Medicaid. Is it being abused?

Specialties Emergency

Published

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 in designer clothes and lots of gold jewelry and they are on medicaid. I know of many who are the working middle class who are struggling to pay their own insurance premiums. Why do so many folks get a free ride? Or am I missing something here?

There are people with large incomes who cheat on their taxes too, so income is not the indicator for stealing.

:yelclap: :yelclap: :yelclap:

well said!

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Specializes in Public Health, DEI.
I am sure that there are some who feel that some of my ER visits are misuse of my Medicare coverage. I stayed away from Managed Care Medicare because I would have had to speak with someone and get approval before seeking out treatment. Ever wonder why people use the ER as their primary source of care? Most because they can't find a physician or when they call are told they can have an appointment in a week or because one or both parents work, or the person just gets worse. I may have problems breathing during the day but resist going in because my rescue inhaler works for a while. And generally my breathing difficult gets worse in the evening or night. Generally I get yelled at for driving myself in and not coming in sooner. Can't win for losing.

I never had a problem in dealing with a patient who came into the ER for treatment of whatever their problem was. It wasn't my place to sit in judgement of why a patient came into my ER, it was my place to treat them. I am just so tired of hearing about all this alleged abuse, misuse and/or fraud on the part of people who receive second rate care and wait hours, in an ER.

Enough said.

Grannynurse

And that goes back to the fact that it isn't so much abuse of Medicaid, it is a system that encourages, and in some cases, necessitates, the very things that end up being problems.

Specializes in ER, PEDS, CASE MANAGEMENT.

I think Medicaid/Medicare is wonderful for the people who really need it. I too get tired of how patients abuse the system. The ones that come in at 0200 in the morning, wanting a pregnancy test, that's it, nothing else. I tell them they can buy a pregnancy test at the dollar store or go to the health dept for free, they say... it's okay, I'm on medicaid. Just makes you want to blow your top!!! I had a patient the other night who came in with an asthma attack, we gave her a couple of nebs and when I was handing her her D/C papers and scripts, she asked me for an inhaler. Told me she couldn't afford the $1.00 it took to buy it. I asked her if she smoked... her reply was yes. Well, if you can afford a pack of cigs, you can afford your inhaler, bye-bye.....

I think Medicaid/Medicare is wonderful for the people who really need it. I too get tired of how patients abuse the system. The ones that come in at 0200 in the morning, wanting a pregnancy test, that's it, nothing else. I tell them they can buy a pregnancy test at the dollar store or go to the health dept for free, they say... it's okay, I'm on medicaid. Just makes you want to blow your top!!! I had a patient the other night who came in with an asthma attack, we gave her a couple of nebs and when I was handing her her D/C papers and scripts, she asked me for an inhaler. Told me she couldn't afford the $1.00 it took to buy it. I asked her if she smoked... her reply was yes. Well, if you can afford a pack of cigs, you can afford your inhaler, bye-bye.....

Sorry but it is not the place of staff to question why a patient comes to the ER, even for a pregnancy test at two in the morning. And I really have to question a person coming into an ER for a pregnancy test but I would be happy she did and take time to educate her. As for the asthmatic comment. Depending on where one lives, there are places where there are no twenty four hour pharmacies. Second, once again it is not the nurse's place to question how a patient spends their money. Sorry, it isn't even the taxpayers place to question how assistance is spent. The patient suffers from asthma and required treatment. Failure to provide the inhaler just sets the patient up for a return visit. And more complaints about irresponsible Medicaid recipients, wasting everyones tax dollars.

Grannynurse

Sorry but it is not the place of staff to question why a patient comes to the ER, even for a pregnancy test at two in the morning. And I really have to question a person coming into an ER for a pregnancy test but I would be happy she did and take time to educate her. As for the asthmatic comment. Depending on where one lives, there are places where there are no twenty four hour pharmacies. Second, once again it is not the nurse's place to question how a patient spends their money. Sorry, it isn't even the taxpayers place to question how assistance is spent. The patient suffers from asthma and required treatment. Failure to provide the inhaler just sets the patient up for a return visit. And more complaints about irresponsible Medicaid recipients, wasting everyones tax dollars.

Grannynurse

Sorry, But it is the nurses and societies (taxpayers) responsibility to question and educate people on the fact that they should utilize a primary care practitioner for theit health care and not the ER. Kudos to the RN for telling this patient to cut back on the smoking and buy his/her inhaler instead. Perhaps if they quit smoking they wouldn't need to visit the ER for an inhaler period. Using your logic a bartender should not question a drunk who keeps ordering shots of whiskey.

Specializes in ER, PEDS, CASE MANAGEMENT.

fortunately, our town is blessed with a 24 hr pharmacy, it was the doctor's decision, not mine, that the patient not receive the inhaler. As far as the pregnancy test is concerned, well, that's a whole other matter. We do ask questions as to why they present to the ER. If they want a pregnancy test, we ask them if they are having any problems. Bleeding, nausea, etc.... Just wanting to know if they are pregnant or not? We do tell them the resources they have.. the pregnancy center, the health department, the clinic, the list is endless. But followup is always a problem. They never do.

