Patients on Medicaid - page 28

I hope not to offend anyone out there, but I would appreciate some feedback on taking care of young to middle-aged adults who are on medicaid. It seems that so many (I realize not all) are some of the most difficult patients to... Read More

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    Quote from Tweety
    I think the thread is fine. All opinions should be respected and are valid, although it's so easy to pass judgement when they are different than ours.

    As a nurse I need to know who has insurance or not in order to plan discharge. For example, do I need to set them up with a free Lovenox program, do I need to find them a free walker somewhere, do they need help with their prescriptions, do they have insurance to go to rehab or do I need to get the family more involved because they are going to be taking care of the patient at home without home health or a short stay at rehab.

    Working for a not-for-profit has made me an advocate for equal care, and how I take care of you isn't based on your insurance information, but in the end it does matter whether or not you have benefits in our health care environment.

    In that case I see your point.

    I also edited my first comment, as it was my knee jerk reaction to some of the posts I read- and I didn't read the entire thread. Like you said, everyone is entitled to their own opinion.
    Tweety and sharona97 like this.

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    Quote from beachbum3
    In that case I see your point.

    I also edited my first comment, as it was my knee jerk reaction to some of the posts I read- and I didn't read the entire thread. Like you said, everyone is entitled to their own opinion.
    Thanks for the open mind.

    I edited my response as well.
    sharona97 and beachbum3 like this.
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    I have been a liberal Democrat, since I was 12 years old. I do not apologize for my liberal views. I only ask, that if you want me to respect your views, please respect mine. Please respect that mine are grounded, not only in liberal feelings, but facts. And like many others, I paid taxes, as a matter of fact, I continue to pay on an old tax bill that the IRS has decided I still owe. I lived my young life overseas, in other countries, on the economy. I've also lived in different parts of our country and at different ecomonic levels. When I worked, I treated all my patients the same. It didn't matter who paid their bill, them and insurance company or the tax payers or no one. Everyone is entitled to their own opinion. And I have found, living in other countries, even those with national health insurance, have their people who moan and groan about paying taxes to pay for people they don't feel deserve their benefits. It makes no difference where you live, there will always be those that complain.

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    In my state, Medicaid doesn't pay for circumcision. (I'm glad, but that's another debate for another thread.) So, when I'm in charge in the nursery, part of my job is witnessing moms sign consents for babies' circumcisions.

    I have to ask whether they have private insurance or Medicaid, and I always feel bad doing so. I tell them that it's doesn't matter to me, but there is a difference in paperwork depending on which you have. If they have Medicaid, there is a form our hospital has moms sign stating they understand Medicaid doesn't cover circs, what the cost is out-of-pocket, and that they understand they'll receive a bill for it.

    So sometimes there is a legitimate reason to need to know someone's insurance status, but it's not because we necessarily care one way or the other. I'm not for people abusing the system, but I do have compassion on those who are truly trying and finding out that sometimes working hard isn't enough.
    Simplepleasures and sharona97 like this.
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    Quote from Arwen_U
    In my state, Medicaid doesn't pay for circumcision.
    And this is my point about healthcare in this country.

    Correct me if I am wrong, but I was under the impression that circumcision was considered ultimately healthier for a man. If so, why would we withhold that future health from a child?

    I was also thinking about others on medicaid: orphans, foster children, disabled people, and I am sure many others who had no choices in their lives. Why wouldn't we give others the same opportunity for health, that we all should have. That's why I'd like to see national healthcare-education, maintenance, check ups, and simple procedures known to increase health...made available to all.

    If you are in NJ today VOTE!
    Simplepleasures and Jo Dirt like this.
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    Well, my beef with some medicaid patients is that they RUN to the ER with every little quirk. Now, I was on Medicaid at one point in my life and I appreciated every time I needed it, but I did NOT take advantage of it at all. The ER is not a physicians office, its for emergencies. Ive seen some go into the ER with a sore throat they have had for 5 days. Why didnt they make a doctors appointment like everyone else does.....because they dont have to pay the additional high cost of an ER visit, and its convenient. I had one man get mad and slam the IV machine to the floor and busted it (he was ETOH detox)...his response insurance paid for it so its mine. He was on medicaid. I calmly responded that it paid for his USE OF IT, not to GIVE IT TO HIM and not to bust. 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. And my tax dollars pay for this. My dad is now at an old age...past retirement. He has worked all his life and paid taxes and health insurance. Now he has applied for Medicare, and he has to pay full price for it as if it were health insurance. But had he never worked, he would get it for free. My mother is unable to work due to major health issues (she also has worked all her life and paid taxes) and there is no help for her either. She cant afford her medications and was turned down for any assistance. My cousin draws a check and makes more money than I do as a nurse. He claims his back is messed up. He gets pain medications and SELLS THEM rather than takes it. Ive seen him lift a 4 wheeler into a truck, but yet he cant work and gets medicaid. Its people like THAT who make it hard on those who actually need assistance. The system is backwards. Its sad for the ones who have to pay out the arse for health insurance and medical attention, because they usually cant afford to go.
    Last edit by chenoaspirit on Feb 5, '08
    Jo Dirt likes this.
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    <<<what amazes me most, is the people who decry national healthcare and socialization....are the ones who tout their christianity or holiness. wwjd? again, if they are reading their bibles they know the the poor.

