How soon we forget.

eriksoln, BSN, RN · Feb 1, 2011

To the op, why start this political BS conversation in the first place? You must be pretty damn proud of your healthcare coverage at the moment (while it lasts) however I am between jobs and may even be an educated, experienced nurse also. My wife has a pre-existing condition that requires regular brain MRI's. We are both on medications, We pay out of pocket like most do during this crappy job market. To be told I have to purchase obamacare would be simply unconstitional at best. This bill will fade just like the job market did. And then you can go back to complaining about the pt's that provide you with a living not paying their bills As you get older you will see things much differently. political and religion discussion only creates hostility among people.

Thats the problem though, they don't provide me with a living. They ones who pay do. They just stretch me thin and compromise the quality of care for the payers.

Ten people walk into McDs and order a hamburger. Nine of the ten pay. The one person who didn't pay didn't provide me with any of my salary. If anything, they detracted from it. Took product, didn't reimburse the business for it, and took up service time meant for others.

I realize with medical care, its a little different cause hospitals do get some reimbursement for those who don't pay......but the general public are abusing that. The free rides far outweigh the "charity care" fees the hospital receives.

SweettartRN · Feb 2, 2011

Both the MA and Obama plans count on having everyone pay premiums, those who are chronically ill, and those in good health. By including the healthy, the cost per person to the insurer gets diluted allowing for lower premiums for all. I am all for change in health care financing. I've been disabled for a year, could probably return to work if I can get the care I need, but spending half my income for my healthcare is bankrupting me. After 30 years in healthcare it really hurts to see that when your money runs out, so does your doctor.

Wow. Lower premiums for all? Where?

Everyone I know has seen their premiums increase since this bill passed a year ago.

I don't want the government telling me that I have to do something with my own money. They already use and abuse my tax dollars. I don't want to see our healthcare system become even more flawed.

SweettartRN · Feb 2, 2011

Oh yes.

I also wanted to add this. To those who complain about those who can't pay. I have seen many a person have their credit ruined by high cost unexpected ER visits. There is a consequence already in place for those who don't have insurance.

eriksoln, BSN, RN · Feb 2, 2011

Oh yes.
I also wanted to add this. To those who complain about those who can't pay. I have seen many a person have their credit ruined by high cost unexpected ER visits. There is a consequence already in place for those who don't have insurance.

:rolleyes:Hmmm..........yes and no.

Honestly, for the people I am talking about (the addicts, coming in for a fix, no job), is this a punishment really? I don't think so. To them, a bad credit score is, well, meaningless. Credit scores matter to people trying to buy a car or a house and who want to finance other things (home improvements, furniture). Not things the average non-payer is in the market for anyway.

Kellie626 · Feb 2, 2011

Credit score? Are you serious? The people being referred to here are not hardworking, down-on-their-luck, ladies and gentlemen. These are people that milk the system their whole lives and get away with it. When someone throws around the terms "less fortunate" to describe those people, I have to point out that just because someone has less than you or me, doesn't necessarily have anything to do with being fortunate. I didn't win the lottery, I work my butt off everyday to pay for what I have. "Good fortune" had nothing to do with it.

As for this health plan, no matter what you do and how much you give those who abuse the system, it will never be enough. Case in point: I had a middle-aged guy in my ER a few months ago who spent 10 minutes complaining to me that Medicaid was sh!t because now they were making him pay all these copays. "3 dollars to come to the ER, 5 dollars for my inhalers, 1 dollar for my other prescriptions!" Then he pulls out his upper false teeth and says "These cost me 40 dollars!!" I wanted to say really? Cause it costs me $150.00 for the ER, 50 dollars for my prescriptions and I don't have dental insurance.

Wonder what they'll say about Obamacare if they actually have to pay for it lol.

eriksoln, BSN, RN · Feb 2, 2011

Credit score? Are you serious? The people being referred to here are not hardworking, down-on-their-luck, ladies and gentlemen. These are people that milk the system their whole lives and get away with it. When someone throws around the terms "less fortunate" to describe those people, I have to point out that just because someone has less than you or me, doesn't necessarily have anything to do with being fortunate. I didn't win the lottery, I work my butt off everyday to pay for what I have. "Good fortune" had nothing to do with it.
As for this health plan, no matter what you do and how much you give those who abuse the system, it will never be enough. Case in point: I had a middle-aged guy in my ER a few months ago who spent 10 minutes complaining to me that Medicaid was sh!t because now they were making him pay all these copays. "3 dollars to come to the ER, 5 dollars for my inhalers, 1 dollar for my other prescriptions!" Then he pulls out his upper false teeth and says "These cost me 40 dollars!!" I wanted to say really? Cause it costs me $150.00 for the ER, 50 dollars for my prescriptions and I don't have dental insurance.
Wonder what they'll say about Obamacare if they actually have to pay for it lol.

