[Anthony]

Excaliber, What ?, No Response ?

It's very unusual not for you to have a response/comeback.

All this talk about dying, you repeatedly stating people are dying left and right due to lack of insurance, medical care, as well as the need to reduce unnecessary medical care by letting people die.

Is it getting a little too personal of a topic for you? Well, I deal with death and dying almost on a daily basis, more like a weekly basis, not like other doctors where it is an everyday issue.

Well, I'll talk about 3 little stories I've witnessed within the last month, about people dying, and medical care.

The first is an old patient of mine, someone who I had treated 3-4 years ago for a specific problem. He came in within the month to catch up on things. Anyways, in 10-11/09, he began having symptoms of nausea and vomitting. He does have medical insurance, touted by some as excellent, state of the art care, Veteran's Administration (VA) care. He doesn't have private insurance, and payed me $50 for the office visit to see me the other day. Anyways, he goes to his primary care doctor, at the VA clinic, with these symptoms a couple months ago. The doctor runs some tests, all normal. Over the next week, the symptoms comtinue, and gradually get worse, so he goes back to his VA doctor who orders more tests and places him on medications. Still, no improvement with his symptoms still getting worse. He goes back to his VA doctor a couple more times for more tests and medications, without any improvement or definitive diagnosis. At this point, over a month later, he is losing weight because of his nausea, inablility to eat, so his VA doctor tells him to instead go to the nearby private hospital ER (remember he doesn't have insurance to cover this). He goes there, they immediately get a CT scan of his abdomen and diagnose him with pancreatic cancer. Now, he's going back to the VA, a different VA center, for cancer treatment. I donlt think he's too worried about his hospital bill, and the hspital is probably not too worried either. How do you think of government run healthcare handled his problem?

Story #2. About two weeks ago, my brother (10 years younger and who has private insurance) woke up sunday night at 3 AM with severe nausea. He doesn't remember much after that, other than laying on the bedroom floor in a semi-conscious state, with crushing chest pain, with his wife and kids crying and screaming around him. Ambulance came, and took him to the closest hospital with cardiac services, where he was diagnosed with a heart attack, and he had 4 stents placed early that AM (5-6 AM) by a cardiologist who emergently came in to help him. He's OK now. He's vowed to stop smoking and to start eating healthy.

Story #3. Another middle-aged patient of mine is now on the kidney transplant list, put on the list over the last month. He was a severe alcoholic, and developed chronic pancreatitis which "burned up" his pancreas, and therefore his insulin making cells, and became a diabetic. He didn't watch/manage his blood sugars well, and went into kidney failure and has been on dialysis for many years, all due to his own actions, and has been on SSI disability for years and Medicare. Now he is on a kidney transplant list. If he lived in any other country (France,etc.), they never would have put him on dialysis, and would have let him die as a complication of his alcoholism, diabetes, and renal failure, and nobody would have questioned it, FACT. Here in the US, everybody with kidney failure has the option of dialysis, and in his case, transplantation as well (you also talk about trransplants almost like you're an expert on the subject- I've done-participated in kidney, heart, lung, and liver transplants myself)

I've worked in several VA hospitals, and I don't remember anything ever done on an emergent basis, especially on a weekend. In the one VA hospital, the lab department shut down every weekend, no matter there were patients in the ICU. Do you think the VA system can provide care like my brother received? Do you think any government run system can provide care like he received? I'm guessing that anybody who's in the same situation as my brother will probably receive the same care no matter their insurance situation. I don't think care like my brother received is the norm in the rest of the world. And, the medical care of patient #3 is definitely not the norm for around the world.

I believe you have good intentions, but there are many variables and unforseen issues with a government run healthcare system, systems that I have alot of experience with already, that it's hard to see any good coming from trying to control the private healthcare system.

If anything needs reform, its the government run healthcare systems already in place. The problem that nobody wants to face is the increasing cost of medical care due to mainly more and more people put on government run healthcare programs, and more and more medical care available to help people. It's going to cost more money no matter what, and there's not much waste in the system. Just because you "think there is", along with Obama, doesn't mean that it is true, and I can tell you it isn't true.

You and many others wish for more government control of our healthcare, thinking it will be alot better. I don't agree.

I hope you and your family do well over the years. If you are unfortunate enough ever to witness first hand a medical crisis in your family, and I hope you never do, you will never know if more really could have been done or not, and with every additional increase in control the government places on healthcare, the less options will be availble for all of us, like what happened to my employee's father who lives in Canada, who was initially denied treatment for his heart attack, but that's another story.

Finally, I brought up "Iatrogenic" causes of death, and you brought up some studies. First, I believe most people die from diseases from their own actions/choices in life, like my brother and patient #1, including heart disease, cancer, etc, and therefore I would say people in general are killing themselves from their own stupidity, not primarily from any medical care needed to treat their own self inflicted disease. Second, I have unfortunately seen many patients die, and it really is very rare that a mistake in medical care results in the death of an individual. Believe what you want to believe.