It seems the USA is at a critical crossroads. Tuesday we will choose a new president and decide who will make laws and policies in the congress. These men and women who are on our ballots are often called “representatives.” And here’s my question for you, do they truly represent you?

Do you feel like your elected representatives know the kinds of things you deal with? Or do they look at the Americans with Disabilities Act and think they’ve done everything they need to do for people in wheelchairs?

If you had 5 minutes with your senator or congressman, what would you say? What would you ask him to do for you? What perspective about life in a wheelchair could you share with him or her?

And have you studied the healthcare plans from the Obama and McCain campaigns? Do you feel that those plans accommodate your needs? Which do you prefer?

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.

A 2006 survey of people with disabilities showed that 75% of them have at least a moderate degree of difficulty using the examination tables in a doctor’s office. The most obvious problem is that most of the tables are too high. But also there is a lack of railing and hand-holds to allow safe transfer.

The survey also indicated difficulties with imaging equipment like x-ray machines and MRIs. Something as simple as getting weighed can also pose significant challenges for those with disabilities.

The survey was published by the Western University of Health Sciences Center for Disability Issues and the Health Professions in Pomona, California, and Houston’s Independent Living Research Utilization.