The issue boils down to this: Are those with chronic conditions, like Diabetes, one of the primary causes of an almost unfathomable increase in healthcare costs and the corresponding jumps in health insurance costs?

I think not. Other, much more substantial, causes exist. Start first with the insurance industry itself. In this country built on capitalism, why must the vast majority of healthcare costs and the subsequent quality of service be based on a nearly monopolistic stranglehold by a very few companies - i.e. insurance carriers? Okay, maybe I'll drop the harsh term of monopolistic in favor of oligopolies based on collusion.

Too, why must drugs be so expensive in the U.S.? I understand the need for R&D, but I ask Big Pharma not to hide behind R&D as to why they charge high prices for their drugs. One reason is the outrageous amount of money spent on promotion for drugs we usually don't need for conditions we never knew that we had and probably could survive without knowing that we did have them. Pharmaceutical companies spend nearly double on promotion than that of R&D. Let me repeat that: for every dollar of R&D money spent, Pharma spends almost two dollars on marketing.  I can't watch the 30 minute segment of Charlie Gibson's ABC World News without being bombarded by drug ads. Much to my chagrin, "Viva Viagra" is my 11-year-old son's favorite jingle.

Finally, shouldn't we Americans consider tort reform when it comes to healthcare? Maybe that will help to curb practitioners feeling the need to have every decision they make be backed up by expensive and often unnecessary tests and procedures. It's a well known fact that John Edwards and his focus on cerebral palsy cases contributed to the incidence of Caesarian Sections to increase by 22 percentage points from 1970 to 2003. 

I've only glanced across the surface of the deep mired pool of the culprits that shoot our healthcare costs sky high. Many, many others exist.

Yet, for those wearing the Scarlet D or whatever other letter, rest assured you are not the sole or even primary cause for the astronomical cost of care. So get out your scissors, snip off that letter, and consider yourself absolved.