By Matthew T. Mangino

There is a crisis in America. Two-thirds of the states in this country, and the federal government, are spending billions of taxpayer dollars caring for a small group of people in need of a rather simple medical procedure.

Although there are about 3,000 people waiting on the procedure, only about one-quarter of one percent receive the inexpensive procedure each year. As the cost for caring for these people increases annually - about $4.5 billion a year - the number receiving the procedure has decreased to a 25-year low.

The selection process has been labeled arbitrary and each and every recipient is tied up in years and years of litigation. The layered government bureaucracy begins at the county level and often ends up in the lap of the U.S. Supreme Court. The process is so flawed that medical practitioners want nothing to do with it.

Where is the outrage at this ridiculously dysfunctional government initiative?

Outrage? On Election Day, California, Nebraska, and Oklahoma had an opportunity to abolish the death penalty - the state-sponsored medical procedure used to end the life of condemned killers - and all three states declined. In fact, voters in California voted to speed up the execution process.

That is not a complete surprise. A Gallup poll in October found that support for the death penalty has remained consistent at about 60 percent. That number is still a solid majority of Americans, but far below where it was in the 1990s, when about 80 percent of Americans backed the death penalty.

If this were a medical procedure to save lives - as opposed to snuffing them out - and managed in a patch work of statutes and policies, congressional hearings would be convened and ultimately heads would roll ... so to speak.

If this were a life-saving medical procedure, the medical profession would adopt a best-practice and the process would be standardized and uniform. But then, medical standards are not promulgated by the legislature. Politics - posturing, looking tough, and getting re-elected - is not part of the equation in the medical profession.

Even though there are signs that some lawmakers and a majority of the public do not want to see the death penalty abolished, the decline is obvious.

There were only 20 executions nationwide this year - the fewest number in the United States in a quarter century. Executions have dropped dramatically from the late 20th-century peak of 98 in 1999.

Not only have executions dropped, the number of death sentences being imposed have declined even more precipitously. There will be a total of 30 new death sentences this year, the lowest number since the Supreme Court struck down the death penalty in Furman v. Georgia in 1972. According to the Washington Post, in 1996 juries in death penalty states across the country handed down 315 death sentences.

Just five states carried out executions this year. Sixteen of the 20 executions were carried out in only Georgia and Texas.

In Pennsylvania the process can only be described as bizarre. Gov. Wolf has declared a pseudo-moratorium on executions, an action for which the governor was skewered by lawmakers and prosecutors alike. In fact, the Philadelphia district attorney sued him to start re-imposing executions.

This in a state that has executed three people since the new death penalty statute was enacted in 1976. All three men volunteered to be executed. They waived their appeal rights and sought to be put to death. The last involuntary execution in Pennsylvania was in 1962.

Pennsylvania officials are fighting about something that, for all intents and purposes, will not happen any time soon, if ever. The time may be at hand to end the insanity of the death penalty.

Matthew T. Mangino is of counsel with Luxenberg, Garbett, Kelly & George P.C. in New Castle, Pa., and the author of "The Executioner's Toll, 2010." @MatthewTMangino