The health care crisis of the uninsured and under-insured was in the spotlight Monday as two women prepared for free surgeries thanks to Miller Orthopaedic of Council Bluffs and Alegent Health.

The patients have both been living with pain for years. Diane Chapman needs both knees replaced and Rebekah Brown needs a hip.

They would have had the surgeries years ago but they don't have insurance.

Rebekah says, "It's cost prohibitive. What do you do? Pay the rent or have insurance."

"You have to choose," adds Diane. "Do you want to pay a premium or do you want to put groceries in the refrigerator?"

According to the census bureau more than 46 million Americans don't have health insurance and it is estimated that 16 million more are under-insured. Doctors say many times these individuals forgo medication or treatment because of costs.

Dr. Kent Boese, with Miller Orthopaedic says, "Folks that have a bad knee or a bad hip just kind of push it aside and it's not an emergency so it never gets treated."

When Miller Orthopaedic put out word they'd do the free surgeries, they were amazed by the number of responses they got. Within days they heard from 78 people.

Diane and Rebekah have both worked all their lives. Diane has put in 37 years at a nursing home and without the offer of free surgery she wouldn't be able to continue.

"I'd probably end up on disability and not be able to contribute like I want to," she said.

The surgeries are planned for March and both women are expected to go back to work pain-free.

Dr. Boese says the plight of those with little or no health coverage is often a vicious cycle. They can't afford a procedure because of the cost of insurance but then have to cut back their work due to the pain they're suffering.