Bad medicine, poverty and obesity as causes

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I am currently in the midst of a snafu situation with health care. I have a skin condition with a possible diagnosis of HS. I've had it for many years, and up until this July, no one mentioned a possible diagnosis, just said to use antibacterial soap. I have been, but it doesn't help much. So anyway, due to the poor level of care I receive at my current clinic I try to use the urgent care clinic as much as possible, one of the doctors there is very good and seems to care about what she is doing. It was she that offered a possible diagnosis for what is going on with me. They also have gone out of their way to make referrals for me. The first was to a surgeon, since some of the cysts will need to be removed that way, in order to keep they from continually returning. Unfortunately this surgeon was primarily a bariatric surgeon, (stomach stapling and related procedures) and since I am quite over weight, he gave a cursory look at the sites where the skin condition is and proceeded to do a hard sell for me to get the surgery. My support person who was in the room at the time described it as like being with a used car salesperson. When I told the doctor that I only had state medicaid for insurance he backed off slightly. When I tried to steer him back onto the subject of my condition, he dismissed the diagnosis since I do not currently have cysts in the most typical area associate with the disease, despite the fact that the areas I do have it are other places it occurs, according to what little info I could find about it on the internet. As far as he was concerned the skin problem was caused by my weight. As to actually treating the condition, he said I needed to see a dermatologist and sent me on my way without a referral. So. when I had finished my current course of antibiotics and my condition flared again, I went back to urgent care. I didn't get to see the really good doctor this time, instead it was the one who when I first went in to deal with the abscess one of the cysts had turned into, she freaked me out by saying the only time she had seen something like it before it turned out to be cancer. After a bit of flaky behavior on her part and a recommendation that I quit smoking, (smoking slows healing apparently, but also keeps me saner than any psych medication I've been on) she settled down and did the research to find out how to treat it. She started me on suppressive antibiotics, and gave me a shot of steroid in the area that was currently causing the problem. And put into motion a referral to a dermatologist. About a week later I get a call from them, saying that apparently there is not a single dermatologist in the state that accepts medicaid. They recommended I contact medicaid for a possible out of state referral. Medicaid has yet to return my phone calls. The moral of the story is, since I have been on SSI my entire adult life, and cannot work, the level of health care available to me is really very low. Added to that, since I am obese, most of the doctors I can see write everything off as "it's because of your weight," and often provide no other treatment than to suggest I diet and exercise more. I do actually watch what I eat to the best of my ability without making myself crazy over it. In addition, I've been loosing inches, if not pounds, suggesting that I am doing enough exercise in my daily life to be building muscle. And since much of this weight was put on due to years on various psychiatric medications, now that I am tapering off the last of them, I can expect more weight to come off, assuming the medications haven't permanently damaged my metabolism. Is anyone out there in similar situations? And if so, what do you do about it? I'd really like a way to unlock better health care for myself.