    i am not religious, but i do believe in helping my fellow human beings. sometimes these threads truly make me ill...this is definately one of them. i just can't understand people in this industry having these ideas. how can they ever be impartial when caring for those without?>>>>>>

    i have heard some pastors preach about how the church should take care of the poor and needy. this is why we are to give to the church so that the church can be an outreach to those in need. however it also says in the bible- if you don't work, you don't eat. ( something to that effect, (
    for even when we were with you, we gave you this rule: "if a man will not work, he shall not eat." 2 thessalonians 3:10.)

    i believe that as nurses we should be constantly assessing the abilities of our patients- maybe they could not wash their own face yesterday but they can today. that means today they wash their own face. my personal belief is that god expects us to do all we can and he meets us there. (lol that makes me sound like i think i am god like- and for clarification i have no such illusion)

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    Quote from MAISY, RN-ER
    And this is my point about healthcare in this country.

    Correct me if I am wrong, but I was under the impression that circumcision was considered ultimately healthier for a man. If so, why would we withhold that future health from a child?

    Hopefully this won't start the circ debate. Circumcision is considered to be a cosmetic surgery, with no medical purpose. Now there are some indications that it might help reduce the transmission of AIDS. There are people that feel, like I do, that this is not a good enough reason to put a baby through a surgery, and would rather the adult male make a decision about circ.

    This is why medicaid doesn't pay for circ's. Lots of private insurances are refusing to pay also. Just wanted to let you know!:spin:
    MAISY, RN-ER likes this.
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    Woody is right. No matter what type of Heathcare system you work under, people will complain. I worked in the NHS for many years and even though healthcare is free at the point of service, our ER would be overflowing with patients very similiar to the ones who overflow the ER's here. Now, they get the treatment 'free', whether they make an appointment to see the doctor or whether they come to the ER, except at the ER they usually have to wait but they will be seen that day and usually within 4 hours (thats a whole nother issue, 4 hour targets in the ER in the UK). Whereas, it can be difficult to make an appointment to see their doctor in some areas or they won't be seen for a few days. And, people can't wait with their ailments, which in my opionion is a reflection of todays society. Everybody wants instant gratification and they don't want to pay for it. And, despite the fact they are getting this 'free' treatment they still moan and complain and throw things. And, you know who complains the loudest a lot of the time and verbaly abuse the nurses and doctors? Professionals and what we call 'middle-england' and above. Many of whom could afford health insurance or at least a co-pay for an ER visit but don't have to and would kick up a stink if that was implementated. Which in my opinion it should be. So, its not just patients on 'medicaid' who act like chenoaspirit suggested, from my experience its anyone who thinks they are entitled to free heathcare. Come on over to any ER in the Uk and you will see what I mean. I think patients on insurance, tend to appreciate their heathcare coverage and don't have this 'entitle me' attitude.
    Not only that, but universal healthcare does not get rid of inconsistencies between different areas and regions. The UKs healthcare system totally varies where you live. It depends on your catchment area. I worked in an innercity London ER and we were swamped with the same problems that swamp your inner-city ERs (except the daily GSW, more like weekly in the UK!) and thereby putting pressure on that particular hospital as they often get the same or less money than the affluent areas. So, universal healthcare is not this rosy ideal that illimnates disparity.
    The NHS in the Uk is not great and is going through hardtimes but I still wouldn't swap it for the US system. As in perfect as it is, no-one will lose thier house over trying to get a serious illness covered.
    (And, I am sorry, this is a subject for a different thread but I can't help respond to Maisey RN-ER's comments about circs. There is no research that proves that circs are 'healthier' for the man. There is so-called evidence from Africa but that research has proven to be flawed. The only proven benefit is reduction in UTI in boys in the first year of life. Thats why the American Association of Paediatrics, sit in the fence about circs and say its parents chioce, as that it is all it is.And, why its not covered by medicaid)
    Altra likes this.
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