Medicaid. Is it being abused?

Specialties Emergency

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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?

The federal poverty guidelines DON'T apply in Massachusetts when it applies to MEDICAID. You can make 150% of the federal povery guideline, own your own home if it's worth less than $400,000 market value (if you, your spouse or your disabled adult child lives in it),and own a car worth $8000 or less. Please check your facts-I did w/a social worker. You said the cost of an OTC script is the world to her, but like I said--IT'S CHEAPER THAN HER 2 PACK A DAY HABIT!!!!! And it is up to me when it's for something unnecessary b/c I pay for it even though she is able-bodied, besides-I QUIT COLD TURKEY!

I'm sorry but here in Florida income eligibility for Medicaid is much less then it is in Massachusetts, or even my old home NYS. One cannot own a $400,000 home without signing it over to the state, or an $8,000 car, or having a bank account with more than a few hundred dollars-the exact amount escapes me right now. And yes, the eligibilty requirements vary from state to state. And down here, in the South, they are much stricter. And like I said in another post, you want to save a few of your taxes dollars, only to have to spend many more, at a later date, when your patient requires hospitalization for her COPD or lung cancer.

By the way, I'm happy you quit cold turkey. I wish my daughter and SIL could but apparently they lack that ability. And there are many others that lack it as well. And if Medicaid will pay for the patches, so be it.

Grannynurse:balloons:

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Specializes in Public Health, DEI.

It is a well established fact that very few people who try to quit cold turkey are able to do it. I think it is far more sensible for health care providers to urge patients to take quit any way they can, than to say "well, I quit cold turkey" as if that means that everyone is able to do that. Obviously, they aren't!

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Like I said to the nursing student- I quit cold turkey. That was when I went to the ER one night (lips blue, SOB) and the MD told my very stupid self to quit smoking b/c now I had the dx of asthma. It killed me to do it and I STILL want a butt!

But, just like when the MD told my fat ass to go on a diet, I just did what had to be done and controlled myself. I'd love a bowl of the ice cream that my kids are eating right now, but too bad, I've exceeded my caloric limit for the day!

Just b/c accepting personal responsibility is no fun doesn't mean we don't have to do it!

You have every right to feel proud of your ability to kick the smoking habit. And lose the necessary pounds. But not everyone is as strong as you. They need help, be it in the form of a patch or a group. And you have the right to tout your personal responsibility. AS a health care professional, you have the responsibility not to impart your own personal beliefs on any of your patients. And by refusing and chastising a medicaid patient, you stepped beyond your professional role and enter into the personal realm. People need to remember that, when they schold a patient who does not follow their belief system.

Grannynurse:balloons:

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You have every right to feel proud of your ability to kick the smoking habit. And lose the necessary pounds. But not everyone is as strong as you. They need help, be it in the form of a patch or a group. And you have the right to tout your personal responsibility. AS a health care professional, you have the responsibility not to impart your own personal beliefs on any of your patients. And by refusing and chastising a medicaid patient, you stepped beyond your professional role and enter into the personal realm. People need to remember that, when they schold a patient who does not follow their belief system.

Grannynurse:balloons:

H

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I know your heart is in the right place, but you are putting yourself in a dangerous situation by transporting patients home. If you get into an accident you are going to held responsible. It also sets up an unrealistic expectation for the patients. If you provide rides, then the next time the patient needs a ride, they are going to expect staff to give them one.

Personally, I don't feel any responsibility for transportation. If there is a problem, then Social Services needs to be involved or Discharge Planning needs to make arrangements. You shouldn't have to pay out of your own pocket.

As far as the heroin addicts personally asking for you, I know it feels good to be someone's favorite nurse, but these folks are also some of the most manipulative patients. My guess is that the "other mean" nurses, probably won't drive them home or pay for a cab for them.

Take care.

O

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Hello, Hello!!!! I didn't refuse the patient. How many times do I have to say she didn't want to wait for the script after her friend told her the price of the patch! (the doc was in w/another pt and the wait would've been about 15 min). Of course I asked for the script (duh). I said I don't agree w/the rules. I never wouldn't follow them--my license is too valuable to me. And I think people grossly underestimate themselves in their ability to stop and addiction. However, a little patch or appetite suppressant pill isn't a bad thing. Different subject comes to mind, though- what amazes me is these people who quit heroin w/o methadone or anything else. Now those people deserve our admiration. I don't know how they do it! Never did heroin but it's the worst thing to quit, I hear.

