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?

Specializes in Public Health, DEI.
Gee, here in Florida and up in New York, if you are on Medicare and need transportation home, you do get a voucher for a cab ride home. Can't really understand that. Florida is one of the tight wat states and New York is one of the most liberal.

Grannynurse:balloons:

In my County, we're given tokens to give clients. (I don't work in a hospital). It is really kind of a stupid system; with vouchers, you pay exactly what the fare is. With the tokens, if you've given $25 and the ride is only $23, it is difficult to recoup the change. Also, when we used the vouchers, the County had a contract with the cab company that addressed gratuities for the driver. Now, we hear clients telling us that the drivers become rude when they don't get a tip.

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That's certainly true, regarding babies born in other countries being a citizen. It will never change here; isn't it a constitutional protection? I also don't really think you can accurately compare England and France with the United States, since they don't share a border with any developing nations. However, and I'm sure any of our British members could speak to this, doesn't Great Britian have an immigration problem of their own? (Not addressed to you, specifically, grannynurse, just including it in this post.)

One of the nice things about reading several newspapers a day. Yes, Britian has a problem with immigration. You see any citizen of a Commonwealth Country, of which there are numerous ones, has a right to immigrate to Britian. And so does Canada, which share the commonwealth title. And France has a similar problem plus the guest workers program. A program Bush is trying to push in this country as a relief measure to illegals.

Grannynurse

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Specializes in ICU,ER.
Because of the large number of ER nurses who share this opinion (abuse of the ER/Medicaid) that I personally know, and also see here on Allnurses, and that is just about closing in on 100% of them, to me personally there must be some element of truth to this, just by the sheer volume of agreement.

hhmm DiDi, sounds like some basic common sense there.:)

~from, one of those ER nurses~

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hhmm DiDi, sounds like some basic common sense there.:)

~from, one of those ER nurses~

I am not disagreeing that there are abuses of Medicaid and Medicare and private and/or employer health insurance programs. I am questioning the rather outlandish claims, made by several posters. of abusers of Medicaid driving $30,000 cars, owing homes, wearing designer clothes. And even if some of their claims are true, such as the wearing of designer clothes, who and what is to say these were not purchased prior to their loss of income. I wore designer clothes when I was receiving Medicaid. Guess what? I had made the purchase of such clothes before I lost my income. To satisfy some, what am I suppose to do? Throw the clothes out and wear what? I think not and I think it is unreasonable to demand people dress down to suit some warp sense of propriety.

Likewise I question people stating that those on food stamps buy better cuts of meat or spend them on items they themselves cannot afford. One needs to understand the food stamp program. It is not a free give away federal food program. You must purchase your food stamps. The purchase gives you a set increase in the amount of money you can spend on food. And what food you can purchase is also tightly regulated. And if one sees someone making purchases they suspect are not allowed, they have the obligation to speak to the store manager and/or the food stamp program. Like wise, WIC is also a federaL program that ensures that infants and toddlers receive juice, milk, cheese. And it is also a tightly regulated program. And if anyone sees a person violating that program, again they have the responsibility to report the store and the clerk Believe me, stores do not wish to lose their ability to accept WIC checks.

As far as owing a home and receiving Medicaid. Most states have the following program in place. In order to be eligible for Medicaid and continue to own and live in your home, you must sign an agreement that turns the home over to the state upon the death of the eligible individual and his/her spouse. It is an old and established rule and is accepted by many eligible individuals. So, that explains that situation.

I take issue with misrepresentations, be they intentional or non-intentional, by some on this thread. I have offered explanations, as have others, yet none of you apparently are able to offer any reasonable exceptions to the rule. Instead offer more misrepresentations of what they have supposedly seen. And I have yet to see any offer steps they have taken with their own state legislature to correct those laws they take issue with. And please do not offer the busy life excuse. I have been active in politics since high school. And I have been a single mother, working full time and attending school full time, and still made the time. And I instilled my activism in my daughter, who is sometimes at odds with me politically.

