I have been an ER nurse for exactly one week....

Specialties Emergency

Published

And:

1) I now understand why I lose 1/3 of my pay to taxes

2) I have no idea how my hospital can afford to stay open with the amount of self-pay and government-funded insurance

:eek:

Specializes in Peds/outpatient FP,derm,allergy/private duty.
Yes, I swear this county takes care of immigrants better than its own people sometimes...

What happens in my state is that people are experts on every possible form of public assistance and also on under the table transactions and bartering they don't pay taxes on. I'm not interested in a ****** match with anyone about the subject. I am the least entitled person and I try to bend over backwards to see the other guy's POV. I've taken sociology and related classes that study the subject matter. I think most nurses have. I can talk about what I have seen over the last 25 years. You can't read that in a textbook.

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Specializes in NICU, Peds.

Bah I can't stand the idea of "user pays" when it comes ot health care. Why should kids suffer because their parents don't have a decent income? Health care should be free for all. The rich or even reasonable income earners shouldn't have better "choice" and greater likelihood of health care than those who can't afford decent insurance.

The healthiest nations, those with the highest "livibility" that rank highest in all wellness factors are those that have free healthcare for all.

The day that health became a "for profit" business, is the day that humanity took a back seat to money.

It disgusts and angers me that hospitals are run as businesses expected to make a profit. It turns healthcare into hospitality and gives those with money greater options than those without. Equal opportunity healthcare is the way to go and while money has to be a factor, it shouldn't be at the individual level. Parents should not have to chose their home or debt for the rest of their lives to save the life of a child.

Bah I could go on about this for hours and hours. GRRR GRRR GRRR.

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Specializes in Emergency Dept, ICU.

Ohh give it a month and you won't believe what you will have seen

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Specializes in Peds Hem, Onc, Med/Surg.
What happens in my state is that people are experts on every possible form of public assistance and also on under the table transactions and bartering they don't pay taxes on.

I 100% agree with this. The people I normally see using financial aid is not "immigrants", its people who know how to work the system. I work right next to the billing office for the hospital and the people I see walk in don't look like they need any help at all. Very rarely do I see some one who genuinely looks like they need the help.

Its annoying but you know what the system is made by imperfect humans so it will always be flawed and there will always be injustice. Unfortunately that is the way it is. IMO, no matter how they change the laws or whatever they do, someone will always end up losing. :twocents:

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I 100% agree with this. The people I normally see using financial aid is not "immigrants", its people who know how to work the system.

I always wonder about this... in my current line of (non-nursing) work, my personal experience has been that immigrants tend to work hard, keep to themselves, and send money home. Generalization, yes, but it's made me wonder when I hear people say that immigrants get everything in this country... what benefits are they receiving that others are not? Where I live the majority of immigrants are refugees (who are generally invisible to the public) and migrant farmworkers (who live out in the sticks).

On the other hand, our "homegrown" public assistance users... you probably don't want to get me started on that topic. :uhoh3:

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Specializes in Peds Hem, Onc, Med/Surg.
I always wonder about this... in my current line of (non-nursing) work, my personal experience has been that immigrants tend to work hard, keep to themselves, and send money home. Generalization, yes, but it's made me wonder when I hear people say that immigrants get everything in this country... what benefits are they receiving that others are not? Where I live the majority of immigrants are refugees (who are generally invisible to the public) and migrant farmworkers (who live out in the sticks).

On the other hand, our "homegrown" public assistance users... you probably don't want to get me started on that topic. :uhoh3:

I see the exact same thing.

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Specializes in future OB/L&D nurse(I hope) or hospice.
i 100% agree with this. the people i normally see using financial aid is not "immigrants", its people who know how to work the system. i work right next to the billing office for the hospital and the people i see walk in don't look like they need any help at all. very rarely do i see some one who genuinely looks like they need the help.

its annoying but you know what the system is made by imperfect humans so it will always be flawed and there will always be injustice. unfortunately that is the way it is. imo, no matter how they change the laws or whatever they do, someone will always end up losing. :twocents:

i agree with most of what you have said, all except the part highlighted in red. many times you can't see a disabililty. those who have suffered with chronic pain have learned to look fairly normal because for them the pain has become normal....the person who has some forms of cancer also many times look normal. so, please, please don't judge a book by it's cover. yes, there are those who have learned how to "work" the system; probably many, many have. children and seniors, imop, should be getting free health care for sure. and don't even get me started on the foreign aid.:madface:

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Specializes in Peds Hem, Onc, Med/Surg.
I agree with most of what you have said, all except the part highlighted in red. Many times you can't see a disabililty. Those who have suffered with chronic pain have learned to look fairly normal because for them the pain has become normal....The person who has some forms of cancer also many times look normal. So, please, please don't judge a book by it's cover. Yes, there are those who have learned how to "work" the system; probably many, many have. Children and seniors, IMOP, should be getting free health care for sure. And don't even get me started on the foreign aid.:madface:

Very true. I meant more along the lines of........ for example this lady I helped last week. Female comes in carrying her child and leading two children. She has a manicure, wearing top of the line pants, and has an Iphone 4. All three kids are wearing name brand clothing and shoes. I was speaking to her in Spanish because she said she didn't understand English when she did (and spoke it well to boot). When asked about her income she said she didn't work but her bf did. When asked about how much he made, she said very little. When I asked how did the bills get paid she confided in me about all these side businesses but she didn't want me to tell the F.A. lady because she knew if she told they would have to show proof which would lead to a bunch of other stuff such as her having to report it the side businesses. She clearly knew how to work the system.

