I pay Amazon an annual fee to buy and get my stuff delivered post haste. Oftentimes it’s delivered a few hours after it’s ordered. Amazon’s business model seems to encompass much of our lives, including, as I recently learned, health care. A friend has been going to One Medical Seniors, a rebrand of Iora Seniors that Amazon bought in 2021 for $ 3.9 billion. The company has offices in a number of American cities.

Health care management in America continues to disappoint as it undergoes confusing, radical changes within the current corporate model, where almost anything goes. Two Colorado companies — Bright Healthcare and Friday Health Plans — failed after making promises they couldn’t keep. Sometimes it seems corporations’ objective is to stir everything up so vigorously that in the resulting turbulence, no one can make sense of medical care. Physicians and patients have been taken hostage by forces that squeeze the business of healing the sick from every angle.

Although most physicians didn’t go into medicine to get rich, to Wall Street, health care is a mine with rich veins of profit. In the profit mining, some companies commit corporate larceny. The best example is HCA’s payment of $1.7 billion in 2002 to the feds for Medicare fraud.

For-profit medicine in America started with two lawyer-entrepreneurs, David Jones and Wendell Cherry, who started a for-profit nursing home company in 1961, selling that company in 1972 to buy hospitals. Humana, the for profit hospital company, was born in 1974. Humana went through several iterations; the hospital part was acquired by HCA. Today’s health-care picture is a mix of for-profit and not-for-profit hospitals, entities that squeeze every dollar out of the business.

As the business model changed around them, physicians did the best they could to adapt. From solo practices, groups formed for better bargaining power. Amazingly, doctors made no attempt to fight the new corporate masters. Rather, they fought each other to curry favor with the new corporate landlords.

When there’s turmoil between owners of a health-care institution and the workers, the greatest losers are the patients. Since profit is the primary motive, patients are but numbers; you squeeze as many of them as you can through the turnstiles. This explains the ethical infractions of behemoths like HCA.

Over the last three decades, as venture capital, insurance companies and sundry corporations have aimed to extract as much profit as they can from the health-care business, they have come between doctors and their patients. I often imagine large insurance companies’ departments named: The Rejection Department. It’s one way profits are made — deny, refuse service, stonewall your clients.

The independence of physicians’ practices has been jeopardized and, in some instances of corporate consolidation of practices, abolished. Today, 10% of all U.S. physicians are employed by United Healthcare’s Optum Health. When a corporation, be it Amazon, United Healthcare, Kaiser, employs health-care providers, employers always have the final say.

Increasingly as reimbursements falter, doctors are seeking corporate employment. The current system in America leaves most medical graduates in debt, sometimes to the tune of a quarter of a million dollars, something especially true for minority and underprivileged students. In our plans to increase numbers of doctors from society’s underrepresented sectors, let’s be mindful of the price of the prize — large school debts.

My concern about Amazon’s venture into the health-care arena was sparked by what I know about health-care corporations. That said, I am grateful that ACA, also known as Obamacare, was passed into law, through a fortunate concatenation of a number of improbable circumstances. Since 2010 Republicans have tried and failed to repeal it more than 50 time — a sign that, perhaps, universal health care beats all profit-based systems.

The foregoing is belied by the potential merger of Cigna and the current Humana, a merger that will clearly lead to further curbing of competition in the health-care market. Cognizant of this and what has been lost over the years, a new group, Take Medicine Back, led by Dr. Robert McNamara, is trying to organize American doctors to reform and take medical practice back from corporations.

In the end, whoever doctors work for, they must remember their allegiance is to patients — the tenets of the Hippocratic oath their north star.

After all is said and done, it is sad, corporate money is the lifeblood of the political system.

It’s hard to see change coming to decelerate corporatization of America’s health-care system.

Pius Kamau, M.D., a retired general surgeon, is president of the Aurora-based Africa America Higher Education Partnerships (AAHEP); co-founder of the Africa Enterprise Group, and an activist for minority students’ STEM education. He is a National Public Radio commentator, a Huffington Post blogger, a past columnist for Denver dailies, and is featured on the podcast, “Never Again.”