The national controversy over the Affordable Care legislation is so conflicting and universal in scope that I have stayed away from any commentary up to now. Everybody else in politics and media are saying too much!

That was until a political cartoon caught my interest for commenting on the status of health care in America. The particular issue concerns the vast inequality in health care for Americans. The cartoon refers to Sen. John McCain being absent from Congress due to a serious medical condition being diagnosed, even though his name was not shown in the cartoon.

So what is the point if a Senator has medical treatment? It reminded me that members of Congress, and probably most Congressional staffers, get gold-plated health insurance free for life. Meanwhile those same Congressmen dally around passing a universal and affordable health care plan for all Americans while millions suffer waiting.

This is probably the most brazen example of inequality in our democracy. Social groups lobby for homeless, immigrants and many under-served residents. Who lobbies to keep health care limited only to those who can afford it? The insurance companies. Congress listens to their big bucks with the best of medical coverage.

Before affordable care was legislated, MediCal enrollees increased from 300,000 to 800,000 in a decade. There was also a big increase in emergency room dependence by the uninsured to the extent that many hospitals had to close ER services for lack of funds to operate.

Add to those demographics impacting the health-care system the high cost of medical service. A survey by the Commonwealth Fund in March placed the U.S. at the top of the list of 13 wealthy nations for the highest cost of health care; example – Switzerland spent $2761 less per person than the $9086 spent in the U.S. each year.

Why are U.S. health care costs the most expensive in the world, columnist Paul Sisson pondered? There are a multitude of reasons, including the observations above. The bottom line is the providers charge more; example – an MRI in Switzerland costs $138 vs. $1145 in the U.S.

(Note: Switzerland has the second highest cost for medical service of the 13 countries in the survey.)

Waste is another cause of expensive medical care. A 2012 report by the Institute of Medicine estimated $750 million is spent on unnecessary procedures. Doctors and technicians are inclined to prescribe more expensive tests just to be sure they can’t be sued by the patient.

Probably one of the most wasteful elements of healthcare is the bureaucracy of forms and billing documents. If all this paperwork was eliminated, thousands of jobs at the insurance companies and the government would be lost with the efficiency of using electronic medical records for billing purposes.

The book I read several years ago written by an American diplomat that had a chronic medical condition sought consultation and treatment in each of the foreign countries where he was posted. The one system that impressed him was in France.  French citizens are covered under universal healthcare and carry a plastic card the size of a credit card that contains the complete medical history.

When obtaining medical services, patient submits his card for the doctor or technician to enter the purpose of the visit that updates the medical record using a coding device to automatically bill for the service. The patient pays a nominal co-pay as he leaves the office and the doctor or technician receives payment automatically to his bank account within five days.

No paperwork and a reduced cost of medical care.

I don’t believe any of these efficient cost savings are built into the proposed Affordable Care Act now being debated in Congress. Whatever legislation is passed will just be more of the same old-same old high cost of medical services as long as the insurance companies can influence the legislation.

Is this fair to the underpaid, under-served public? What are those Congresspersons thinking when they vote against equal universal coverage for all citizens or impose limits of coverage? It is one of the most self-centered political obstacles of gridlock in Congress today.

Meanwhile millions of American continue without medical insurance or threatened by cutbacks in coverage. Congresspersons should be given the same treatment for their medical coverage and discover how inequality feels.