctor. This is the first time the hospital district has been able to quantify the extent of the problem.

Dr. Robert Trenschel is in charge of the clinics. He got the data from culling the system's electronic medical records. He found that most doctors have a heavier patient load than medical groups recommend. And that's not counting what happens in 2014, when the Affordable Care Act, the new health care law, goes fully into effect.

DR. ROBERT TRENSCHEL: This is just where we are right now. As new patients get insurance, as new patients are able to access the system, there's this concept called pent-up demand so when patients finally get insurance, then the demands on the system really become exponential.

FEIBEL: For NPR News, I'm Carrie Feibel in Houston.

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