If you want to continue to offer incorrect assessments of supposed abuses, feel free to do so. Please do not complain when I and others take issue with your statements of supposed abusers, it only lessens your argument.

Grannynurse:balloons:

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Specializes in ICU,ER.
If you want to continue to offer incorrect assessments of supposed abuses, feel free to do so. Please do not complain when I and others take issue with your statements of supposed abusers, it only lessens your argument.Grannynurse:balloons:

When I am working in the ER/triage, I have no idea what the person drives up in, it could be a clunker or a Bentley. I have no idea what their home looks like. They could be carrying a Louis Vuitton, but these days, 95% are knock-offs. They could be covered in ice, but CZ is sold everywhere. My point is, I have not the time OR desire to make personal judgements. It is none of my business.

I do, however, make nursing judgements when I triage. And I know there is an astounding amount of Medicaid that come to the ER for obvious clinic type issues. In my 10 years of ER nursing, when I tried to educate, was met with everything from nonchalance to hostility. I will interject that I am a very tactful and diplomatic person. Therefore, I believe the majority of the problem is not as much misinformation as it is a sense of entitlement. People can not be bothered with silly things such as making an appointment and maybe having to wait a couple of days for a semi/chronic condition.

Do I think that Medicaid patients are the only ones that abuse the ER/health care system? No. But that is what the topic is about.

In the long run, poor saps that work and pay for insurance are the ones that put off seeking care due to astronomical deductables.

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Likewise I question people stating that those on food stamps buy better cuts of meat or spend them on items they themselves cannot afford. One needs to understand the food stamp program. It is not a free give away federal food program. You must purchase your food stamps. The purchase gives you a set increase in the amount of money you can spend on food. And what food you can purchase is also tightly regulated. And if one sees someone making purchases they suspect are not allowed, they have the obligation to speak to the store manager and/or the food stamp program. Like wise, WIC is also a federaL program that ensures that infants and toddlers receive juice, milk, cheese. And it is also a tightly regulated program. And if anyone sees a person violating that program, again they have the responsibility to report the store and the clerk Believe me, stores do not wish to lose their ability to accept WIC checks.

Grannynurse:balloons:

Kind of OT, but I was wandering if you could tell me what foods aren't supposed to be bought with food stamps? I worked in a grocery store and the people with foodstamps have been able to purchase sodas, candy, and anything else they want as long as it can be eaten. The only thing I have seen that they cannot purchase is fresh made foods from grocery store salad bars or the deli. Thanks. :)

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When I am working in the ER/triage, I have no idea what the person drives up in, it could be a clunker or a Bentley. I have no idea what their home looks like. They could be carrying a Louis Vuitton, but these days, 95% are knock-offs. They could be covered in ice, but CZ is sold everywhere. My point is, I have not the time OR desire to make personal judgements. It is none of my business.

I do, however, make nursing judgements when I triage. And I know there is an astounding amount of Medicaid that come to the ER for obvious clinic type issues. In my 10 years of ER nursing, when I tried to educate, was met with everything from nonchalance to hostility. I will interject that I am a very tactful and diplomatic person. Therefore, I believe the majority of the problem is not as much misinformation as it is a sense of entitlement. People can not be bothered with silly things such as making an appointment and maybe having to wait a couple of days for a semi/chronic condition.

Do I think that Medicaid patients are the only ones that abuse the ER/health care system? No. But that is what the topic is about.

In the long run, poor saps that work and pay for insurance are the ones that put off seeking care due to astronomical deductables.

I spent almost twenty-five years of my professional life attempting to impart some health care wisdom on many of my patients. There were those that listened and learned. And there were those that did not. And they ended up back in my ER, or on my unit, or as my home health care patient, again. Where I once more attempted to teach them the appropriate things necessary for improving their health. And again and again I had to reteach them. Eventually most learned but not before suffering complications but what am I to do? Throw my hands up and not attempt to continue to educate them? For me, the answer is no.

