Medicaid. Is it being abused?

[SWFlorida]

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?

[irishnurse67]

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.

I

[mstigerlily]

B) None of what you've posted speaks to the claim that undocumented aliens can get full scope Medi-Cal. However, it does all speak to the systemic issues within Medi-Cal. The problem isn't abuse of the rules, it's the rules themselves. The end.

Uh..ok. My point was that there isn't much difference between "Full scope Medi-Cal" and the Medi-Cal offered to illegal aliens.

Thus:

a) If Medi-Cal only covers you when you are pregnant and you are pregnant most of the time (and there is no restriction on this), then that is "full scope"

AND

b) If Medi-Cal only covers you when you have an "emergency" (and there is no restriction on this) but nearly *everything* counts as an emergency and you use the ER as a doctor's office, then that is "full scope"

[grannynurse FNP student]

Uh..ok. My point was that there isn't much difference between "Full scope Medi-Cal" and the Medi-Cal offered to illegal aliens.

Thus:

a) If Medi-Cal only covers you when you are pregnant and you are pregnant most of the time (and there is no restriction on this), then that is "full scope"

AND

b) If Medi-Cal only covers you when you have an "emergency" (and there is no restriction on this) but nearly *everything* counts as an emergency and you use the ER as a doctor's office, then that is "full scope"

So what do you suggest be done? I have an idea. Pregnant and go into labor, illegal, ship their a** back across the border before they can give birth. And make sure you hold their legs together to impede their ability to deliver until you drop them off on their side of the border. In this manner, you save tax dollars and make one less citicizen to grab your California, Arizona, New Mexico, Texas tax money and clog up your ERs, school systems, etc, etc. And if you have a baby in this country and you are illegal, we will tie your tubes, solving two problems--you can't have any more kids and you can't use up our tax dollars, by coming back here to deliver.

Now this idea sounds like a bit much, doesn't it? I sure hope so. Emergency rooms could help solve part of the problem by operating twenty-four hour Urgent Care units, couldn't they? It would certainly cut down on the abuse of ER visits. And these units could be staffed by NPs and PAs with one physician, cutting down the cost even further. And Medicaid could reduce the payment, since a full service ER would no longer be used. And I'm sure health insurance companies and over worked PCP would love to refer to them as well, especially on off hours.

This is one idea but it will never float. The people with health insurance will never go for it, lessing of their benefits. And some patients, such as myself will object because by the time we arrive we really do need emergency care, not urgent care. And those funding Medicaid through their tax dollars will view it as another give away program and more waste of their tax dollars.

All right people, I am open for any fresh, new ideas, that save money and treat patients, regardless of whose is paying and their legal status. ANYONE?????????????????????????????

Grannynurse:chair:

[Multicollinearity, BSN, RN]

Well, I have on occasion been 'invited' to leave the country if certain matters don't suit my liberal heart. So I have a similar suggestion.

If someone truly cannot bear living in a country that provides a social welfare safety net such as Medicaid, there are fanastic alternative countries you could go to. Ethiopia comes to mind. Mexico.

Now, you couldn't go anywhere in Europe. No, can't go to Australia. I guess that leaves any of the African countries except South Africa. Or the Middle East, some of those countries don't provide indigent care. Ooooh...Afghanistan! Lovely place. Your taxes would be sooooo much lower.

Think about it. Any civilized country provides at least indigent care, and most provide care to all.

[grannynurse FNP student]

Well, I have on occasion been 'invited' to leave the country if certain matters don't suit my liberal heart. So I have a similar suggestion.

If someone truly cannot bear living in a country that provides a social welfare safety net such as Medicaid, there are fanastic alternative countries you could go to. Ethiopia comes to mind. Mexico.

Now, you couldn't go anywhere in Europe. No, can't go to Australia. I guess that leaves any of the African countries except South Africa. Or the Middle East, some of those countries don't provide indigent care. Ooooh...Afghanistan! Lovely place. Your taxes would be sooooo much lower.

Think about it. Any civilized country provides at least indigent care, and most provide care to all.

Come come, our fellow country men just want our government to ex cerise more control over who we let into this country of ours. Of course they also want low price vegetables, lawn care, to name a few jobs illegals do but they certainly do not want to pay for their health care and to educate their children. And of course, a large number of them have forgotten their immigrant grandparents, great grandparents and the horrible conditions they came to this country under and lived under. Perhaps we are not as civilized as we like to think of ourselves.

Grannynurse:chair:

[lindarn]

My grandparents and greatparents came to this country LEGALLY!!!! They waited their turn in the visa line, left adult children, older parents, and siblings. and came to America. In my grandmother's case, she left her older brothers in Italy, because they were in the Italian army, and they would not let them leave. She never saw them again. My grandfather' brother was unable to obtain a Visa to come to America, and eventually emigrated to Australia, where his family lives today. They imposed on no one, took care of their own, and assimilated into this country. There were no bi- lingual Italian classes in our public schools. You learned in English, or not at all. There were no bi lingual signs, or voting pamphlets, you get the picture. In other words, they did not impose their culture, or their problems on Americans. They were their own problems. If you did not want to be an American, the boat was waiting for you.

