Most people are quite satisfied with their health insurance and, should they stumble on Wonks Anonymous, probably wonder: Why this guy is so shrill? What is he talking about?

Well, the fact is that most people have no intimate knowledge of their health insurance. Their employer bought it for them or they bought insurance through an agent who assured them everything was O.K. and they have never been sick enough to have to use it.

On the other hand Wonks Anonymous has spent over a decade running data for major health care/insurance provider. Where most people have a sample of one, maybe two or three, Wonks Anonymous sees a sample of millions. It is not likely that you will have a major illness or medical emergency. At the same time very many people will have this misfortune.

If you do get unlucky and you are covered by a high out of pocket plan - and these plans are becoming all too common - you will find your finances strained to the point of bankruptcy. It is highly likely that you will be in debt for the next decade if you manage to pay back all that you owe.

Your health care provider and the hospital that you go to will provide care. They will feel deep compassion for your plight. They will also have to pay their own bills. There is nothing more draining and ugly than collecting payments from the sick and the poor.

Which explains why doctors and hospital administrators are so acutely sensitive to the problem of inadequate health insurance. I quote Sue Currin, SF General CEO from the SF Comical:

But if you were to ask anyone who works in a public hospital, or the woman described above or the thousands more like her who come to our public hospitals each day seeking care, that person would tell you that the health care insurance system is, in fact, quite broken. We all see firsthand the toll that this national health care crisis takes on our communities.

Every day, patients come to our public hospital ERs and clinics who have no health insurance and who have gone for much longer than should be acceptable without care for serious, sometimes life-threatening health conditions. They arrive seeking treatments and tests that many of us take for granted - such as antibiotics, medications for high cholesterol or diabetes and mammograms - or for chemotherapy or radiation they need to fight a cancer diagnosis.

These problems aren't limited to the chronically uninsured. We also are treating patients who are turning to us because they have recently lost their jobs and their health insurance. And there are so many more who do have health insurance, but their deductible or out-of-pocket expenses are so high that, for all intents and purposes, they have no coverage because they can't access medical care.

Anyone who sees what we see every day would understand that the need to make changes in the health care system and insurance market is urgent. As leaders in the Bay Area public hospital systems, my colleagues and I are proud of the special role that our hospitals play and are deeply committed to continuing to be there when people need us - to provide needed primary and specialty services and the trauma and burn care upon which our communities rely. But the magnitude of the problem demands that action - serious action - be taken.

Which is why Wonks Anonymous will continue to be shrill.