"It would be nice if something made sense for a change." – Alice, from Alice in Wonderland.

Perhaps we live in an alternative universe.

One in which two thirds of Americans want the government to guarantee healthcare for everyone, while the policy makers in Washington labor to craft a reform plan that caters first to the threats and demands of the insurance industry and the minority voices on Capitol Hill.

One in which the Senate Finance Committee plays congenial host to the insurance industry, the drug companies, and right wing think tanks and it's chairman Max Baucus can proclaim all options are on the table while slamming the door on the nurses and doctors — and arresting them when they speak out.   Why? For advocating the most comprehensive, cost effective reform of all, a single-payer/Medicare for all approach.

One in which single payer is considered off the table inside the rarified airs of Congress, but when President Obama ventures into a town hall meeting with regular folks, the first question he is asked is:

"Why have they taken single-payer off the plate?" asked one woman in the audience to great applause. "And why is Senator Baucus on the Finance Committee discussing health care when he has received so much money from the pharmaceutical companies? Isn't it a conflict of interest?"

Watch here:

http://www.youtube.com/watch?v=Q6d45duX_WU

And one in which Drew Altman, CEO of the Kaiser Family Foundation can ponder today about how baffling it is that the "experts" — presumably people like him who was given a seat at the table by Baucus — sees the world so differently than the vast majority of Americans struggling to survive a cruel, inefficient, and inhumane healthcare system:

"Experts believe the health care system is full of unnecessary care and troubling variations in care, … The public has a very different world view: People think that underservice is a bigger problem than overservice. They want relief from the problems they are having now paying for health care and health insurance in very tough economic times. … And many are worried that they will not be able to afford their health insurance in the future or may lose it altogether."

The "experts" say the problem is too much "unnecessary" care. The public thinks too many people are being denied care they need.

The experts think costs are so high because consumers don't have enough "skin in the game" (i.e., we like to go to the doctor, get invasive tests, and endure long waits for care and high out of pocket costs). The public thinks the reason is "because drug and insurance companies make too much money."

The experts think health care information technology is a panacea to improve quality and cut costs. The public thinks it will probably increase costs (the Congressional Budget Office happens to agree) and are concerned about the privacy of their medical records.

The experts think we must have comparative research to limit future costs. The public thinks "insurers should pay even if their doctor recommends a treatment that has not been proven to be more effective than a cheaper one." (Imagine, getting the care you actually paid your insurance company to provide, what a concept)

Either we need to get more in tune with the self-appointed experts, or they ought to listen to what the people actually think. Or perhaps, as Marcia Angell, former editor of the New England Journal of Medicine told the Great Falls Tribune in Baucus' home state of Montana, "Single-payer is simply considered not realistic for a politician. The medical industrial complex just won't permit it."

But at a price, to our health, to the well being and financial security of American families, and to the cause of health care reform.

Or as Michael Lighty, national policy director for the California Nurses Association/National Nurses Organizing Committee put it:

"Hillary Clinton and President Clinton took single payer off the table much more dramatically than Baucus has, yet everyone draws the lesson that because of 1994 we can't do single-payer. They should draw a different lesson from the Clinton-era struggle. The lesson is we didn't fix the problem. We didn't offer a solution that works and so no one wanted it. That's the risk they run this time going down the road they're currently going. They won't solve the problem, it'll ruin their credibility even if it's enacted, and that's much greater risk."