THE STOCK MARKET has begun ticking upward but hiring has been slow to recover, meaning that the promising economic reports coming out of Washington haven't made much of a difference to thousands of uninsured and underinsured Philadelphians.

In the meantime, low-cost health clinics are feeling the crunch as more and more Philadelphians turn to them.

Delaware Valley Community Health (DVCH), which operates three clinics in Philadelphia and one in Norristown, has seen a rise in both uninsured patients and visits, said DVCH spokesman Steven Tyson.

"It's because of the economy, losing jobs or they just can't afford insurance anymore," Tyson said.

He said that in 2008, DVCH's clinics saw 9,225 uninsured patients. In 2009, they saw 10,331. In 2008, the clinics had 32,854 uninsured patient visits, he said. In 2009, that number rose by more than 15 percent, to 37,860.

And those hoping for help from Congress in the form of health-care reform shouldn't hold their breath.

Both houses of Congress have passed health-care reform bills, meaning that reform is closer than it has been for decades, but the two versions differ over issues such as the so-called "public option" run by the federal government, insurance delivery and language over abortion.

A conference committee begins meeting next year to work out a compromise between House and Senate versions of the bill. Experts expect that those talks will likely last into February.

But even if reform passes, it could take years before it has much impact on those hurting most.

Patients aren't the only ones suffering. DVCH raised $2.5 million in 2006 and 2007 when it built its new health center, Maria De Los Santos Health Center, at Allegheny Avenue and 5th Street, Tyson said. In 2009, he said, DVCH has raised only about $400,000.

"All those resources we relied on before are cutting back, and we're finding a lot more competition for other funding," he said.

One major donor has had to cut his usual donation in half, he said, while a corporate sponsor that contributed $100,000 a year over the last two years said that it might not be able to contribute anything next year due to its own current economic woes.

St. Agnes Nurses' Center, in West Chester, provides free health care to the poor, said director Maryanne Lieb, a Villanova professor of nursing.

It is open for patients on Wednesdays and Saturdays, and has seen about 35 patients a month for the last 10 years. Since 2007, though, Lieb said, that number has doubled to 70.

"There were weeks we had patients spilling out doors," she said of previous years. "But now, every time we open, we can count on them spilling out doors."

"Being such a small operation has stretched our resources," she said. "Some of the larger clinics that have more funding and are open more hours have closed their doors to new patients because they are feeling the pinch of the job market and the economy — so those patients are coming to us."

And Philadelphia's eight city clinics have seen an increase of about 4 percent, about 12,000 more visits a year, said Jeff Moran, spokesman for the city's Health Department. He noted that not all of the increase can be blamed on the poor economy — some were likely due to swine flu. *