Another thing I noticed is when a person really needs help when they walk out of that office there is a sense of relief, typically when they don't there is a sense of oh yeah I deserved it. Its kind of a smug look. I can't explain it well sorry. :D

Those are the type of people I see. That is what I meant about the looking as if they don't need the help.I know you can't judge people by what you see because you never know. :)

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We met with the bean-counters once during a budget discussion. They revealed that a full 34% of our emergency room patients do not pay. That's not the Medicaid/Medicare population. We see money from the government.

What business entity is expected to lose 34% and remain viable?

I wish all emergency departments could and would turn away people that can't pay? Harsh? Oh well...

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Specializes in Peds/outpatient FP,derm,allergy/private duty.
I always wonder about this... in my current line of (non-nursing) work, my personal experience has been that immigrants tend to work hard, keep to themselves, and send money home. Generalization, yes, but it's made me wonder when I hear people say that immigrants get everything in this country... what benefits are they receiving that others are not? Where I live the majority of immigrants are refugees (who are generally invisible to the public) and migrant farmworkers (who live out in the sticks).

No -- I would not single out immigrants at all. I've found that it tends to be a family thing where the members have varying immigration statuses (stati?). It's more of a low-recorded household income thing. The most disadvantaged people are those who come here alone and/or are less likely to be conversant in English which is not to say anyone's language is inferior (touchy subject lately) but that I doubt anyone would argue that learning English affords vastly more opportunities to get out of poverty.

The group who work the system (and I hasten to add some are on a program for a legitimate reason) have received benefits I don't have across the board. They have their healthcare paid for - I can't afford it. They get expensive drugs like Singulair and Advair that I would have to pay over $300 per month to pay out of pocket.

This is because I pay taxes on my income and follow the rules to the letter. Here are a few examples. Medi-caid coverage is supposed to help people who have no other assets. If they own a house, they will quit-claim the deed to other family members to hide that or they claim it is their legal and permanent residence when it isn't. One guy I know stays in another city for long enough to establish residency and avoid anyone finding out that they own a house and get all the tax-payer funded low income benefits on top of it. I pay taxes for that. I don't own a house.

Another group have family members qualify for SSDI and hire other family members as state-paid caregivers. Person number one is not incapacitated from their "permanent disability" but will likely receive between $800-1000 per month for living expenses plus free medical care and free prescription drugs and their family members get paid around $1100 out of the state coffers to be a "caregiver". Add to that the fact that many of them do work. They work at their uncle's gas station or some other cash only trade. You can figure that all adds up to a pretty decent looking bank account without all the fuss of filing an income tax return. I always file a tax return on the mere pittance of money the government(s) let me keep.

I wish all of that wasn't true, but it is true. The worst part of this is that if I am out of work and file an unemployment claim, the amount of fraud in the system is so rampant that when I as a taxpaying citizen need that at some point, I have to go through living hell because they presume you are a crook until proven otherwise. Yeah. I'm really a compassionate person. I'm beginning to seriously resent the situation, though.

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Specializes in future OB/L&D nurse(I hope) or hospice.
Very true. I meant more along the lines of........ for example this lady I helped last week. Female comes in carrying her child and leading two children. She has a manicure, wearing top of the line pants, and has an Iphone 4. All three kids are wearing name brand clothing and shoes. I was speaking to her in Spanish because she said she didn't understand English when she did (and spoke it well to boot). When asked about her income she said she didn't work but her bf did. When asked about how much he made, she said very little. When I asked how did the bills get paid she confided in me about all these side businesses but she didn't want me to tell the F.A. lady because she knew if she told they would have to show proof which would lead to a bunch of other stuff such as her having to report it the side businesses. She clearly knew how to work the system.

Another thing I noticed is when a person really needs help when they walk out of that office there is a sense of relief, typically when they don't there is a sense of oh yeah I deserved it. Its kind of a smug look. I can't explain it well sorry. :D

Those are the type of people I see. That is what I meant about the looking as if they don't need the help.I know you can't judge people by what you see because you never know. :)

Oh, ok... Please forgive me if I offended you in any way. Yea, I would be totally mad if I saw that lady with the kids, heck I don't have an Iphone, manicured nails etc and I work full time+. Those are just luxuries that I can't afford... Anyway, thanks for clarifying for me:)

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Specializes in Peds Hem, Onc, Med/Surg.
Oh, ok... Please forgive me if I offended you in any way. Yea, I would be totally mad if I saw that lady with the kids, heck I don't have an Iphone, manicured nails etc and I work full time+. Those are just luxuries that I can't afford... Anyway, thanks for clarifying for me:)

Of course you didn't offend me! :D I never can explain myself well enough. :lol2:

But it's funny but I thought the same thing you did. I've been working for years as a nurse and I still can't afford half the stuff these people walk in with. :lol2::lol2::lol2::lol2::lol2:

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