During the general election last year, then-Sen. Barack Obama and his rival, Sen. John McCain, met in Nashville, Tenn., for a "town hall" format presidential debate. Midway through the proceedings, a woman named Lindsey Trellow asked Obama one of the most cogent questions of the campaign: "Senator, selling healthcare coverage in America as a marketable commodity has become a very profitable industry. Do you believe healthcare should be treated as a commodity?"

Both candidates danced around the issue for a few minutes before debate moderator, Tom Brokaw, muddied the waters with a follow up question of his own. Today, as Congress considers a major overhaul of the healthcare system, this fundamental question is still off limits in political circles and the establishment media.

Despite all of the high-minded rhetoric and political posturing on either side of the aisle, the central question of whether we should treat healthcare as a marketable commodity or as a fundamental human right is the proverbial elephant in the room: Everyone knows it's there, but no one wants to talk about it.

Instead, congressional Democrats and Republicans try to score political points with the electorate through incremental reforms, such as putting medical records online and other "cost-cutting" measures, that leave the status quo unchanged.

"Corporate media frame the healthcare debate in terms of winners and losers among the political class in Washington."

For its part, corporate media frame the healthcare debate in terms of winners and losers among the political class in Washington. This "insider baseball" style coverage makes for good copy, but it reduces substantive policy deliberations to a spectator sport.

The result is a lopsided policy debate that fails to address the root causes of the healthcare crisis: a system predicated on profit making rather than cost-effective, high quality universal healthcare.

According to Ellen Shaffer, co-director of the Center for Policy Analysis, "Private insurers, drug companies, hospital chains and equipment suppliers are able to soak up every dollar we might save. Instead of reducing costs, potential savings are diverted into high administrative expenses and profits. As a result of our fragmented, investor-driven system, the U.S. pays higher prices per unit of service compared with other countries."

Shaffer believes that the solution to the rising costs of healthcare, and the alarming number of uninsured Americans, is a single-payer option. "The most effective reform would be to improve and extend Medicare's ability to control costs to all Americans. A single-payer system is the most reliable, proven route to the costs savings and the improvements in quality and good health we so desperately need."

"The result is a lopsided policy debate that fails to address the root causes of the healthcare crisis."

Nevertheless, a single-payer healthcare program -- one that would replace the for-profit system with a government program that guarantees healthcare to all Americans -- is considered a political nonstarter. Indeed, advocates of single-payer system had to apply enormous pressure on the White House to even get an invitation to Obama's health care summit a few months ago. And just the other week, single-payer advocates were compelled to disrupt the Senate Finance Committee hearings and some were arrested in an effort to put a single-payer option "on the table."

Appearing on Pacifica radio's Democracy Now! Rose Ann DeMoro, the executive director of the California Nurses Association, one of the leading organizations advocating single-payer healthcare, claimed there is a "conspiracy of silence" surrounding the single-payer option. In light of how little traction the single-payer option gets in Washington, and the paucity of fair and accurate reporting of this healthcare reform approach in the mainstream press, DeMoro's conclusion is hard to deny.

And yet, despite political stonewalling and a news blackout, recent polls indicate that a majority of Americans favor a single-payer system. Makes you wonder what the healthcare debate would sound like if the single-payer option got a proper hearing.

In the coming weeks, President Obama will launch a major public relations effort to promote what can only be described as an incremental approach to the healthcare crisis. To borrow a phrase from Obama's stump speech, "This is our time" to let the President, the Congress and the healthcare industries know that technical fixes and half-measures aren't the sort of change we had in mind last November.

Kevin Howley is associate professor of media studies at DePauw University. He can be reached at khowley@depauw.edu.