Drug coverage raises similar problems. "Choice" is limited by insurer formularies listing "approved" drugs, which often change at a whim. In fact, a drug can be arbitrarily removed from the list in the middle of a policy year.

Insurers push you to swallow generics or allegedly equivalent (and cheaper) prescription alternatives, even if such drugs haven't worked as well as the brand name you are already taking but which has been tossed from the list. Want to keep your preferred drug? Fine, but pay for it yourself. What "choice" is there under those circumstances?

Meanwhile, we are prohibited from buying cheaper drugs in Canada (as if Canada is some Third World country with a dark history of drug quality problems) or using the leverage of Medicare to negotiate for better prices (as large drug store chains and health insurance carriers commonly do).

Then there is the myth that maintaining a private market will drive down costs by forcing "consumers" (sick people) to "shop" for providers. First of all, the market isn't "free" if "consumers" are forbidden from seeing qualified providers. And in any case, people in dire need of medical care are not able to waste a lot of time "shopping" for a cheaper provider.

What we are left with is a shell game in which services are increasingly expensive, real choice is a fantasy, and patient care is left to the not-so-tender mercies of the free market.

I am not a wild-eyed radical calling for socialized medicine. I know firsthand from a critically-ill friend how hard it is to get timely care in the nationalized Canadian health insurance system. I realize the easiest answer isn't always the wisest, and that rationing of some sort is likely under any scenario.

But I also know the status quo is unacceptable, and I am anxious to hear presidential candidates from both parties detail where they stand on reforming our cockamamie system.

President George W. Bush wants to tax those lucky enough to have decent coverage to finance a tax credit for uninsured people to buy their own policies. That's literally robbing Peter to pay for Paul!

People hammered Hillary for trying to "destroy" our private health care system, only to abandon us to a dysfunctional market that has morphed further out of whack in the years since her plan crashed and burned.

Do any of you have a better idea? If so, I'd like to hear it.