Medicaid. Is it being abused? - page 15

Medicaid was a great idea when first introduced to assure that even the very poor could get quality health care. I just wonder when I see someone drive up in a newer car come up to the triage desk... Read More

  1. by   mercyteapot
    Quote from irishnurse67
    Different than me? I could tell you stories about my childhood that would make your hair stand on end! Instead of saying poor me, I act w/the morals of someone who had a priviledged upbringing.
    Since when is it ethical (or legal?) for us as nurses to apply our personal morals to decisions concerning the care of others? If you have some problem prescribing the patch because you think that Medicaid patients should have to pay for it themselves, you should be handing those patients over to a nurse who is able to make the decisions based on what's appropriate given the pt's history, s/s, etc. That is just grand that you pulled yourselves up by your bootstraps, but which day in nursing school did they tell you to use that as criteria in deciding an appropriate course of tx?
  2. by   irishnurse67
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    Last edit by irishnurse67 on Apr 17, '06
  3. by   DutchgirlRN
    You betcha!!!!
  4. by   mercyteapot
    Quote from irishnurse67
    So I guess it doesn't count when I pay for cabs or actually give rides home to pts who have no family. I guess it doesn't count when I stop at the drug store on the way so they don't have to hobble in and out. And I don't apply my values to medical decisions. As much as I'd like to, it's against the rules. When the heroin addicts come to my hospital, they actually ask for me b/c the other nurses are mean to them, they say.
    You did tell us you applied personal decisions to medical care in an earlier quote. You said something along the lines that because you stopped cold turkey, patients shouldn't be able to have the patch. You can't make statements like this and then act hurt and confused that we seem to be "misunderstanding" you. And as far as paying for a cab for patients, what is that you want it to "count" for? It makes you a nice person, perhaps, but speaks nothing, pro or con, to your professional ethics.

    EDITED TO ADD: I was mistaken about the deleted post. It is still there. Sorry.
    Last edit by mercyteapot on Jan 7, '06
  5. by   Multicollinearity
    Quote from irishnurse67
    So I guess it doesn't count when I pay for cabs or actually give rides home to pts who have no family. I guess it doesn't count when I stop at the drug store on the way so they don't have to hobble in and out. And I don't apply my values to medical decisions. As much as I'd like to, it's against the rules. When the heroin addicts come to my hospital, they actually ask for me b/c the other nurses are mean to them, they say.
    You applied your values to a medical decision today by rebuffing this woman's request for a script for the patches. Your reasoning was "free for her, not for me" rather than a strictly medical reason.

    While what you have stated above is to be applauded, it has absolutely nothing to do with denying a woman's request today based upon political beliefs rather than medical ones. Admit it, you screwed up.
  6. by   hipab4hands
    Quote from irishnurse67
    So I guess it doesn't count when I pay for cabs or actually give rides home to pts who have no family. I guess it doesn't count when I stop at the drug store on the way so they don't have to hobble in and out. And I don't apply my values to medical decisions. As much as I'd like to, it's against the rules. When the heroin addicts come to my hospital, they actually ask for me b/c the other nurses are mean to them, they say.
    I know your heart is in the right place, but you are putting yourself in a dangerous situation by transporting patients home. If you get into an accident you are going to held responsible. It also sets up an unrealistic expectation for the patients. If you provide rides, then the next time the patient needs a ride, they are going to expect staff to give them one.
    Personally, I don't feel any responsibility for transportation. If there is a problem, then Social Services needs to be involved or Discharge Planning needs to make arrangements. You shouldn't have to pay out of your own pocket.
    As far as the heroin addicts personally asking for you, I know it feels good to be someone's favorite nurse, but these folks are also some of the most manipulative patients. My guess is that the "other mean" nurses, probably won't drive them home or pay for a cab for them.

