I hope not to offend anyone out there, but I would appreciate some feedback on taking care of young to middle-aged adults who are on medicaid. It seems that so many (I realize not all) are some of the most difficult patients to care for; they often are rude, demanding, and unappreciative of nursing care. I have cared for many who demand tests/procedures/an extra day or two in the hospital/supplies that they don't really need; doctors often admit to just giving them what they want, rather than arguing. I have had medicaid patients say to me after I suggest to them, they can probably purchase an item for cheaper at the store, "Oh I don't care, I'm on Medicaid". Recently, a woman openly admitted that she had another child because she wanted more Medicaid money. When a woman has six kids by different men, and lives off Medicaid, I asked myself, "how does this happen"; aren't there people out there monitoring this system". About a year or so ago, I was taking care of a woman - and because the census was extremely low, patient-nurse ratio was 2:1 (unusual but nice). Anyway, I took so much extra time visiting with, caring for and going way beyond what I really needed to do to ensure quality nursing care, and at lunch, her Diet Pepsi wasn't on her tray. She gets on the phone and proceeds to rant and rave about this to a friend. I could hear her end of the conversation. Yes, she was a Medicaid patient.
Wow, I was blown away and got quite upset. I can't believe these are isolated incidences. Many nurses I work with are able to identify Medicaid patients just by their behavior.
As I said earlier, I don't mean to offend, but I am interested to learn if others out there in the nursing world encounter the same type of thing. I realize it is not right to label or generalize people, and I don't let it affect how I care for people; I certainly don't like the way I feel when confronted with this behavior. Any responses are welcome.
Apparently, those who call my comments snotty or think that I was saying that medicaid patients are stupid and don't deserve the same caring attitude from their nurse totally missed what I was saying. Medicaid patients should be more gracious and kind BECAUSE they are forcefully taking money from anyone who pays medicaid taxes. Medicaid is not insurance due to the fact that a person doesn't have the right to opt out. If anyone decides they would rather pay for something else besides their private insurance they can. Try that with medicaid and you will go to jail. Healthcare isn't a right if someone else has to provide it against their will. So, I expect them to be gracious, no matter what circumstance happened to put them in the position that they use medicaid, because I have to take more time away from my wife and family to provide insurance for people who can't or won't make the sacrifice or do what is needed to provide it for themselves. Time equals life and you have to spend time working to provide for yourself and family. So if I have to spend more time working to pay for medicaid for people I don't know then that is time and life I don't get to spend with my wife and family.
Then support Universal Health Coverage and that will no longer be an issue for you.
And what may seem as lot of money that it takes to pay for medicaid. What actually comes out of your pocket per annum. Would not pay for me a round of Golf. To the individual it really is a small small amount
Earle, I agree. I can't imagine that a person could ever have a good life being in that situation. My heart goes out to them especially ones that really need the help. But, that is the problem with medicaid. It takes the human element out of compassion and help. If someone did need help with their bills and they came to me for help I would do whatever it took to help them, plus it gives me the opportunity to screen out ones who don't really need it and are just looking for a free lot in life. Medicaid takes away the responsibility and connection that people should have on a personal level to each other, and it takes away the freedom recognized by old America in the founding documents that people can be selfish bungholes and not help anybody if they don't want to.
Are selfish people awful? Yeah, they are but you cannot force someone to be compassionate or to have a heart. Communist countries force their citizens to be compassionate and provide for the many and no one can say that that is the ideal situation that you want to live in.
Name one communist country that forces its citizens to be compassionate and provide for the many. That statement is seriously wrong
Medicaid "TAKES" away the responsibility and connection that people should have on a personal level to each other. Medicaid does not take away anything, all it does is help. Help some that for no other way would be able to get it.
What qualifications do you possess to determine what criteria and who should be denied, and how do you determine that some "people are just looking for a free lot in life". So I am really curious, is really what special training do you posess to make these harsh judgements.
