I'm not going to belabor this, but the causes for the advice received are simple:
1) The uncertainty attendant on offering less than "the best care" available--which is, of course, driven by the public, reinforced by the legal profession, and often mandated by law;
and 2) The facilitation of offering that "best care" by the evil old insurance companies (which are threatened and controlled by state legislation and regulation) and Medicare (the greatest vote-buying machine ever instituted by the Federal government). My heart condition lies just within the boundaries which qualify one for the implantation, so how would any physician who values his license not recommend this "care"? The boundaries are set, in my case, by Medicare, and ignore whatever particular problems exist, looking only to the patient's ejection fraction.
I note again that some of this nonsense is going to change once medical expenses become more of a drain on the public treasury and a direct expense to the Federal government, but the changes will not be what those who deride the health care system imagine and/or advertise to others.