I tire of the illegal immigrants who are running, and ruining, this country. One only has to watch CNN, Lou Dobbs, to see the ramifications of the misguided policies of this country. There are plenty of Americans who could take these jobs, if they were made to, or given the opportunity- job or no welfare. What did the farmers do before the illegal immigrants over- ran this country-they hired american citizens. They can have inmates from the prisions to do the fruit an vegetable picking. It will give them something to do, instead of wasting oxygen, and our tax dollars, in the prisons.

If an illegal immigrant needs extensive medical care here, there are plenty of ambulance services who can bring these individual back to their own country, before they ran up a huge tab. I also support the idea to deny American citizenship to illegal alien children, the "right" to educate them in our public schools, and clog up our hospitals. Other countries deny citizenship to immigrants. We can send the medical bills to Vincente Fox, the president of Mexico, and he can pay them. JMHO>

Lindarn, RN, BSN, CCRN

Spokane, Washington

[Multicollinearity, BSN, RN]

My grandparents and greatparents came to this country LEGALLY!!!! They waited their turn in the visa line, left adult children, older parents, and siblings. and came to America. In my grandmother's case, she left her older brothers in Italy, because they were in the Italian army, and they would not let them leave. She never saw them again. My grandfather' brother was unable to obtain a Visa to come to America, and eventually emigrated to Australia, where his family lives today. They imposed on no one, took care of their own, and assimilated into this country. There were no bi- lingual Italian classes in our public schools. You learned in English, or not at all. There were no bi lingual signs, or voting pamphlets, you get the picture. In other words, they did not impose their culture, or their problems on Americans. They were their own problems. If you did not want to be an American, the boat was waiting for you.

I tire of the illegal immigrants who are running, and ruining, this country. One only has to watch CNN, Lou Dobbs, to see the ramifications of the misguided policies of this country. There are plenty of Americans who could take these jobs, if they were made to, or given the opportunity- job or no welfare. What did the farmers do before the illegal immigrants over- ran this country-they hired american citizens. They can have inmates from the prisions to do the fruit an vegetable picking. It will give them something to do, instead of wasting oxygen, and our tax dollars, in the prisons.

If an illegal immigrant needs extensive medical care here, there are plenty of ambulance services who can bring these individual back to their own country, before they ran up a huge tab. I also support the idea to deny American citizenship to illegal alien children, the "right" to educate them in our public schools, and clog up our hospitals. Other countries deny citizenship to immigrants. We can send the medical bills to Vincente Fox, the president of Mexico, and he can pay them. JMHO>

Lindarn, RN, BSN, CCRN

Spokane, Washington

Well, I can actually agree with a few points here. I live within a couple hours of the border so this is not a debate point but matters of daily life here. I do agree that illegal immigration is a crisis. My state remains largly a poor state and alot of that has to do with hundreds of thousands of illegal immigrants and the cost of the services for them. I actually support "the wall" that is being debated to stop illegal immigration. I think we need to control and get rid of the illegal immigration and have controlled legal immigration. I too would like Vicente Fox to get a significant bill and shut his stupid mouth. The things he says...it blows my mind.

I have also griped for years that prison inmates shouldn't sit all day, that they should be doing manual labor under supervision.

My various gripes regarding Medicaid on this thread have had to do with the need for Medicaid forlegal citizens.

[DidiRN]

So what do you suggest be done? I have an idea. Pregnant and go into labor, illegal, ship their a** back across the border before they can give birth. And make sure you hold their legs together to impede their ability to deliver until you drop them off on their side of the border.

I have seen something similar done recently where I work at, but it wasn't someone in labor. It was a critically ill person who was not in this country legally, and this was the first time I have seen this facility attempt this (ie ship them back). In the past, they have kept all others. But I guess they are tired of handing out free care. And frankly, I don't blame them one bit.

[grannynurse FNP student]

My grandparents and greatparents came to this country LEGALLY!!!! They waited their turn in the visa line, left adult children, older parents, and siblings. and came to America. In my grandmother's case, she left her older brothers in Italy, because they were in the Italian army, and they would not let them leave. She never saw them again. My grandfather' brother was unable to obtain a Visa to come to America, and eventually emigrated to Australia, where his family lives today. They imposed on no one, took care of their own, and assimilated into this country. There were no bi- lingual Italian classes in our public schools. You learned in English, or not at all. There were no bi lingual signs, or voting pamphlets, you get the picture. In other words, they did not impose their culture, or their problems on Americans. They were their own problems. If you did not want to be an American, the boat was waiting for you.

