Patients without insurance who self prescribe from livestock supply catalogues

Nurses General Nursing

Published

My patient went home the other day who had pulmonary fibrosis secondary to having raised pigeons and other farm related exposures. They are ranchers and very independant people without insurance. She told me how she did apply for government medical aid at one time. She said the place was filled with people who don't speak English, but she was denied help. No wonder people resent immigrants!

What she has been doing for years, she told me, was order animal supply antibiotics to treat her infections and illnesses. They are ranchers and raise cattle, horses, sheep so they have access to these things through their animal supply catalogues. They barely scrape by and obviously can't afford insurance. I heard from the doctor that they lost it at some point. Obviously, a lung transplant candidate isn't going to be viewed favorably by insurance companies.

I really loved this family. They were very appreciative and modest people, soft spoken and hard working gritty types. Yes, they own 100+ acres which has been in their family for more than one generation. The adult children follow the rodeos for a living. Should people like this be denied healthcare because they make their living from the land? Should they be forced to sell their land? Meanwhile, people who come into the country illegally get free medical care?

There's something wrong with our healthcare system where hardworking Americans are forced by financial neccessity to obtain antibiotics from livestock supply catalogues!!!:angryfire

Specializes in Emergency & Trauma/Adult ICU.
well their clinical diagnosis and assesment skills need polishing - good primary care providers whether MD or NP can determine betwene probably a virusand probably an infection that needs ABx clinically ...

It's not the skills of the NP I question ... it's the way these clinics are being marketed.

"Feeling under the weather? Don't wait -- go to the MinuteQuick clinic." ... quote from the radio ad being aired currently for a retail clinic in my area.

So the clinic's customers go ... and expect SOMETHING. After all, "I'M SICK -- SOMEONE MUST DO SOMETHING." The pool of customers would dry up quickly if many were told that what they needed was a day or 2 of rest, some OTC analgesics and a dose of common sense.

The primary family practice group my doctor is part of has an urgent care clinic near the hospital.

If I get sick at night or on a week end I call and a nurse practitioner calls back. Her telephone triage determines whether I need to be seen in the clinic, have her recomment self treatment (including a telephone prescription) or call 911.

(I've only called once with a painful dizzying sinus infection on a Friday night that was treated with recommended OTC)

People who come to the ER who don't need to be assigned to a nurse are walked to a similar clinic across the street. Staffed with MD's. NP's, PA's, and LVN's they stich a lot of wounds, swab throats, do minor surgery like ingrown toenail, and such.

Once a young man walked in and said he was having an asthma attack. He had no HX of asthma. He was in DKA and admitted to our unit after ER.

I agree that our current system is broken and a disgrace.

What continues to surprise me, however, is the number of people including health professionals here at allnurses.com and elsewhere who can describe in great detail the shortcomings and outright idiocy of the rules and regs of the current government assistance programs ... but believe that a government-designed universal coverage program will be all shiny, bright and new.

JMO, but I think it's pure fantasy.

I do think that some form of universal health coverage is coming within 15 years or so, but I think it will result in an increase of what we are already seeing now and what exists in some other countries: a 2-tier or parallel system. Everyone gets rolled into the universal system, but those with the means to pay out-of-pocket get their care from private providers.

Interestingly, this tends to keep prices in line -- as in the significant drop in the price of Lasik and other similar vision-correction procedures in the last 5 years. This is almost never covered by insurance, so those patients are paying out of pocket for their procedures. When providers need to attract customers who will not be dipping into the vast well of insurance industry and/or government monies VOILA -- suddenly they find a way to keep costs in line. Go figure.

As for ER abuse -- there are several categories of ER abuse but from where I sit the biggest abusers are not those without other means of getting care but those who simply cannot differentiate wants from needs, no matter how much education you provide re: what constitutes an emergency. Patient A has insurance with a $20 PCP copay and a $75 ED copay. Patient A has had XYZ symptom for 3 weeks, then calls PCP office at 4pm on a Friday. Patient A becomes irate when phone triage nurse at PCP's office suggests appointment the following Tuesday and comes to the ER instead. And loudly makes known how pissed off she is by the expectation that she pay her copay. No matter what "system" is in place it will always be circumvented by those who simply want what they want when they want it.

I don't think a single payer system will be shiny, bright, or perfect. I do think we can do much better when focused on our peoples health rather than profits.

When providers must compete because patients can truly choose then we nurses will have to work to educate the public about true quality.

Excellent medical and nursing care is more important than a harpist in the lobby while patients vomit on the floor because there are not enough nurses to answer their lights.

As Gilda Radners character said, "I's a;ways something."

But we can do better.

Specializes in Emergency & Trauma/Adult ICU.
When providers must compete because patients can truly choose then we nurses will have to work to educate the public about true quality.

Excellent medical and nursing care is more important than a harpist in the lobby while patients vomit on the floor because there are not enough nurses to answer their lights.

As Gilda Radner's character said, "It's always something."

But we can do better.

I agree.

The agriculture subsidies are not going to the family farmer.

http://www.cato.org/pubs/handbook/hb105-9.html

Saturday, December 15, 2007

Farm subsidies Corporate Welfare, Dead Farmers get Billions, Corporations get millions! ...

...Today farms have one of the lowest failure rates of any industry in the country. But that is because of the millionaire farmers subsidized by Politicians as the small farmer continues to be left to fail and helped only by Willie Nelson and Farm Aid....

http://anaverageamericanpatriot.blogspot.com/2007/12/corporate-welfare-program-has-passed.html

+ Add a Comment