I am sorry but you did. I am not engaging in an argument but in your very first posting, regarding this issue, you made no mention of the physician. You took all the credit for refusing to obtain the script. You made no mention of her friend. And you were the one who told her if she smoked two packs a day, she could afford the patch, without a script. You are now dancing the crazt dance of someone who has been confronted by her peers for pushing her personal attitude on her patients. And now are trying to explain your way out of your mistake.

As I said, self reliance is a great thing. And there are many peoople who are able to deal with their addictions and problems without any medications or outside help. But there are a lot more who are not. And that is why Medicaid pays for their treatment. For those that disagree with such treatment and waste of their tax dollars, feel free to lobby your state legislatures for changes in coverage. Just remember that stopping early treatment will only increase later cost on both the medical aspect and sociaital cost.

My daughter and SIL are strong willed individuals except for their nicotine addiction. My mother and young brother never did find the appropriate support for their drinking. I have a problem with my weight, as did my father. My family needs every bit of help with their addiction problems that medicine can offer. WE ARE NOT STRONG ENOUGH IN THOSE GIVEN AREAS.

Grannynurse:balloons:

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Of course I don't give the addicts a ride home--I'm too scared. I'm talking about the little old ladies. I still shouldn't do it though. I just feel so sorry for them. And the heroin addicts ask for me b/c I don't glare, I'm gentle w/the IV and I don't "snip" at them when they ask for pain med. True, some of them manipulate.

Makes no difference who you give a ride home or to a pharmacy. Have an accident and YOU will be the one who is sued. And you are the one that will be fired by your facility for crossing the professional line. Don't think so? Ask your car insurance agent and the hospital risk manager.

Grannynurse:balloons:

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Specializes in Public Health, DEI.

Where I work, giving clients a ride in our car is a termination offense.

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I am sorry but you did. I am not engaging in an argument but in your very first posting, regarding this issue, you made no mention of the physician. You took all the credit for refusing to obtain the script. You made no mention of her friend. And you were the one who told her if she smoked two packs a day, she could afford the patch, without a script. You are now dancing the crazt dance of someone who has been confronted by her peers for pushing her personal attitude on her patients. And now are trying to explain your way out of your mistake.

As I said, self reliance is a great thing. And there are many peoople who are able to deal with their addictions and problems without any medications or outside help. But there are a lot more who are not. And that is why Medicaid pays for their treatment. For those that disagree with such treatment and waste of their tax dollars, feel free to lobby your state legislatures for changes in coverage. Just remember that stopping early treatment will only increase later cost on both the medical aspect and sociaital cost.

My daughter and SIL are strong willed individuals except for their nicotine addiction. My mother and young brother never did find the appropriate support for their drinking. I have a problem with my weight, as did my father. My family needs every bit of help with their addiction problems that medicine can offer. WE ARE NOT STRONG ENOUGH IN THOSE GIVEN AREAS.

Grannynurse:balloons:

Y

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Grannynurse:balloons:

Y

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Specializes in Acute Care Psych, DNP Student.

This is an example of lack of bounderies. First demonstrated by rebuffing the request for nicotine patches. (Free for you! Not for me! Cheaper than your cigs!) Then, a lack of boundaries with providing rides to patients. One is for ill, the other well-meaning. The take home lesson is a reminder in boundaries. We don't get to deny treatment because of our political beliefs, and we don't get to provide rides to patients who tug on our heart-strings.

What we are supposed to do is provide medical care within the scope of RN practice.

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I had Medi-Cal on and off for a few years and I was thrilled that it covered OTC meds, I never asked but doctors wrote prescriptions where I got condoms, Tylenol, Motrin, Monistat and tons of other OTC things free. I was wondering why some of the pharmacy clerks seemed irritated by this - now I know.

As far as some posters saying they have never seen people abusing Medi-Cal I just can't believe that. Maybe they should move to San Diego. Any illegal alien (especially a pregnant one) can get approved instantly for benefits here while us English speaking white taxpaying citizens are treated with suspicion if we ask for Medi-Cal. It took me nine months to get approved and I had to endure many, many visits to the county office, copies of paperwork brought to them - even a surprise home visit from the Medi-Cal worker where she looked in my cabinets and in my closets. That was fun. I had a second-trimester miscarriage in the ER while using temporary Medi-Cal and I"ve never been treated so badly before.

Well sure she didn't ask for the script again -- you shamed her.

I say shame on you. It's not your place to decide you don't want her to have something that her benefits cover. Shame on you.

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