I have to say any one can have an attitude or be a difficult pt to deal with. I have on the other hand dealt with my fair share of medical (medicaid) pt's. I worked in the ER for 5 yrs as and admitting lead superviser. It was unbelievable to # of pt that would come into the ER for non emergencies and to use as a clinic (some by ambulance) for colds. One even called the amb because her cat scratched her(when the rn asked why she called the amb for it she said that medical would pay for the amb ride and if she took the bus she would have to pay $1.25). IMO if some of the ppl had to pay a small copay for the services they need I think they would appriciate it a little more. I am not knocking the system by any means I grew up on and actully had to go on aid for a few months during LVN school so I am glad its there. But some people make it a career. As said prevously you cant be on welfare for ever, that is not entirely true. The adults can only collect for a max of 60 month (in most states). As for the kids they can be on till they are 18. So if an adult goes on when thier child is born they can collect as a 2person family till the child is aprox 5 then they only get benefits for 1.(hope that is not confusing). I agree with teeituptom in a the nurses and dr's should not have access to the ins info, I have seen dr.'s treat the same complaint 2 different ways and the determining factor was the ins. I think only the business office and the admtting dept should be the only ones that have access to the ins info.
It was unbelievable to # of pt that would come into the ER for non emergencies and to use as a clinic (some by ambulance) for colds. One even called the amb because her cat scratched her(when the rn asked why she called the amb for it she said that medical would pay for the amb ride and if she took the bus she would have to pay $1.25).
Some people come to the ER for things like colds because they can't get care anywhere else. Clinics and doctor's offices and such have the option of accepting Medicaid patients; the ER does not. So where are you going to go? The place where you might get turned away or the place where you know you'll get care?
Besides, plenty of people who have private insurance and/or are private pay also use the ER for non emergencies. I know that I myself have gone in on a Sunday for strep throat, simply because my doctor's office wasn't open and I get a bigger finanical break for going to the ER vs. one of those supposed "urgent care" clinics.
As for the woman who called an ambulance for the cat scratch ... well, while I don't know that particular patient's situation, I can say that there are many people who simply can't afford the $1.25 for the bus. And there are people who can't figure out how a bus schedule works. Or perhaps some people feel their problems warrant a quick trip in the ambulance. If you're going to shame anyone for that particular situation, then personally, I'd shame the ambulance personnel for bringing in someone for simply a cat scratch. But perhaps there was more going on there than you were aware of. Surely you're not claiming you know *every* single detail of that person's situation?
I think it's very easy for people to sit and say that they resent paying for other people's medical care, but most people fail to consider - tomorrow it may be *you* needing the handout. Disaster and catastrophe can strike anyone at any time in any place. Being a nurse doesn't make you immune. Tomorrow, you could make a stupid mistake, get fired, then get sued and lose, and end up losing everything ... your job, your license, your savings, your house, your car ... literally everything. And then you might very well be one of the people out there in need of a little help. And if - when - that day comes, I sure hope that you'll be gracious and grateful for the second class citizen status many financially secure individuals push off onto those in need.
Specializes in icu, er, transplant, case management, ps.
This gets into a very tricky area. Who is to judge. What are the SocioEconomic Selection criteria.
Nice of you to take some time away from your hitting those little dimpled balls around;)
Just my point. Who gets to decide? And on what should their decisions be based on? Should only people who are on welfare and receiving Medicaid get kicked off. Or should people who are on SSDI and Medicare, who just don't want to return to gainful employment be kicked off after a period of time? And who gets to decide who they are? And how about those who use their own health insurance too much, especially as they get older? Shouldn't they be warned that if they don't take care of themselves and after they reach a certain amount, they will no longer be entitled to health insurance?:trout:
I have an idea idea. We better buy a large empty island to deport all these ungrateful people to. That way they will not be our problem any more.
i really don't think anything should be free, the medical system is far too streached. i remember my mom and dad saying that in the depression when people got assistance , if they were able they did jobs for the pay , such as road work, child care for others that are on assistance and working , elder care etc... i see no excuse to sit at home and collect pay. however, the human rights advocates need to lay off a little. people are really more resiliant then they seem to think. i really think if you have any doubts about how the system is abused, go to work in an er for about a week. i understand people can't get to dr's appts, clinics have long waits, but i always amazes me how many people can afford cell phones, cigarets and "baby phat" clothes but can't afford even a 10 $ co pay. don't forget about the free bus ride or cab ride home. many days i wish we could ask for a co pay of 1 pack of cigs,,,,most people would leave b4 they did that. don't take me wrong, there are people who need medicade, i welcome them.