Sorry, But it is the nurses and societies (taxpayers) responsibility to question and educate people on the fact that they should utilize a primary care practitioner for theit health care and not the ER. Kudos to the RN for telling this patient to cut back on the smoking and buy his/her inhaler instead. Perhaps if they quit smoking they wouldn't need to visit the ER for an inhaler period. Using your logic a bartender should not question a drunk who keeps ordering shots of whiskey.

Whatever or not a patient smokes and suffers from asthma is really no one's business except the treating physician. I am an asthmatic. I do not smoke and never have. My daughter and SIL both smoke. They go outside to smoke so as not to impact second hand smoke on myself or my grandchildren. And you know something, I am sick and tired of anyone asking me if I smoke when I come into the ER. And I am equally tired of some of the judgmental attitudes that I have had the misfortune to read, regarding the wasting of their tax money. I don't like some of the things that my state and federal government waste tax dollars on. I certainly do not impart my distaste on the recipients of such latest. And just perhaps some should up date their education on the causes of asthma and its treatment. The comment regarding drinking, it is worth ---------------------------------

Grannynurse

fortunately, our town is blessed with a 24 hr pharmacy, it was the doctor's decision, not mine, that the patient not receive the inhaler. As far as the pregnancy test is concerned, well, that's a whole other matter. We do ask questions as to why they present to the ER. If they want a pregnancy test, we ask them if they are having any problems. Bleeding, nausea, etc.... Just wanting to know if they are pregnant or not? We do tell them the resources they have.. the pregnancy center, the health department, the clinic, the list is endless. But followup is always a problem. They never do.

Your town is lucky. And you could have made the information regarding it being the doctor's decision, in your initial post but for some reason you chose not to. My town also has an 24 hour pharmacy. And they charge the most for any medications. I always tell the physician I can't get it filled until regular business hours (at my regular pharmacy) and is it all right. I have lived in towns that don't, believe it or not. And as I said, I worked in several ERs and never had a patient present demanding a pregnancy test. Guess I have just be extremely lucky. But then again, I haven't worked in 15 years and perhaps the public has changed since then. But then I would wonder why someone was coming in at such an hour and do something a little more then provide them with a list.

Grannynurse

Specializes in Psych.
just because a person is broke does not mean they have to look it. i understand the whole idea of brand new cars and jewelry and this used to upest me to, but i realize that you never know what life experiences a person has had and it is unfair to judge them off looks and possesions alone. when i was a medical assistant( a long time ago) i had to apply for financial aid. i was an independent student, living alone, no children and no help from my parents. when i sat down with the counselor she made a comment about my coach purse and said that if i could afford an expensive purse like that, i obviously could afford the tuition. she pointed out that she did not have a coach purse and she worked full time. she also assumed i had children. i politely told that idiot that the purse was a gift form my grandparents for my birthday and that i lived alone with no dependents. well let me tell ya....she apologized after picking her face off the ground. she went on to explain about other girls in the program and how they had this and that and were applying for financial aid. she was making assumptions and generalizations for alot of reasons i don't care to discuss (it will be a whole other thread). i can't concern myself with what other people APPEAR to have. sometimes the more people have is just an indication of how much debt they have. i mean, how well can you really live off a medicaid check? a nice car and jewelry does not always equate a nice quality of life.

Hey, no kidding, a gov't stipend is not exactly a windfall. Then again, there are people receiving it that make big bucks under the table. I see TOO many people abusing the system, while others work hard, are un- or under-insured and can't afford a doctor visit or hospital stay no matter HOW sick they are. And as to the system itself, I'm not a big conspiracy theorist, but, if someone is paying your bills (i.e., the gov't), that person/entity has you under it's control to a certain extent. . .Something to think about.:cool:

Specializes in Psych.
Is Medicaid abused? YES

Can citizens who have temporarily fallen on hard times qualify for it- often not.

Can women come from anywhere in the world and give birth and have their child qualify for the best in medical care,PT,OT,medications,home health,DME, transportation to and from appointments? YES

My son who made $8000 one year and ended up with a $12,000 hospital bill could not receive one cent worth of "free" anything- monthly RX was over $250. They continue to pursue him to the ends of the earth for money even years later. The hospital has a religious foundation, but couldnt see fit to reduce the bill through charity for a 23 year old male who couldnt work at the moment because he made 8K the previous year.

Same hospital,family brings in a non resident alien family member who receives inhouse care for several weeks- they go home with bill forgiven,free meds and DME and home health visits.

I see this stuff on a daily basis. If you know the system, it is very easy.Why live in a third world nation when you can come here and live even without official documentation and enjoy what everyone else has to work for for free?

Just keep those babies coming......

NOT FAIR:o

Specializes in Psych.
I once had a pt come in with c/o "toothache". while she was there she said her son needed his finger looked at, I checked him out and he had a hangnail! I asked her if she really wanted to pay for an ER visit for a hangnail and she quickly informed me that she had Medicaid and she didnt have to PAY for anything in this hospital..... alrighty then...

There's your answer right there, OP. A resounding YES!:angryfire

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