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I.L. Seamster, 62, is examined by Dr. Narayan Bhetwal at the Tutwiler Clinic in Tutwiler, Miss. Mr. Seamster is a maintenance worker at an apartment complex, but his work does not provide health insurance, and he cannot afford it on his own. More than a third of Tutwiler's patients are not employable because of illnesses or other conditions, and a quarter of the rest of the patients could work, but have no job. (Katie Falkenberg/The Washington Times)