The good news is the Palmetto State isn't as bad off as some states, particularly out West, where large numbers of Hispanics mean that as many as a fifth of the working population is uninsured, according to the study by the Robert Wood Johnson Foundation.

Nevertheless, more than 18 percent of South Carolina adults were without insurance in 2001, according to the study, which analyzed federal information on the issue. That's 470,864 people.

Nearly two-thirds of those people, 293,566, are employed. Put another way, 16.4 percent of the state's working population didn't have health coverage in the period in which the study was done.

The study, set to be released to help kick off Cover the Uninsured Week this week, is the latest in a growing pile of evidence reflecting serious shortcomings in the nation's health care system.

Earlier this year, the state Department of Insurance released a study that found 19.4 percent of the population goes uninsured at some point during the year. Locally, one in five Charleston-area residents goes without coverage.

The health care system relies on employers to provide the bulk of coverage, with the government stepping in to cover the poor, disabled and elderly. The cost of providing coverage keeps going up and has been for decades. The natural result is that small businesses with smaller budgets drop coverage. Others shift more of the cost to their workers, who sometimes drop out themselves.

The latest study found that blacks are more likely to be uninsured than whites. In South Carolina, 21 percent of black adults are uninsured, compared with 15.2 percent of whites. But the highest uninsured rate -- 35.5 percent -- is among Hispanics.

People without health coverage are much less likely to get health care. The study said that in this state, 17.7 percent of the uninsured went without care the past 12 months, compared with 5 percent for insured adults.

HOSPITALISTS

Roper St. Francis Healthcare has signed an agreement with Cogent Healthcare to provide hospitalists for patients who don't have a doctor or for doctors who want to use these specialists.

Hospitalists are becoming increasingly popular, and experts expect there will be 25,000 of the specialists by the end of the decade, up from an estimated 6,000 now, according to the Society of Hospital Medicine.

Other area hospitals, including Trident Health System and the Medical University of South Carolina, already have hospitalist services.