In the contentious, confusing snarl of the health-care debate, it is a very good thing to consider the young doctor who still gets to the heart of the matter.

Dr. Matt Zuckerman is 29, could pass for 18 and sometimes grows weary of the Doogie Howser jokes. He works the brutal schedule of a Brown University resident in emergency medicine, which sometimes runs to 80 hours a week of treating every real and imagined ailment known to man or woman.

Then he goes to the third-floor miracle on Broad Street in Providence and works for free.

“I really wanted to see people in a free clinic setting,” he said. “There’s the feeling of really helping with a problem, not just putting on Band-Aids.”

It is fun, says the doctor, to use skills he might not have used since medical school. Yes, fun.

“Here, I’m a primary care doctor.”

The Rhode Island Free Clinic is the doctor’s office without that little sign by the reception desk telling patients to have their insurance cards ready. It is a place where the path from illness and injury to treatment is as straight as it can possibly be. It is one small piece of the health-care system that underscores how far out of reach some of the bigger pieces are.

And Rhode Island’s abysmal economy means that more people need the free clinic than the free clinic can possibly accommodate. On the first Thursday of the month, a line forms outside the Hindle Building at 655 Broad St. Each person in line needs to see a doctor and each gets a number. Each has to show that he or she makes less than 150 percent of the federal poverty level and does not have health insurance.

Then there is a drawing, and the number of people chosen to come inside and be examined is based on the number of volunteer doctors available.

It is health care by lottery, treatment by the luck of the draw. It means some people will wait in line and walk away with their mental and physical problems still not diagnosed or treated.

It is a hard, cold way to work, but it is necessary to match patients with available resources. Some of those not chosen might be referred to a doctor in a network of doctors who agree to see patients in their offices for free.

“Our goal is to lose the lottery,” said Julie White, the clinic’s director of development.

But for now, the lines will form and relief will mix with disappointment on the sidewalk on Broad Street.

There are about 130,000 Rhode Islanders under 65 who do not have health insurance, according to clinic officials. Many hold one or two low-paying jobs, so they put off medical treatment in favor of things like food and rent. Bad conditions get worse, and many end up in emergency rooms where doctors like Matt Zuckerman see the desperate side of health care.

And it is frustrating, said Zuckerman, because there is often the one visit to the emergency room and nothing more.

“Here [at the free clinic] we do have follow-up treatment,” he said.

At the clinic, White says, it costs about $1,000 a year to treat a patient, compared to $8,100 in those places where everything costs something.

The clinic has just six full-time staff. The rest are all volunteers, people who claim rich personal benefits from the experience.

Not surprisingly, fundraising is a never-ending part of the free clinic. Benefactors have been generous. Textron, CVS, Brown University and the University of Rhode Island are among those who have helped give Rhode Island a unique place where very good treatment is provided to very needy people in an atmosphere markedly free of charity trappings.

When you reach the clinic on the third floor, you could be reaching the office you go to for your annual checkup if you’re one of those fortunate people with health insurance. Actually, the clinic might be a little nicer, with its well-equipped examination rooms, the state-of-the-art eye-examination room and the full pharmacy, which replaced a “sample closet” last year. There are rooms for psychological consultation, for wellness classes, for yoga.

“The level of care people get here is at or better than they get at local clinics,” said Zuckerman.

The free clinic is a window on Rhode Island. People familiar with hard times and people new to hard times meet in the waiting room. And doctors and nurses and a bunch of other people help ease the terrible load of uncertainty.

“It’s great place,” said a woman who had health insurance when she underwent gall bladder surgery but has since lost it. “Somewhere else, there would be a huge bill.”

She is 35 and comes from Peru and has found the United States an expensive place. She works but can no longer afford insurance. She was at the clinic last week for stomach pains she thinks might be connected to her surgery. She was scheduled for some tests as part of her follow-up care.

Matt Zuckerman thinks there will always be something like the Rhode Island Free Clinic in his medical career. Life is better that way.

“It’s certainly personally rewarding to use the skill set I have,” he said as he munched a sandwich during a short break between patients. “To volunteer and provide this service, that’s really nice. I feel good after every shift.”

bkerr@projo.com