The patient tugs at her shirt, pulling it down to expose a red spot on her chest. She has one on her shoulder, too, she tells the doctor. They’re skin tags, caused by prolonged sun exposure over the years, internist Kerry Humes explains, as she examines 55-year-old Debbie Cassimatis of Moline.

She needs to see a specialist.

But Cassimatis doesn’t have health insurance, even though she works full time.

“We’ll call around and see who we can find to help,” the doctor tells her.

The hope of providing more health-care access for the working poor is what spurred Humes and two others to open the Good Samaritan Free Clinic in May 2007 in the Wildwood Office Park, 602 35th Ave., Moline.

She said she sees the need for national health-care reform in the faces of every one of her patients.

But none of the proposals still on the table would protect medical providers against malpractice lawsuits, and that’s crucial to bringing down medical costs for everyone, Humes said.

The fear of getting sued over a medical case casts a shadow over just about every decision that medical providers make as they deal with their patients. Many end up ordering medical tests and analyses, even when they don’t necessarily need them for a diagnosis — because they need them to cover themselves for liability reasons, Humes said.

With more tests getting done, people (and their insurance companies, if they’re lucky enough to have them) are paying for more high-priced medical services. That’s causing health-care costs to rise, right along with the price of medical malpractice insurance.

“It’s really insane,” she said. “It’s really spiraled out of control.”

That’s another reason Humes wanted to launch the free clinic, where the only patients allowed are those who work but don’t have health insurance. Under the “Good Samaritan Act,” Humes and the rest of her volunteer staff are protected from malpractice lawsuits.

It’s highly unlikely anyone could win such a lawsuit against her, because the clinic’s services are free, she said. To underscore the point, she said she pays only $48 per year for medical malpractice insurance, taken out as a precaution.

Compare that to Quad-City radiologist Reid Schroeder’s payments of about $30,000 per year for medical malpractice insurance.

Schroeder, 46, reads diagnostic imaging at Advanced Radiology in Moline. He said growth in his field has been “explosive.” He’s seen more radiology tests — such as CAT scans and MRIs — coming through his office over the years, which means more income for him to interpret those images.

“Having less of those ordered would affect my business,” he said.

But Schroeder would rather see fewer radiology tests — and get less pay — than watch the country go further into health-care debt. The country just doesn’t have enough money to continue on with Medicare as it stands, especially as baby boomers get older, he said.

“To me, the problem with the current system is there’s no price transparency at all,” he said. “They have no prices shown. So, there’s no price incentive.

“If there were prices, that would make things more competitive.”

The current plans under debate do not call for price discussions between medical providers and patients before tests are ordered, like Schroeder would like to see happen.

They also don’t include the concern he shares with Humes and her husband, Tim Humes, who also is a radiologist: The need for malpractice protection for medical providers.

Schroeder agrees with the idea that some doctors are ordering more tests to protect themselves from lawsuits. “It’s constantly on our minds,” he said, referring to medical providers. “I can’t get anyone upset, or they can sue me.”

If the final plan doesn’t include this type of reform, “then it’s a highly partisan reform,” he said, and not dealing with a core issue, he said.

“If doctors were given legal immunity, they could say, ‘I’ll do the best I can, but let’s do it as cost-effectively as possible,’” Schroeder said.

That’s how Humes operates at the free clinic. If she’s confident that a medical test wouldn’t change her diagnosis or treatment, then she doesn’t order it.

If she thinks it’s necessary, she works with her friends in the medical community to get it done for cheap or free.

“When I practice here, it’s very different in a good way,” she said. “It’s a completely different way of practicing.”