I tire of the illegal immigrants who are running, and ruining, this country. One only has to watch CNN, Lou Dobbs, to see the ramifications of the misguided policies of this country. There are plenty of Americans who could take these jobs, if they were made to, or given the opportunity- job or no welfare. What did the farmers do before the illegal immigrants over- ran this country-they hired american citizens. They can have inmates from the prisions to do the fruit an vegetable picking. It will give them something to do, instead of wasting oxygen, and our tax dollars, in the prisons.

If an illegal immigrant needs extensive medical care here, there are plenty of ambulance services who can bring these individual back to their own country, before they ran up a huge tab. I also support the idea to deny American citizenship to illegal alien children, the "right" to educate them in our public schools, and clog up our hospitals. Other countries deny citizenship to immigrants. We can send the medical bills to Vincente Fox, the president of Mexico, and he can pay them. JMHO>

Lindarn, RN, BSN, CCRN

Spokane, Washington

Funny, my paternal grandfather immigrated to this country via Ellis Island (I know because I went there and search their data base) and he was not required to have a visa. And my grandfather got a job, after being sponsored by a relative and it being a condition of his immigration. He worked his way up, married, had my father and seven other brothers and sisters. Things were, in a way, a lot simpler back then. White, European, you were not viewed as much of a threat back then, although my grandmother remembers the no Irish need apply signs. And she was Irish.

As for the large number of U.S. citizens who will take the jobs the illegals do, question, will they work for the same poor pay, live ten men to a room, sleep in shifts? I doubt it. You see, I live in SW Florida not too far from the major truck farms of this wonderful state of Florida. A lot of illegals do the crop work here, for much less pay. That is one of the reason's your vegetables are so cheap. And since our last two bad, very bad hurricane seasons, we also have a large number of non=U.S. citizens working on construction crews, road repair crews, etc, although it has lowered the cost of construction. And I doubt that any U.S. citizen would live in the substandard housing they are offered and charged an arm and a leg for.

And I really hate to tell you this but the opportunities for immigrants has changed. Back when your and my grandparents immigrated, picking crops was a big opportunity. It was left mostly to blacks. Opportunities were in the sweatshops, which, horror of horror, unions forced out of business. And no thank you, I do not want prisoners out picking and doing construction. Too much of an opportunity for abuse by the state and the employers. And I don't view work as a form of punishment.

And you should read a little more rather than get your information from Mr. Dobson. Studies have shown that more then 70% of the illegals are from Central and South America. And as such, would have to be flown back to their home countries, they can't be deported to Mexico. It is against the law.

If you want to deny education to illegal off spring, feel free to. Just be prepared to increase your law enforcement, justice and long term prison systems. And be ready to build a wall around your home and lay in a supply of guns, you may need them.

What the heck, same old rhetoric, same old misinformation.

Grannynurse:balloons:

[DutchgirlRN, ASN, RN]

From the little of the thread that I've read it seems to have become really heated. I'm not sure what that is all about but I just wanted to make an observation.

Friday I went to see a medicaid patient in a very poor area of town. Very tiny house, nasty carpet, nasty curtains, just nasty nasty. The patient was very pleasant. BTW they had a large flat screen TV and a Direct TV satellite hanging on the side of the house. Hum, not taking his generic Dilantin because he cannot afford it, again, Hum.

[grannynurse FNP student]

I have seen something similar done recently where I work at, but it wasn't someone in labor. It was a critically ill person who was not in this country legally, and this was the first time I have seen this facility attempt this (ie ship them back). In the past, they have kept all others. But I guess they are tired of handing out free care. And frankly, I don't blame them one bit.

Perhaps they stopped their attempt because they were breaking federal law. Any facility that accepts Hill/Burton funds, what one doesn't, must provide care to any person presented at their door. They must stabilize them before they can transfer them to an appropriate public/foreign facility. And that facility must accept the transfer. What your facility attempted to do is not only illegal, it is unconscionable. I really do not give a good hoot if the patient was legal or not. He was a critically ill patient, according to you, and deserving of treatment. And by the way, facilities do not lose everything treating illegals, they do get federal grant money.

Grannynurse

Now I am going to bed

[LydiaNN]

Uh..ok. My point was that there isn't much difference between "Full scope Medi-Cal" and the Medi-Cal offered to illegal aliens.

Thus:

a) If Medi-Cal only covers you when you are pregnant and you are pregnant most of the time (and there is no restriction on this), then that is "full scope"

AND

b) If Medi-Cal only covers you when you have an "emergency" (and there is no restriction on this) but nearly *everything* counts as an emergency and you use the ER as a doctor's office, then that is "full scope"

I understand full well what your point was. My point, which is the one I'm attempting to make, after all, I suggested you post something to document that undocumented immigrants get full scope Medi-Cal. Instead, you posted a bunch of information about emergency Medi-Cal, which, while interesting, merely strengthened what I was saying.