Patients on Medicaid

Nurses Relations

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rph3664

1,714 Posts

I also don't expect to pay a penny before I see the doctor in a doctor's office setting. That's just bad business. lol

My doctor also requests payment up front. My attitude is, "I'm going to pay anyway, so might as well get it over with now." I'm guessing they've had people walk out the door without paying, so that's why they do it.

JMHO.

banditrn

1,249 Posts

A personal observation...I work with an aide who has 1) a brand new truck 2)has the cell phone that you put in your ear to wear 3) has gone on two cruises in the past 6 months 4) just moved into a new house last summer and 5) cannot afford to pay for health insurance so the kids are on a state-funded insurance program and she goes to the free clinic. So why am I driving a 5 year old car and paying $400 per month plus a $4000 deductible for health insurance???

mc3

mc3 - We drive a 4 year old vehicle, and my insurance costs me $645 monthly - just for me. I could care less what other people do with their money - I don't have bill collectors calling me, and I sleep at night.

I do understand your frustration, tho. I'm afraid it's just the way our culture is becoming - there is little pride left in taking care of yourself without entitlements.

woody62, RN

928 Posts

Specializes in icu, er, transplant, case management, ps.

I hear ya Woody.

Fortunately, when I have had to go into the ER or the hospital, no one has asked me about my insurance, except the insurance lady, regardless of whatever it has been here in Charlotte County, Albany County, Chattanooga or San Diego County. And I have visited ER's and/or been a patient in all those places. And all since I have been on disability. And none of the staff, when I was an inpatient asked either. And for the most part, the care I received was good to excellent.

And when I worked, I was interested in my patient's insurance only when making discharge plans for him/her. Other wise, everyone got treated the same, rich or poor, Medicaid, private pay or health insurance. It wasn't part of my problem to be interested in how the patient paid. And if he got an attitdue, he got sweetness back tripl4e. It usually shut him right down. I understand that there are patients and families that play havoc on the staff. But responding in kind usually results in behavior in kind. Or so I have observed. The only time I have gotten an attitude is when either I or my parents have bveen treated in a less then respectful manner. Or have been verbally abused or treated as if we didn't have a brain. Just remember, I may be getting up there in years but my mind is still very alert. More then likely much more then yours is. Just try to remember that the next time.

Woody:twocents:

sharona97, BSN, RN

1,300 Posts

Specializes in IM/Critical Care/Cardiology.

Gosh Woody,

I'm on your side and you sound like I might have been dissing you. I'm not. I was referring to a company in Charlotte County. And this was in response to your post about the disastors of Hurricaine Charlie.

I think you misread or possibly misunderstood where I was coming from.

I totally agree with your last post, it was the tone of it that I am responding to now.

Sorry if it came across a way different issue than intended.

Sharona:typing

Susan9608

205 Posts

I had one man get mad and slam the IV machine to the floor and busted it (he was ETOH detox)

ETOH detox? It's no wonder he was belligerent and abusive. You can't really expect reasonable, rational behavior from someone detoxing. If you're an ER nurse, I'd think you'd already know that.

Perhaps he was an alcoholic. If he was detoxing that badly, it certainly sounds like he was. Alcoholism is a disease. Alcoholics need treatment, not attitude from their nurses about their financial status.

It bothered me that he lays at home drunk, then gets a free stay in the hospital with phenobarb, ativan, etc. While he lays drunk, Im working.

I really think you'd rather have your life of work than the life of an alcoholic, don't you? Even despite their many perks of getting to lay in the hospital with phenobarb and ativan?

And my tax dollars pay for this.

Yes. And if something happened to YOU making you unable to work, then other people's tax dollars would go to support YOU.

It doesn't have to take major calamity to bankrupt someone. I had my appendix out last year, and the bill was $36,000. $36,000 for a relatively minor procedure. Had I not had insurance, it would have taken a HUGE chunk out of our savings. For minimum wage workers without insurance who don't qualify for Medicaid, that one bill alone would be enough to keep them from ever being able to save and gain ground. Then, if something else happened on top of that, it would just set them back more.

Perhaps there are people who abusive the system. I have no idea - I don't have the pleasure of knowing the ins and outs of everyone's financial status and what exactly they pay for vs. what welfare/medicaid pays for. But if people do abuse the system, doesn't that say more about *those* particular people than the system itself? Why should all of the rest of the population suffer and do without (often times through NO fault of their own) because of a few dead beats? How is that fair?

And why is everyone who's so against Medicaid/welfare so reluctant to see that the same thing could happen to them one day?

Katie82, RN

642 Posts

Specializes in Med Surg, Tele, PH, CM.

[quote=puddingpie;2376874

Rudeness comes in walks of life, rich or poor.

AMEN - I recently moved to the rural south from Maryland, where I lived in one of the most affluent counties in the country. Most of my neighbors were inexcusably rude. They were impatient and demanding and all thought they were my only patient. They were much too busy to wait in line or wait their turn. THey allowed others to raise their children, then blamed everyone when they turned out to be brats. Of course, not everyone was like that, just as not all poor people on Medicaid are rude and demanding. But having known both groups, I would prefer to work with southern Medicaid any day. At least I can rationalize their bad behavior with poor upbringing and lack of education.

Altra, BSN, RN

6,255 Posts

Specializes in Emergency & Trauma/Adult ICU.
ETOH detox? It's no wonder he was belligerent and abusive. You can't really expect reasonable, rational behavior from someone detoxing. If you're an ER nurse, I'd think you'd already know that.