    Take care.
  7. by   irishnurse67
    Quote from mercyteapot
    You did tell us you applied personal decisions to medical care in an earlier quote, which I see you have now deleted. You said something along the lines that because you stopped cold turkey, patients shouldn't be able to have the patch. Hopefully someone who has replies emailed to them has saved this, in case you are going to argue the point. You can't make statements like this and then act hurt and confused that we seem to be "misunderstanding" you. And as far as paying for a cab for patients, what is that you want it to "count" for? It makes you a nice person, perhaps, but speaks nothing, pro or con, for your professional ethics.
    q
    Last edit by irishnurse67 on Apr 17, '06
  8. by   Multicollinearity
    Quote from irishnurse67
    Like I said, the pt didn't want to wait for the script after her friend told her the price of the patch. (Guess she thought it was more expensive than it is.) If i deleted something, didn't mean to. I'm retarded when it comes to computers. I didn't mean to come off as hurt and confused. It takes a lot mre to hurt and confuse a nurse. Although it's true I think the patient should pay a co-pay for the patch, it isn't b/c I could quit cold turkey (although now that I read my post, it may have sounded that way), it's b/c if she could pay $8 a day for butts, the patch would be a bargain!
    By your own words she asked you twice, and after your response she didn't ask again. Why would she think she might get the Rx then?

    Also, you have every right to think she should have a copay. But when you say the things you said, you are substituting your own political beliefs for medical care. You are her RN, not her personal budget hawk.

    Admit it, you screwed up.
  9. by   mercyteapot
    Quote from irishnurse67
    Like I said, the pt didn't want to wait for the script after her friend told her the price of the patch. (Guess she thought it was more expensive than it is.) If i deleted something, didn't mean to. I'm retarded when it comes to computers. I didn't mean to come off as hurt and confused. It takes a lot mre to hurt and confuse a nurse. Although it's true I think the patient should pay a co-pay for the patch, it isn't b/c I could quit cold turkey (although now that I read my post, it may have sounded that way), it's b/c if she could pay $8 a day for butts, the patch would be a bargain!
    You didn't delete anything; I'm sorry, that was my mistake, made in the haste to reply. I should have checked more carefully.
  10. by   irishnurse67
    Quote from multicollinarity
    By your own words she asked you twice, and after your response she didn't ask again. Why would she think she might get the Rx then?

    Also, you have every right to think she should have a copay. But when you say the things you said, you are substituting your own political beliefs for medical care. You are her RN, not her personal budget hawk.

    Admit it, you screwed up.
    q
    Last edit by irishnurse67 on Apr 17, '06
  11. by   Multicollinearity
    Quote from irishnurse67
    I had a pt today who wnted me to get the MD to write a script for a nicotine patch. I told he "Oh no honey, you don't need a script for that-you can buy it over the counter!" She told me she knew this but if the MD gave her a script, then Medicaid would pay for it and it would be free (free for HER, I think she meant!). I told her that the patch would be MUCH cheaper than two packs of cigarettes a day. She didn't ask for the script again. I should've told her to do what I did-quit cold turkey!
    Well, your story seems to have changed. In your first post you boasted that after you told her the patch is cheaper than her cigs she didn't ask again.

    I'll leave this topic now.
  12. by   irishnurse67
    Quote from multicollinarity
    Well, your story seems to have changed. In your first post you boasted that after you told her the patch is cheaper than her cigs she didn't ask again.

    I'll leave this topic now.
    I
    Last edit by irishnurse67 on Apr 17, '06
  13. by   grannynurse FNP student
    Quote from irishnurse67
    The federal poverty guidelines DON'T apply in Massachusetts when it applies to MEDICAID. You can make 150% of the federal povery guideline, own your own home if it's worth less than $400,000 market value (if you, your spouse or your disabled adult child lives in it),and own a car worth $8000 or less. Please check your facts-I did w/a social worker. You said the cost of an OTC script is the world to her, but like I said--IT'S CHEAPER THAN HER 2 PACK A DAY HABIT!!!!! And it is up to me when it's for something unnecessary b/c I pay for it even though she is able-bodied, besides-I QUIT COLD TURKEY!
    I'm sorry but here in Florida income eligibility for Medicaid is much less then it is in Massachusetts, or even my old home NYS. One cannot own a $400,000 home without signing it over to the state, or an $8,000 car, or having a bank account with more than a few hundred dollars-the exact amount escapes me right now. And yes, the eligibilty requirements vary from state to state. And down here, in the South, they are much stricter. And like I said in another post, you want to save a few of your taxes dollars, only to have to spend many more, at a later date, when your patient requires hospitalization for her COPD or lung cancer.

    By the way, I'm happy you quit cold turkey. I wish my daughter and SIL could but apparently they lack that ability. And there are many others that lack it as well. And if Medicaid will pay for the patches, so be it.

    Grannynurse

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