Here I go sounding all sappy, but when I was on orientation at the hospital this past week, I walked by the ER and sitting outside on a bench was a scruffy looking guy and he was holding a very sick-looking boy of maybe 7 yrs. old and he was wrapped up in a dirty looking, raddy superman comforter. That kids family may smoke and they may p$$ away what little money they have on Direct TV (which, you know what, if having satellite tv can bring a short-term escape from the miserable situation these people are in by golly let them use their welfare check to pay for it) but by God I wouldn't put that sick child behind someone who came in with Lloyd's of London insurance no matter if they had Medicaid or nothing at all, and anyone who looks down on people because they are stuck in a bad situation can just get off their high horse because you know what? We ALL pay taxes. I pay DOUBLE taxes to the IRS for the privledge of filing a 1099 every year. I pay property taxes, I pay taxes like anyone else. I only have Medicaid for pregnancy-related health care. My children have Medicaid. Thank God our family doctor does not feel the way many here do about Medicaid patients.
Thank God our childrens' dentist doesn't, either. Most of the prejudice I see toward Medicaid patients seems to be from the ones who are a few paychecks away from the Medicaid office themselves.
And just because Medicaid children may be seen in designer clothes doesn't mean their family is wealthy. I have found clothes at the Goodwill from the Gap and Old Navy. Some mom's are expert at scavenging yard sales. Or should Medicaid kids be like the little street urchin ragamuffins in that Charles Dickens novel?
We've got to face that some people will always be stuck in the rut they are in. Some people make it a way of life. Poverty causes depression. Not everyone has the brains or know how or gumption to pull themselves out of it. This doesn't make them unworthy.
I appreciate your opinion Susan I wasn't casting judgement on any one just stating my own opinion and the observations that I have made from past experience.
Some people come to the ER for things like colds because they can't get care anywhere else. Clinics and doctor's offices and such have the option of accepting Medicaid patients; the ER does not. So where are you going to go? The place where you might get turned away or the place where you know you'll get care?
As for the clinics and dr offices accepting medicaid so do the ER's here in CA, we did not see alot of self pay pt's in the ER a few but not many.
As for the woman who called an ambulance for the cat scratch ... well, while I don't know that particular patient's situation, I can say that there are many people who simply can't afford the $1.25 for the bus. And there are people who can't figure out how a bus schedule works. Or perhaps some people feel their problems warrant a quick trip in the ambulance. If you're going to shame anyone for that particular situation, then personally, I'd shame the ambulance personnel for bringing in someone for simply a cat scratch. But perhaps there was more going on there than you were aware of. Surely you're not claiming you know *every* single detail of that person's situation?
No I do not know the full scope of everyone situation there for as I said earlier do not pass judement on anyone. I was quoting what the Pt told the nurse.
tomorrow it may be *you* needing the handout. Disaster and catastrophe can strike anyone at any time in any place. Being a nurse doesn't make you immune. Tomorrow, you could make a stupid mistake, get fired, then get sued and lose, and end up losing everything ... your job, your license, your savings, your house, your car ... literally everything. And then you might very well be one of the people out there in need of a little help. And if - when - that day comes, I sure hope that you'll be gracious and grateful for the second class citizen status many financially secure individuals push off onto those in need.
I did say in earlier post that I grew up on the system and have had to go on it myself so I am grateful that it is available. You dont know me personaly and it seems like you attacked all I said in my reply. I never said I was immune to proverty because I am a nurse you twisted my words and interpreted tehm totally out of context.
I REALLY LIKE THIS SITE AND WOULD REALLY HATE TO STOP COMING IF I'M GONNA GET BASHED IF I STATE MY OPINION.
The vast majority of people on Medicaid are children. I vote we treat them.
As to abuse - work in LTC for a week. See what we spend on keeping the living dead alive after their kids have had all of their stuff transferred out of their name so they don't lose their inheritances.
The vast majority of people on Medicaid are children. I vote we treat them.
As to abuse - work in LTC for a week. See what we spend on keeping the living dead alive after their kids have had all of their stuff transferred out of their name so they don't lose their inheritances.
What we as a society do to the elderly, when they are terminal. Or as you phrase it the
Living Dead. What we see done is so cruel, sometimes.
teeituptom, BSN, RN
4,283 Posts
Then support Universal Health Coverage and that will no longer be an issue for you.
And what may seem as lot of money that it takes to pay for medicaid. What actually comes out of your pocket per annum. Would not pay for me a round of Golf. To the individual it really is a small small amount