Agreed. I had a woman not too long ago, typical "I've given up on life and its just easier to sail on through the system milking it" type. Quit working as a secretary after her medical problems mounted up on her. IBS, diverticulosis and COPD. When you'd go to D/C her, she'd take her scripts, separate the anti-anxiety and pain med ones, throw away the antibiotic and steroid ones and then tell the nurse to call around and find out what the OTC equivalent med would be (to which, for most of her scripts, there was none). If there was no OTC equivalent, she didn't bother with them. Her co-pays were $1, some were $3 (and, unless they were pain meds, those got pitched). And, of course, she had no problem pointing out "Cigarettes keep going up and up, I can't handle these outrageous co-pays too. Marlboro is the only thing that tastes right to me sooo.........".

Here is the kicker. Turns out, the reason she was so interested in "the OTC equivalent" was because she would go to the store, but her smokes, get the pain meds AND SHOP LIFT THE REST OF THE MEDS. After being arrested and fined, she came in again BECAUSE AFTER PAYING THE FINE, SHE COULDN'T AFFORD CIGARETTES AND NEEDED A NICOTINE PATCH. Stayed in the hospital almost a week for.........that. DX was technically COPD, but the nicotine patch was why she was there.

Come on people. I know there are a lot of good/decent folk down on their luck but..............the majority of abusers lean more towards the individual I described above than the poster further on up having financial problems.

Is a system that demands these people pay for at least part of their expenses really that upsetting to you?

AbbyD · Feb 2, 2011

Agreed. I had a woman not too long ago, typical "I've given up on life and its just easier to sail on through the system milking it" type. Quit working as a secretary after her medical problems mounted up on her. IBS, diverticulosis and COPD. When you'd go to D/C her, she'd take her scripts, separate the anti-anxiety and pain med ones, throw away the antibiotic and steroid ones and then tell the nurse to call around and find out what the OTC equivalent med would be (to which, for most of her scripts, there was none). If there was no OTC equivalent, she didn't bother with them. Her co-pays were $1, some were $3 (and, unless they were pain meds, those got pitched). And, of course, she had no problem pointing out "Cigarettes keep going up and up, I can't handle these outrageous co-pays too. Marlboro is the only thing that tastes right to me sooo.........".
Here is the kicker. Turns out, the reason she was so interested in "the OTC equivalent" was because she would go to the store, but her smokes, get the pain meds AND SHOP LIFT THE REST OF THE MEDS. After being arrested and fined, she came in again BECAUSE AFTER PAYING THE FINE, SHE COULDN'T AFFORD CIGARETTES AND NEEDED A NICOTINE PATCH. Stayed in the hospital almost a week for.........that. DX was technically COPD, but the nicotine patch was why she was there.
Come on people. I know there are a lot of good/decent folk down on their luck but..............the majority of abusers lean more towards the individual I described above than the poster further on up having financial problems.
Is a system that demands these people pay for at least part of their expenses really that upsetting to you?

But they aren't going to pay. Obamacare will increase enrollment in Medicaid which states are already struggling to fund. There will be an even bigger "free ride" mentality. http://www.politifact.com/truth-o-meter/statements/2010/mar/01/lamar-alexander/health-care-reform-expand-Medicaid-doctors/

Kellie626 · Feb 2, 2011

That's the point, at least mine lol. Medicaid should be reserved for people who really need it. Kids with no insurance? Fine. You have a job that doesn't offer insurance or it's too expensive (like working at McDonald's or something similar that doesn't pay crap)? Fine, especially if you have kids. Able-bodied adults sitting around doing nothing and collecting a check for it? Nope. Find something worthwhile to do with your time and then we'll talk.

