Joe Kellner is CEO of LifeFlight of Maine.

I am concerned for our health care system. I am worried that in 10 years, despite medical innovation, millions of Americans will have less access to high-quality health care than they do today. I am especially anxious about how quickly that access will dwindle as you get farther from our cities.

As the CEO of LifeFlight of Maine, I lead the only health care organization that serves every community and hospital in the state. I have worked in EMS for more than two decades. I’ve been to hundreds of Maine communities and all 35 of its hospitals. I see what’s happening on the ground and from 10,000 feet in the air. I don’t have the answer, because there is no singular solution to the challenges facing health care. However, I am intimately familiar with the issues, and I believe there is reason to hope, because I believe we can do better.

First, the challenges, and there are many. The most obvious are financial. Reimbursements from health insurers, both public and private, often do not cover the cost of care. This issue is especially acute in rural EMS, for example, where more than half of patients are covered by government payors (i.e., Medicare and MaineCare), while reimbursements from those payors cover only about one-third of the costs.

The challenges of working with private insurers are well documented. Contested claims, delayed payments and obstinate negotiating tactics are the norm, none of which does anything to help patients or providers. Meanwhile, considerable costs are passed on to patients in the form of high premiums, high deductibles and even higher out-of-pocket maximums.

Many patients have no insurance coverage at all, and we expect to care for more uninsured people in the future when recent changes to Medicaid funding take effect. What we do at LifeFlight is undeniably expensive — we provide ICU-level care in an aircraft — and it is becoming more so as tariffs and inflation continue to take their toll. Most of our patients cannot afford the care we provide. Most Americans couldn’t. As a nonprofit, we provide them with the best possible care, regardless.

If there’s cause for hope, and I believe there is, it lies in debunking one misconception about the health care system, namely that “the health care system” is some huge conglomerate, the proverbial “they,” making decisions about our health and health care.

What we mean colloquially by “the health care system” is, in reality, a complex collection of agencies, companies, nonprofits, public servants and people.

Yes, many of them have profit motives, and some are outright greedy. Yes, it is messy and doesn’t function as efficiently as we would like. However, in my experience, the “system” is also made of up thousands of doctors, nurses, paramedics, helicopter pilots and health care professionals who are dedicated, compassionate, creative and deeply invested in providing the best care possible to their patients.

I see their dedication every day when I come to work. Our helicopters are big, loud and exciting to see in action, but they are merely a tool. The clinicians in the back and the pilot up front save lives. They can replicate what happens in an emergency room in the best hospitals in the world at the intersection of two logging roads 50 miles from the nearest town. I would unequivocally trust any one of them with the lives of my children.

This level of care is prohibitively expensive for most Maine hospitals. By putting it in an aircraft, we can deliver it to the point of need quickly, making critical care available statewide every hour of the day.

Everyone, regardless of where they live, deserves access to health care. Beyond the headlines, there are so many incredible people working tirelessly to care for us in our hour of need. I am proud to work alongside them, and we should make every effort to invest in these people and their success. Our lives one day may very well depend on it.