I know the topic of healthcare and health insurance is a hot topic because it’s an election year. And there is going to be many perspectives thrown around, each trying to solve the issues.

But as I sit here in my wheelchair, I’ve been thinking about what’s wrong with the healthcare system. I’m not sure any of the candidates for public office can (or will) tell it like it is. Maybe it’s because I have a unique perspective—and not just because I’m sitting in a power wheelchair.

First, the whole idea of employer-provided health insurance came about through labor unions. I’m sure some of the intentions in the beginning were noble. Trying to help your employees live healthier is a good thing. But here’s the deal, by providing health insurance through an employer, you’ve now created far too much separation between the person who is making healthcare “purchases” and the way their money actually changes hands.

What other major purchase decisions do you make in your life where you don’t really know what the “thing” costs? Or without shopping around?

If your car was in the repair shop and the mechanic called you and said “We’re worried that there might be a serious issue with your brakes. We need to run a special diagnostic test to determine if there is an issue.” Wouldn’t you have a few questions? How much is the test? What will it tell us? What are the risks of not having the test? What makes you think my brakes have the issue in the first place?

The funny thing is, doctors are more than prepared to answer all those questions. But because we have our employer and our health insurance company involved in the payment process, we feel separated. We don’t see healthcare “purchases” as purchases. And as a result, there are no (or too few) true market pressures in the healthcare industry.

If the mechanic’s answers to your questions revealed that the risk is that your brake pads might wear out too quickly and the cost of the test is $5,000—you’d tell him that he’s crazy. But if the issue was your brakes might completely fail the next time you drive, you’d be willing to pay quite a bit to get it fixed. Or you might want to check around to see if someone else can do the test for cheaper.

Anyway, my point is, all the solutions being thrown around won’t help the end consumer feel in control of their own healthcare dollars. Therefore, they won’t bring real market pressures into the healthcare industry. And therefore, nothing will change. Costs will continue to spiral. And the average Joe sitting in his wheelchair will be stuck paying ridiculous prices, getting unnecessary treatments, and generally feel constantly frustrated with the whole healthcare mess.

I don’t know about your part of the country, but it’s been a long cold icy winter where I live. It’s not that I can’t get out in my power scooter in the winter. But you know how it goes. It’s just that much harder and in some ways more risky when it comes to falls and such.

But this week the icy grip of winter is finally loosening. I can ride my scooter around the neighborhood, enjoying the fresh air and getting reacquainted with neighbors. It’s like I’m free again. Here’s to a long pleasant Spring.

As a wheelchair user, there are some real safety issues that should always be top of mind. Not the least of these safety issues is the danger of pressure ulcers (also known as bedsores).

The more limited your mobility is, the more you must guard against the danger of pressure ulcers. If you are in your wheelchair for essentially all your mobility needs, you are at greatest risk. Here are some tips to help you avoid this painful condition.

1. A family member or nurse should check every day for the beginning signs of a pressure ulcer. Look for spots of redness that don’t turn white when you press it with your finger. For those with darker skin color, it can be harder to recognize this early stage. The next stage to watch for is the formation of blisters, which then form an open sore.

2. Avoid friction. Be careful not to drag your skin across sheets or out of your seat. Learn to lift properly to avoid creating an abrasion.

3. Control moisture. Too much moisture from excessive perspiration or urine can make the skin soft and more prone to bed sores. Talk to you doctor or nurse about options for those with incontinence.

4. Minimize irritation from chemicals. Avoid irritating antiseptics, hydrogen peroxide, iodine solution or other harsh chemicals to clean or disinfect the skin.

5. Eat healthy and get exercise. A balanced diet that’s high in calcium, vitamins C and E, and zinc will help. Additionally, even the simplest exercises and stretching can increase blood flow and aid in protection.

6. Change positions every hour. When you’re in your wheelchair, be sure to shift your weight and/or position each hour.