Because they can.

In 2002 I had an abdominal cat scan. It cost 900.00.

In 2006 I had the exact same scan. (I'm fine. The conclusion is arthritis in my hip joint.) This time it cost 3600.

Why? Because they can. Pricing is not based on what the market will bear. No, wait, it is, actually, but when you are faced with a threat to your life, what price, exactly, will you not "bear"?

And that's if they let you go into debt to pay it.

Our older daughter, who has Crohn's disease, needs 16 pills a day to keep her stable and able to lead a fairly normal life. Because she has been on low hourly wages, and in fact is currently unemployed, we pay the 500 or so per month to keep her on them. Without that medication her colon will ulcerate. She will become infected, anemic, dehydrated, malnourished. Untreated, she will die.

Ulceration happens within days of interrupting the meds. Once the disease flares up, that does not simply end when she resumes meds. Instead, a course of steroids is needed to transition her back onto the regular meds, and a lengthy healing of the damage must be accommodated with more medication and nutritional help. And that's if the ulceration does not require hospitalization.

A year ago, her medication refills ran out and she phoned her doctor. His appointment staff informed her that he could not renew her prescriptions unless she came in for an office visit. This is the responsible practice of medicine -- the patient should be seen so that adjustments to treatment can be made. The right regimen last year may need tweaking this year. She asked to make an appointment.

No, she was told. She had an outstanding balance of about 500.00, and he would not see her until it was paid. No one knew better than he that this would put her in crisis within days.

She was paying Long Island rent of 1200 a month on an hourly-wage job. She did not have 500.00. She had visited the office several times for lab work, which she paid each time, and had never been told of this balance or given a chance to pay it over time. Now, unless she made a single full payment, she could not make the appointment. Without the appointment, she could not have the meds.

Without the meds she would become dangerously ill quite fast. We took it out of our account, along with the Overnight Express fee.

So do I want some silly government that can't even make its own form fit into its own return envelope running my health care system?

Such questions are an outrage. Lose your insurance, and then have a serious illness or an accident. Watch the doors slam: Medicaid, no; partner's employer, no; Disability, no. Watch your provider refuse care. Does National Health look a whole lot better now?

Like many things, it would be better than our daughter's situation, and worse than the situation that the people who still have good plans are in. If we were a sane nation, we'd be finding a good solution under which nobody would get lousy care or no care at all. Waiting until crisis mode creates emotion-fueled, hasty implementation of flawed cures. Didn't we learn squat about the dangers of that in the past? But again we're keeping the status quo on life support, again we're delaying.

And conservative bloggers are helping that happen with their affectedly precious garbage about how government can't do anything but screw up folding questionnaires and build Bridges To Nowhere.

Those of us for whom health care horror stories aren't just newspaper feature articles but living realities will be, I think, forgiven by humorous bloggers for not having much sense of humor about it, but mocking extremes is a time-honored humor tradition and even I really do understand that.

My problem is that I know, and am surprised that more people do not know, that it's not just benign humor. It's unpaid labor on behalf of BigProfitHealth.

BigProfitHealth needs for the status quo to go on as long as possible. They make sure that only the extreme scenarios of health care reform get talked about. If you want a particular answer, then make sure you control the question:

Do you want no-choice totalitarianism? Delays while tumors grow? Forced abortions? Politicians will set your leg, bureaucrats will cut you open, pharmacists will no longer know the difference between benedryl and belladonna!

Am I being just as silly and over-the-top as the conservatives? Sure, paper-pushers will create a bureaucratic mess, but no one has explained why doctors won't know medicine as well, or why pharmacists will be more likely to make mistakes.

Does anybody really have such a naïve lollipops-and-gumdrops view of for-profit health care as to think it doesn't exert plenty of pressure for fewer people to do more work on longer shifts, to pander to the Sacred Bottom Line? Causing nasty mistakes? Could anyone not know what a blind-maze runaround of bureaucracy people get thrown into right now, to get into programs for which they're technically eligible?

But sincere, good people become convinced that Big Socialism is coming and is a danger to their loved ones. And then those sincere, good people work for BigProfitHealth for free, circulating the cute memes for them, which helps keep the general public wary of change and slows reasoned reform to a crawl.

The other thing they don't know is that BigProfitHealth does not give a tinker's damn about them. A simple change in life circumstances is all it takes. BigProfitHealth will pulp its beloved blogger supporters into Soylent Green the day they can't get any more pecuniary benefit out of them. Seriously, lose your job. Sit in that miserable desert with your sick child and strike that goddamned rock till you're blue in the face, and see if BigProfitHealth issues you one crapping drop of water from it. You've defended BigProfitHealth, even if you thought you were only questioning total socialism, and now they. do. not. care.

The world is particularly scary right now, with jobs evaporating and the possibility of losing everything far too much on the minds of people who should be secure, whose hard work and responsible living should pay off in a decent well-earned life.

In a scary world we get overwhelmed and focus on the bad-enough problems on our own plates. We want to make easy choices between either/or scenarios.

The reality on the ground is that those of us who watch suffering and death happen at the hands of medical price gougers don't want stupidity, inefficiency, "rationing" or any other alternative that will merely hurt different people. And believe it or not, we know that to oppose universal or government subsidized care doesn't mean someone wants us and our children harmed either.

The free market is a good thing. It works pretty well for almost any commodity that gives consumers choices. They can choose among competitors, they can say no. And the value of a commodity or a service can find its level that way.

Health care may be the one and the only commodity that can't be free-marketed. How do you value health care?

The question is, how do you value your own, or your child's life? Because THAT is the "commodity" that they are selling to you. Is there any amount that they cannot ask? They price it all the way they can. Because they can.

What exactly are the choices? In a case in which you must have the money in a lump sum, do you even have a choice?

If you have the choice and can get treated with a resulting debt that will bankrupt you, should you "choose" to say no and die?

Do. not. ever. tell me that there's anything remotely humane or decent, much less "Christian" about the idea that any provider is entitled to immense wealth -- I'm not talking fair profit, I'm talking obscene riches -- and to let someone who can't fork over die when that provider has the knowledge to save them. If anything besides Big Government can stop the price-gouging, let's hear about it, but don't tell me that health care pricing right now is one whit different from selling disaster victims 50 dollar gallons of water.