People young and old crowd the hallway outside the locked door of the Arlington (VA) Free Clinic. They grip small pieces of paper that will determine whether they get in — or give up and go home.

It’s lottery day, and 45 county residents who lack health insurance and money to pay for medical care are competing for 30 openings on a cold afternoon in January…If they meet the clinic’s criteria, they’ll return in a couple of weeks to see doctors or other staff.

…(W)inners are separated from losers…(A) man…strides into the clinic. His broken arm had been set in a hospital emergency room, and he needs to see a specialist for follow-up care. Another man, who has Parkinson’s disease and urgently needs drugs to treat it, leaves disheartened. He will have to return in two weeks and try again in the next lottery…

Neither rich nor poor, this group doesn’t readily qualify for public programs such as Medicaid but often can’t afford to buy insurance or pay hospital, doctor and drug bills…

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