Local opinion: Healthcare or wealth care? How greed is destroying America's health system

The following is the opinion and analysis of the writer:

When we or a family member are sick or injured, the fear can be overwhelming, but there are significant reasons that people don't seek medical care. Gallup reports that 38% of participants have avoided medical care even when they suspected that they should see someone. Why?

One reason is that insurance and receiving healthcare is expensive!

Another reason is that we don't have enough providers, so even getting healthcare is frustrating. If you have been to a hospital in the last few years or even tried to get an appointment with your doctor, I am sure you have felt this inadequate staffing.

Even though we are needed, providers just can't afford to keep our practices open and be available in all areas. Since 2001, the American Medical Association has shown that physician payment from Medicare has decreased by 33%. Many people don't realize that all other insurances reimburse based on the Medicare rate. So even though private insurance pays a bit better than Medicare, all the payments go down by the same percentage. I had to close my practice due to my inability to make enough revenue, even as a full-time practicing surgeon. I was going into debt just to keep my doors open to my patients and I am still paying off the debt I accumulated during the many years it takes of advanced school and training to become a general surgeon, so this was not feasible for me. Some of my colleagues retired early and we lost their valuable skills years before we should have. Others consolidated and became employees of hospitals or private equity groups. Have you ever found a provider that you started to rely on, only to find them gone from the practice by your next visit? You are not alone. When people don't seek care for their ongoing health maintenance, they present only when they are much more ill, utilizing emergency rooms. There is never a shift that I cover at my city hospital that I don't get at least one call from other emergency rooms around the state asking to transfer a patient because they don't have coverage. The emergency rooms are packed, with long waits, and I often end up seeing patients in the lobby because there are no beds. Even if you don't care about the moral problem of cutting Medicaid from our vulnerable patients, Please Be Clear that we are all affected.

Amidst all this chaos at the bedside where us healthcare professionals are trying to take care of patients with limited and strained resources, health insurance companies, pharma, and especially corporate middlemen such as pharmacy benefit managers and preferred provider organizers are making record profits. 2/3 of the industry profits are being seen by those groups—Not by the hospitals and providers of the actual care. Our healthcare system is the worst compared to 9 other high income nations, but it is the most expensive. Our system is not protecting our health, but it certainly is making some people very wealthy. And these powerful industries use at least some of their wealth to get seats at the tables with policy makers, funding their campaigns, and affecting future policy decisions.

The Federal government passed a bill that will cut Medicaid (in Arizona, that is AHCCCS). How Arizona works with those cuts of our taxes being returned to our state has to be done in the best way possible to minimize how many of our neighbors lose coverage, and as few hospitals have to cut services or close all together. As the most basic way to stay involved, please vote, and check the funding sources of the candidates. Consider that if they are funded by big healthcare middlemen, they may not have the health of your family as a top priority. Join patient advocacy groups and get advocacy updates provided by your state and national doctor groups. This is an effective way to tap into grassroots advocacy efforts already underway. Call and email your legislators to let them know that access to medical care is essential, and a priority. Our democracy depends on us telling our policy makers what is and isn't working for us.