The revelation came off-stage at a weekend gathering of universal health-care advocates.

David Benfer (pictured above), president and CEO of the Saint Raphael Healthcare System, came to the United Church on the Green on Saturday to speak with others about a shared priority: Establishing a national, single-payer universal health care plan. The talk, co-sponsored by the Universal Health Care Foundation and the Connecticut Health Foundation, was put on by Squeaky Wheel Productions.

As panelists met with the press before a public community forum, Benfer revealed the strains the current state of the health care system is putting on the hospital.

St. Ray's, a 511-bed Catholic hospital on Chapel Street, has a charitable mission. Poor and uninsured patients who may not end up being able to pay medical bills are nonetheless given treatment. Patients select a "self-pay" method, meaning they do not have insurance, or the insurance they have does not cover the treatment they need, Benfer explained.

Yale-New Haven Hospital has been criticized for aggressively pursuing medical debt through lawsuits against patients.

Unlike Yale-New Haven, St. Raphael's has long had a policy of not attaching debtors' homes to try to recover medical bills, St. Ray's usually ends up forgiving these costs. So classifying a debtor's case as "self-pay" essentially translates to "St. Ray's pays." The amount of "self-pay" medical costs has been inching up year by year, said Benfer.

This year, the self-pay costs jumped dramatically: From $5.8 million in FY05-06 to roughly $9 million in FY06-07, a whopping increase of 65 percent.

That means the hospital is giving away $9 million in free medical care to those who are financially struggling the most, Benfer said. Adding up the hospital's other charitable outreach, such as Project Mother Care and Project Brotherhood, the total in free care comes to about $35 million, he said.

Robin Hood Financing

Why the recent spike in patients who can't afford treatment? The number of uninsured patients is on the rise, Benfer responded. (An estimated one in nine people in the Connecticut are currently uninsured.) And employer health care plans aren't what they used to be.

That's right, jumped in labor leader John Wilhelm (pictured), president/hospital industry of UNITE HERE!, from across the table. Wilhelm, who graduated from Yale University in 1967, has worked with New Haven area unions and led strikes here his entire career.

"Forty years ago, this community looked different," said Wilhelm. New Haveners had steady jobs at factories, with good health coverage. "Now most of those factories are gone." The decline of the manufacturing industry -- and a more recent shift of risk from employers to employees -- have changed the state of health care in the city, said Wilhelm.

"He's dealing with the fallout from that," Wilhelm said, gesturing to Benfer. "What he's doing is unsustainable!"

Benfer added the hospital is also getting squeezed by a nursing shortage that's driving nursing costs up. Meanwhile, Medicare and Medicaid, instead of sending more aid, are "ratcheting down." Medicaid reimburses the hospital only 63 cents for every dollar it costs the hospital to give care.

"So you resort to Robin Hood financing" -- driving up the cost for corporate clients to free up money to serve the poor and under-insured, said Benfer.

"It's not your fault," replied Wilhelm, but those corporations end up shifting those health care costs back to their employees.

Wilhelm: Yale Should Expand Health Plan

Upstairs, Wilhelm's keynote speech focused on how employers are "shifting risk" to their employee through retirement and health care costs.

Hotel workers, whose plans typically cost $250 per month for a family, often can't afford the plan and go without health care, said Wilhelm.

"A mother who works hard every day, does what society asks her to, and she still can't afford health care for her kids? There's nothing more heartbreaking, nothing more immoral," Wilhelm said.

Returning to New Haven's story, Wilhelm said with the loss of so many factories, only one place remains where workers can still get excellent health care coverage -- Yale University. Wilhelm attributed that to the hard work of the Yale unions.

Wilhelm posited a solution: Why not expand the health care pool for Yale employees to include others in the region, such as employees of small businesses? "Yale has the infrastructure to do this better in the whole metropolitan area," said Wilhelm. "I think you could do it without Yale doing it as a charity."

Wilhelm later said he didn't have a more detailed plan, but saw Yale-New Haven Hospital's "incredible infrastructure" as a "great opportunity."

(Full disclosure: The Universal Health Care Foundation, one of the event's sponsors, provides funding to the Online Journalism Project, the not-for-profit organization that publishes the Independent.)