I have a 2003 F550 with the 6.0 Powerstroke. After I bought it about 5 years ago I figured out it had blown head gaskets. Turns out after I tore it down it was blown head gaskets, cracked heads, worn out tubocharger among a few other things. I did the work myself and the bill was about $4500. Works great now. A lot of folks poo-poo the 6.0, but from what I've seen and heard from knowlegable peaople, if you take care of the maintenance and don't hot rod it it is a good engine. Since the price of diesel fuel is now consistenly higher than gasoline, any economic incentive to own a diesel is gone. I had to buy a replacement, since I can no longer use it as a truck (CA commercial emissions rules) and this time I bought a gasoline truck. The only reason that I would buy a medium duty truck with a diesel is if I planned on running it heavily loaded for most of it's life. Otherwise it makes no sense. Don't get me wrong, I do love that F550, but higher purchase, maintenance and fuel costs are way more than the savings from any improved fuel mileage. It gets 6.5 mpg with my Lance 1161 camper on it, so I don't know how much worse a gasoline truck would be but it couldnt be much..