How will it impact the average Joe?

FOR JOE GOTASKIE, of Phoenixville, the debate over health-care reform isn't a distant abstraction.

In August 2008, he got potentially life-saving surgery only with the help of a nonprofit clinic, and he's still struggling with more than $20,000 in medical bills.

Joe and Carol Gotaskie - now 50 and 54 - married in 2003. He quit his computer job, and they opened a gardening service. He paid for COBRA insurance - insurance available after changes in employment - but it soon became too expensive.

"We were pretty healthy at the time," Gotaskie said.

Then he got sick.

"It was an acute thing," he said of the heart disease that threatened his life. Before, Gotaskie said, "there was no indication anything was wrong." But after a day of nausea and pain in his shoulders, he went to a nonprofit clinic affiliated with St. Peter's Episcopal Church, in Phoenixville.

A doctor there referred him to Phoenixville Hospital, where he took a stress test that revealed that his arteries were 95 percent clogged. The stress test cost $7,000, he said.

"They would only take care of me if it was an emergency situation," Gotaskie said.

That didn't sit well with him. "I always wondered, 'Will I collapse?' "

Brian Torrence, a hospital spokesman, said that confidentiality laws prevented him from discussing Gotaskie's case, but that Phoenixville Hospital has financial counselors to help underinsured and uninsured patients sign up for government programs or establish payment plans.

The Phoenixville clinic helped Gotaskie get heart surgery and care at Paoli Hospital. Without the clinic's help, he said, he would be sitting on more than $100,000 in medical bills.

Instead, the costs of his operation and care are about $20,000. "The individual doctor bills, we're paying off a little bit at a time each month," he said.

Gotaskie said that he's not looking for free health care - just health care he can afford.

"People out there think everything out there should be free - they think they're entitled to it," he said.

"I'm not one of those people. But on the other hand, things cost too much."