Reasons for Not Seeking Care

While I embrace Dr. Melvin Kirschner’s appeal for a national health insurance program and feel that such a program should be an entitlement to all inhabitants in a “civilized” country, one must be careful not to assume that the lack of health insurance was the proximate reason why the two unfortunate individuals in his essay didn’t wish to be transported to the hospital and to undergo an evaluation there (Voices, Dec. 25).

Denial of illness is far and away the major reason people do not agree to medical treatment. During the 30 years in which I have practiced medicine, I have seen many patients refuse evaluation and hospitalization. In every case, they have had medical insurance. They have also had many fears, dying being the most significant one. Denying that you are ill, especially that you may be having a heart attack, allows one to feel that the symptoms are attributable to a minor problem, one which may be more simply remedied. In other words, “I’m not really having a coronary, just a pulled muscle, or indigestion.” Patients, on occasion, will sign themselves out of an emergency room against medical advice, only to die before they even reach home.

ALAN MILLER MD

Riverside

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I agree with Kirschner; health insurance for profit has to go. If our Congress can have 100% health coverage, the people who have voted them in should also have complete coverage.

MANUEL ABRAMSON

Monterey Park