To the editor:
As a physician, I must take issue with letter writer Joseph Merlino’s assumption that a “$150 annual physical” would have found his vocal cord tumor (“Affordable Care Act saving lives,” April 19 Review-Journal). Annual physical exams do not include vocal cord examinations, which require laryngoscopy.
The type of tumor Mr. Merlino had would not have been investigated unless and until a symptom showed up, i.e. voice changes. An annual physical would not have changed the trajectory of his illness. His anger at what happened to him clearly comes through in his letter, and I sympathize with him on that. However, the argument that eliminating routine medical exams from the Affordable Care Act would cost lives is not supported by his experience.
And I always take issue with headlines that read, “ACA saving lives.” For how long? Forever? How much does that time cost us as a nation? What is the cost per month or year of “extra” life? That is the real question that we need to answer, and that is the one no one wants to address, because it’s about money, not lives.
Passionate personal experiences such as Mr. Merlino’s are what are driving medical care in this country. But they should not do that. On the national scale, cooler heads must prevail, because we have limited resources that must be shared by all. I realize this sounds unsympathetic, and I can hear people saying, “It’s different when it’s you.” I know it is; I see that every day with my patients. I try my best to help each patient individually in the most thorough and compassionate way that I am able. But that is a personal, one-on-one interaction, not a national one. Scale is everything.
In my opinion, the ACA will destroy our medical system. It is geared toward turning medical care into an industry, and all of us — doctors and patients alike — will become tiny cogs in a giant grinding machine.
JOSIE DALUGA, M.D.
Nevada Medical Center
To the editor:
Regarding John L. Smith’s column on the proposed Nevada Medical Center project (“Hilton focused on medical center,” April 19 Review-Journal), it’s nice to hear that someone like Eric Hilton is interested in placing a medical center in Las Vegas. It will provide jobs, local medical care for major operations and illnesses, and extra income that doesn’t come from “spare money” tourism.
It will also create residual jobs in the form of construction both on the property and off, as stores and other service-based jobs will need to keep up with the increased demand of population growth.
However, I do have some concerns with this plan. First, Mr. Hilton is talking about placing a medical center in the downtown medical corridor, which doesn’t have the room for this type of facility. A facility like this needs to be expansive: the Texas Medical Center in Houston is 44 million square feet, the Mayo Clinic in Rochester, Minn., is 15 million square feet. So the Nevada Medical Center needs to be as large, or larger, than these centers to compete.
The center needs to be pushed to the outskirts, where there is room to grow.
My second concern is that existing hospitals have not proved to be financially stable. When a hospital lacks funds, it cannot stay updated. Equipment gets old, breaks down and becomes obsolete. Staffing gets cut, so care to the patient and the facility declines, which means fewer and fewer patients will make the trip to Las Vegas to use the center, and the center will become a money pit.
This project would give a new look to Las Vegas and could potentially be a positive change for all involved. I just hope the research is done, experts consulted and proper time and energy is given to the details that will make it a success.
NORTH LAS VEGAS