Kinda OT, but I just read an article in the paper that was saying you can't cut funding to medicaid because of all the elderly and disabled people on it. If you're truly disabled, I have no problem with someone being on medicaid. But if we could crack down on people who abuse medicaid (like if you're in the ER for non-emergent issues 5 times in a month) they wouldn't have to worry about paying for the people who need it. We're now collecting the 3.00 and 6.00 copays that medicaid charges for ER visits. Hardly anyone ever pays them. BUT, if welfare starting withholding the copays from people's monthly checks, I think you would see that crap stop pretty quickly. When your check comes up 20.00 or 30.00 short for copays for excessive use of the ER, people might think twice for running in every time they have a broken fingernail. And yes, I had one come in for that last year.

BTW, that wouldn't affect kids on medicaid because minors and pregnant women don't have copays.

eriksoln, BSN, RN · Feb 2, 2011

With major overhauls comes major setbacks. Auto withdraw from welfare checks is a good start. Allowing ERs to turn away those who refuse the copay would be ever better.

Take the woman I had the (cough,gag) privilege of caring for. She goes to the pharmacy, wants her pain meds but does not have the copay. Whats the result? No pain meds. No copay, no service.

Why should it be any different anywhere else?

Then, once we are actually able to collect the copays, they can be adjusted to balance things out. Right now, little one and three dollar copays seem senseless. Once EVERYONE is paying them, like it or not, then we will have a better idea of what the amt. of the charge needs to be to balance things out. Ten and fifteen dollar copays are not extraordinary and would more than likely tip the scales in the right direction.

All's we are doing is accepting payment for what is provided. Its not as if that is "mean" or "inhumane". If you go to McD's and have no money, you get no burger. Thats the way the system works. Why? Give away too many burgers, and you are forced to raise the cost on the paying customers or close down. We've been giving away too many free burgers in the healthcare field. Its a big part of the reason the costs are overinflated.

dizzyray822 · Feb 2, 2011

I thought nursing was a profession of compassion. God help me if I walk into an ER and get one of you who think im "milking the system" because I can't pay or one of you that think I'm taking away from your other better patients because they can pay. My husband and I are VERY hard working responsible people but don't get benefits or insurance. Stop labeling everyone who can't pay so badly.

Kellie626 · Feb 2, 2011

I thought nursing was a profession of compassion. God help me if I walk into an ER and get one of you who think im "milking the system" because I can't pay or one of you that think I'm taking away from your other better patients because they can pay. My husband and I are VERY hard working responsible people but don't get benefits or insurance. Stop labeling everyone who can't pay so badly.

And once again, someone who totally missed the point.

If you read my post, I clearly said I have no problem with people getting medicaid (or charity care or whatever) if they actually work or otherwise need it.

If you and your husband are in the ER 5 to 10 times a month for colds, headlice, broken fingernails, or stubbed toes, then yeah, I have a problem with that. I'm assuming that's not the case since people who are gainfully employed typically don't have a lot of free time to spend hanging around in the ER, eating nachos while complaining that they have 10/10 abdominal pain or smoking cigarettes outside and then strolling in and saying they "cant effing breathe". Once a week. Or more. It's people like that who take up rooms in the ER that are needed by people like you who most likely wouldn't come in unless they absolutely had to.

eriksoln, BSN, RN · Feb 2, 2011

I thought nursing was a profession of compassion. God help me if I walk into an ER and get one of you who think im "milking the system" because I can't pay or one of you that think I'm taking away from your other better patients because they can pay. My husband and I are VERY hard working responsible people but don't get benefits or insurance. Stop labeling everyone who can't pay so badly.

I have to step in here and quote one of my fav. philosophers Satyre. He teaches:

"We are judged by what we do, not the reasons for what we do." Or, in this case, what we don't do, such as pay our bills.

At the end of the day, not paying is the same for those who "really want to but can't" and the one's who "milk it". The results to the system are the same, regardless of which group the non-payer comes from.

I'm sure you and your husband don't wish to be in the same boat as the others, that is plain to see. But, the forced payment would help you, not hinder you. The one's who can pay and choose not to will have to make a choice........pay or stop asking for the service. When that happens, things improve for the hospital and there is less stress on the system. Then, with less non-payers (the by choice types) driving up the costs for everyone else, people like you and your husband will find the challenge of paying the bills much easier.

The goal is to bring the price down for the decent people and make healthcare available to everyone who can follow a few simple rules.