Native American studies opened his eyes to the disparities in the nation’s health-care system.

“I got pissed off,” he recalled.

A friendly, upbeat man, Kovar has practiced medicine in some of the world’s worst trouble spots, including war-torn Africa. He’s also worked on five Native American reservations in this country and embodies the sense of mission many of those who staff community health centers bring to their jobs.

Kovar’s experiences with the extremities of the human condition abroad haven’t blinded him to conditions in Seattle.

“People are people; suffering is suffering. You don’t have to go far to see it,” he said, cocking his head toward the door, where the rare April sun shone on the northeast side of Capitol Hill.

“All of us can be stricken by a bad economic turn,” he continued. “It can be a frightening zone to be in. It could be any of us.”

Kovar said he doesn’t get discouraged: “It’s a cliché, but it’s still one patient at a time.”

Neighborcare Health operates 19 community health centers in Seattle. CEO Mark Secord, 60, sees a penny-wise, pound-foolishness to the coming budget cuts, which he labels “catastrophic,” noting we overspend on emergency services and under-fund preventive care.

Neighborcare Health has not been immune to layoffs. “The basic story is: We’ve been hit in the same way all nonprofits and businesses have been. Revenues are down,” Secord said, pointing out the 2009-2011 budget took away about $4 million from Neighborcare Health’s overall budget of $38 million.

Neighborcare Health is also the largest provider of low-income dental services in the state. Secord estimated about 14 percent of Seattle’s population lacks health insurance, and those lacking dental insurance amount to more than double that number.

“We know poor oral health translates into poor health down the line,” he said, saying those who come in for infected teeth are sometimes turned away for lack of capacity. Many of those end up in the emergency room, where they are given painkillers.

“It’s heartbreaking,” Secord said. Neighborcare Health’s constituency is even more diverse than Country Doctor’s: “Seventy percent of our patients are people of color,” Secord stated. “Our staff speaks 41 languages and dialects.”

Secord’s determination to face the future, whatever it brings, remains intact: “I believe so strongly in what we do that, at the end of the day, society needs us. We’ll find a way — we always have,” he said.

As the budget moves toward approval in Olympia, the outlines of which Gov. Christine Gregoire has called “immoral.” April may, indeed, be the cruelest month for Seattle’s most vulnerable citizens.

As Country Doctor’s Linda McVeigh put it: “One of the most important things to recognize is that not everyone has easy access to health care. There are people who are in pain who are risking their lives by not showing up in a clinic like ours.”

After a pause, she added, “After 40 years I thought there would be more access to health care.”