I have a problem I would like your input on. I have a sixty year old patient, who among other things, suffers from hypertension, insulin dependent diabetes, a seizure disorder and asthma. At one time, her asthma was triggered by cat dander. Her pulmonologist put her on Singulair and it appears to control her asthma. However, she still has some attacks, that require hospitalizations. She lives with her grown daughter, who has several cats. Her pulonomolgist has told her to either move out or have her daughter get rid of the cats, neither of which can happen for a number of reasons. Now, what should I advise her to do? What should I attempt to teach her about limiting her exposure to the family cats? Should I advise her to move out on her limited income? I would really appreciate anyone's input and suggestions on how to handle this patient. She apparently has several choices but refuses to make them. What do you suggest?

Grannynurse

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Kind of OT, but I was wandering if you could tell me what foods aren't supposed to be bought with food stamps? I worked in a grocery store and the people with foodstamps have been able to purchase sodas, candy, and anything else they want as long as it can be eaten. The only thing I have seen that they cannot purchase is fresh made foods from grocery store salad bars or the deli. Thanks. :)

Candies, sodas, beer, wine, and any prepared foods. Also any paper, plastic or other non food items. If one is purchasing soda and candy, you are breaking the law. Suggest you go to your state's food stamp website. They have a list of what cannot be purchased. I have complained to a store manager when I saw someone buying candy with food stamps. The cashier was instructed not to allow it again.

Hope this clears the matter up for you.

Grannynurse:balloons:

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Specializes in Public Health, DEI.

I don't know what food can't be bought with food stamps here, but recipient's now get a card that looks just like a debit card with which to pay. No one in line would know what was going on. It made me think, though, of the last time I was in the ER. I had been doing dishes and a casserole dish broke and a piece ricocheted into my knee. Other than the fact that the triage nurse was incredulous that I was presenting with such a minor looking wound (which in reality took 20 stitches to close), I distinctly remember being sent to an entirely different area to give my financial information. I'm not sure those doctors or nurses would have had a clue who was paying for their handiwork or how. Knowing the reputation of the HMO we had at the time, they probably ended up being reimbursed even less than they would have been through Medi-Cal, but other than the triage nurse, they all treated me with the same respect they were according all other patients.

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Specializes in ICU,ER.
I'm not sure those doctors or nurses would have had a clue who was paying for their handiwork or how.

"face sheets"

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Specializes in ICU,ER.
She apparently has several choices but refuses to make them. What do you suggest?Grannynurse

The old analogy "You can lead a horse to water......" comes to mind.

And I couldn't imagine why the daughter "can't" get rid of the cats. I mean, I am an animal lover myself but come on.... when you choose some cats over your mom's airway/health...........:uhoh21:

I think there are some underlying family dynamics here and as much as we want to help people, they have to WANT to help themselves.

Personally, I think Social Services/counseling could come into play.

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Gosh why did you edit the post? Thankfully I got your original one in my email.

Will you please read back over the posts? You keep making my point for me. (Thank you, by the way!) This is exactly what I'm saying. If emergency Medi-Cal is costing the govt just as much as full scope

Medi-Cal, then the system is broken. I don't think I've ever done this before,

because I find it kind of juvenile when people feel the need to

announce that they're leaving a thread, but I just can't talk to you anymore.

Sorry.

OK I read through your posts and maybe I'm missing it, but this is the first I've heard from you that your point was "the system is broken". You kept saying your point was that illegal aliens don't get "full scope Medi-Cal" and that I needed to link to anywhere that said they did. I did link to an article which said that what they get is nearly the SAME AS full Medi-Cal.

If your point was merely "the system is broken", well we could have agreed about 20 posts ago.

I'm surprised I would make you consider leaving a thread, I thought our conversation rather benign. Sorry to have upset you so badly, that was not my intent.

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