Dr. Matt Heinz is an internist involved with statewide health-care-reform efforts as treasurer of Healthy Arizona.

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I applaud the Star for its recent coverage of our health-care system in crisis. As a hospital-based physician at Tucson Medical Center, I work closely with emergency department personnel to treat acutely ill patients.

We in the medical community are well aware of the steadily deteriorating health care infrastructure. We struggle to keep the system working despite the worsening shortages of emergency physicians, primary care providers and nursing staff, as well as the elimination of emergency departments.

As the population of Arizona grows and ages, it's becoming very difficult to maintain the medical system under these circumstances. We need help.

Medical professionals, conscious of the dangerous situation we face, are devoting themselves to keeping the broken system marginally functional with little spare time to voice their concerns. This results in relative silence as the decline of the health care system continues, punctuated by the occasional media report of a particularly egregious case.

Almost 50 percent of emergency room visitors seek emergency services due to insufficient or absent primary care. Growing the network of primary care providers in Arizona will be central to any health care solution for the state. Arizona must train more primary care physicians and nurse practitioners to meet our health care needs.

The new University of Arizona medical campus in Phoenix is research-oriented and will probably not greatly increase the ranks of primary care providers. Therefore, we must also bolster efforts to attract young, recently graduated physicians to Arizona who will serve in primary care fields.

Regrettably, not enough graduating medical students are choosing the primary care specialties. Recent graduates typically have a daunting $100,000 or more in student loans. The hours are long and often include late-night or weekend call obligations.

Primary care reimbursement rates are low and falling, while insurance companies work tirelessly to delay or even deny payments for services rendered.

As a result, the overall compensation for primary care doctors is the lowest of any medical professional. Meanwhile, specialists can work fewer hours and earn five to 10 times more than their primary care colleagues. These inherent disincentives push newly graduated medical professionals away from primary care. This situation must be addressed if we hope to stabilize the health care system in Arizona.

Let's examine another situation comparable to our health care predicament. If, after a storm, severed power lines were laying in people's yards and across major intersections, and the utility failed to dispatch crews for eight to 16 hours, there would be considerable objection from the community.

If power fails altogether for more than a few hours, there would be public outrage, with subsequent investigations and government intervention.

Why, then, is it acceptable to wait for hours in the ER lobbies across Tucson? Why must patients wait for many weeks or even months to see their primary care providers?

Arizona is suffering from a massive health care brownout that will continue and worsen until we grant health-care infrastructure equal standing with other essential public utilities like power, water, gas and telecommunications, and support that infrastructure accordingly.

Once we frame the health care discussion in this way, it will become easier to begin the long, costly process of reforming the system for the greater good of our community.