But you can bet your sweet bippy that I have every right to expect my work environment to be safe - including my personal space and the equipment that I need to take care of others

Perhaps there are people who abusive the system. I have no idea - I don't have the pleasure of knowing the ins and outs of everyone's financial status and what exactly they pay for vs. what welfare/medicaid pays for. But if people do abuse the system, doesn't that say more about *those* particular people than the system itself? Why should all of the rest of the population suffer and do without (often times through NO fault of their own) because of a few dead beats? How is that fair?

And why is everyone who's so against Medicaid/welfare so reluctant to see that the same thing could happen to them one day?

Perhaps???

While each & every individual on this planet is indeed responsible for his/her own behavior, the system encourages dependence and lack of personal responsibility.

If you had Medicaid in my state, and both office PCP visits and ER visits were covered, but PCP visits required some advance planning and personal responsibility to make and keep appointments ... but the ER will see you whenever you show up when it's convenient for you ... which would you do?

Before you answer, please spend 90 minutes in triage with me, at your convenience. :stone:banghead:

SharonH, RN

2,144 Posts

Specializes in Med/Surg, Geriatrics.
I believe there are many people uninformed/misinformed about what the Government considers a Disability. I've posted this before in another thread, but I will post it again.

Am I Disabled?

Anyone can apply. If you feel you are disabled, it's free to put in an application.

The Government is very strict though. Believe me, they would rather have people working.

'

Amen to this. If anyone out there thinks it is easy to get disability, then I urge you to walk with someone through the process. You will eat your words before you get through the first application. I know this because I work with people too sick and disabled to even take care of themselves but they are routinely turned down for disability. My own mother, a nurse, went blind and she was turned down twice before she got a lawyer. This for a woman who had worked full-time from the time she was 16 years old and for 35 years was never without a job. Never.

Simplepleasures

1,355 Posts

Oh,SharonRN ,I cant thank you enough for posting this.I have been on the waiting list for an ALJ hearing for 19 months. If not for my wonderful children I would be homeless, they pay a portion of my rent,buy my food, I go to a free clinic for medical care. I was denied at age 54 1/2, was told by disabilty examiner denial was based on my age and education, not that I was not disabled. SSDI uses an antiquated sytem of "grids" that they put applicants into, if one does not fit EXACTLY into this "grid", they are denied on initial application. While 65 % of intitial applicants are denied , 65% of them are approved at a ALJ hearing. What is wrong here?

I too worked in LTC as a nurse for almost 30 years, beacme disabled and lost savings, due to medical debt. In WI ,one cannot get Medicaid until one is approved for SSI or SSDI, so those in the nearly two year waiting list for a hearing are unisured. Much reform is needed in our health care system.

http://groups.msn.com/SocialSecurityDisabilityCoalition/general.msnw?action=get_threads

Above is a link to a SSDI support group, read some of the accounts posted here, will open your eyes to the reality of those struggling to get SSDI.

rph3664

1,714 Posts

'

Amen to this. If anyone out there thinks it is easy to get disability, then I urge you to walk with someone through the process. You will eat your words before you get through the first application. I know this because I work with people too sick and disabled to even take care of themselves but they are routinely turned down for disability. My own mother, a nurse, went blind and she was turned down twice before she got a lawyer. This for a woman who had worked full-time from the time she was 16 years old and for 35 years was never without a job. Never.

Unless your primary diagnosis is drug addiction, morbid obesity, back pain, or attention deficit disorder; in these cases, you walk in the door and say you have these conditions, or you encourage your children to misbehave in school, and BINGO! Instant SSI. Or so it seems.

Susan9608

205 Posts

but the ER will see you whenever you show up when it's convenient for you ... which would you do?

I'd do the same thing I do now. My own insurance pays for both PCP visits and ER visits and PCP visits require advance planning, sometimes requiring several days notice, while the ER will see me at my "convenience" for free/small co-pay. When I feel it's warranted, you bet I go to the ER. I have gone to the ER for something as simple as strep throat just because I didn't want to suffer through the weekend with it when my doctor's office was closed. I also went for vomiting and diarrhea on Christmas day because my doctor's office was closed. I don't see how that's any different from what these people on Medicaid do ...

Before you answer, please spend 90 minutes in triage with me, at your convenience.

Generally, I've spent a lot longer than 90 minutes waiting to be seen in the ER.

What I think you're failing to see is that someday it could be YOU on medicaid - YOU could be the one needing assistance someday. When/if it happens, I sure hope the fall from grace is swift and painless from the high horse you're sitting on.

indifferent.gifbanghead.gif

Tweety, BSN, RN

34,248 Posts

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
'

Amen to this. If anyone out there thinks it is easy to get disability, then I urge you to walk with someone through the process. You will eat your words before you get through the first application. I know this because I work with people too sick and disabled to even take care of themselves but they are routinely turned down for disability. My own mother, a nurse, went blind and she was turned down twice before she got a lawyer. This for a woman who had worked full-time from the time she was 16 years old and for 35 years was never without a job. Never.

My neighbor has had at least a dozen operations for a vascular problem, and has a "hearing" next month and has been attempting to get disability for a looooooooooong time.

On the other hand a friend of mine got skin cancer and needed chemo and got disability with relative ease.

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