A 33-year-old Salt Lake woman has been in an induced coma in the St. Mark's Hospital intensive care unit between life and death for nearly three weeks.

As her doctors' list of remaining options to combat the rapid viral colonization of her lungs by novel H1N1 influenza dwindled into the single digits Wednesday evening, the cost of her care topped $300,000 — more money than she, her mother and her two younger siblings will earn in the next four years combined.

"I really don't know what we're going to do," said her mother, who has spent every evening after work talking and praying that her daughter will feel the love and hear the encouragement across whatever twilight terrain she inhabits.

"Getting her better is the main thing, but I can't help wonder how we're ever going to pay for all this," the emotionally frayed mother said on condition that her name not be used in the newspaper. "Mothers have to worry about everything."

The course of her single daughter's case is up in the air, but the one thing her loved ones can count on is a medical debt that will be with them no matter what. She doesn't have insurance because of the insurance industry's practice known as "recision" — she was cut off when chronic kidney trouble became too expensive to cover, and she is uninsurable under current criteria.

Ironically, her kidneys have been functioning normally for more than a year, her mother said.

Not having insurance is a chronic health problem for thousands of Utahns, and it is adding to the high cost of care. Hospitals are required to provide care, no matter how serious or the ability of a patient to pay. Millions of dollars in uncompensated care is absorbed by area hospitals, but those costs get shifted to those who have insurance, adding 15 percent to 18 percent to the cost of premiums.

The uninsured often end up receiving critical care because they didn't seek preventive treatment because they couldn't afford a doctor's visit.

Nearly half of all adults in Utah and nationwide report having problems obtaining necessary medical care because of cost, according to a survey released Thursday by the health-care consumer policy and advocacy group Families USA. The data came from 2007 studies, the latest available.

Mounting medical debt nationwide is emerging as the No. 1 cause of the decreasing incomes of middle-class Americans, according to the Washington-based think tank. Debt poses barriers to access, not just to the uninsured but to the privately insured as well, tens of thousands of which have burdensome debt that is tantamount to a second mortgage for many families, said Families USA executive director Ron Pollack.