Thursday, April 2, 2009

A Rant on Medicaid

The democracy will cease to exist when you take away from those who are willing to work and give to those who would not. ~Thomas Jefferson

For those of you who either work with me, or who are subjected to my militant rants regarding the passing out of Medicaid in this state as if it were Halloween candy, bear with me. For the other two of on.

I can only speak for the state of Washington, because that is where I see abuse firsthand, every day. Our Medicaid system is broken, seriously broken, yet our governor wants to expand the program and hand out free health care at an even faster rate.

Let me interrupt here and point out that I am not against helping those who need it. Welfare as a concept was designed for either those truly unable to work, or as a short-term solution; not a lifestyle. I believe that if children need medical attention, they should get it. I also believe that their parents should bear some of that responsibility for their care, in the way of co-pays. And if the elderly need assistance, I'm all for it. Truly, I'm not a heartless wretch.

However, here's what I see every day in the emergency room. The key word is emergency. Off the top of my head, without exaggeration, I would estimate that 60-70% of our patients in the ER are receiving Medicaid assistance. They come to the ER for coughs, colds, ear aches, slight fevers, sprains, etc. They come without having tried Tylenol and rest. And they come without co-pays, without any attempt at home remedies that take time, effort, or out of pocket expense. And they certainly don't want to go to the walk-in clinics. The number one reason given? They don't think they should have to wait. Seriously. This is the biggest frustration that I hear from staff. We have patients that we see...wait for it...3 or 4 times a week. For the flu, for back pain, for that persistant cough. This is in the ER.

So how to fix the problem? It seems simple. If you are unwilling to work, we are unwilling to spend tax dollars on you. Period. If you are down on your luck, and need temporary assistance, fine. Let's set a limit. But when you go to the ER, it will cost you $20. No more going in for free Tylenol. If you need that, go to Walgreens. It's $5. That's what I do.


  1. I think you should forward this to the governor that "we" keep re-electing!!

  2. I fully understand where you are coming from, and you are right in some key points. The big picture is, the economy isn't getting better and the bailouts just don't seem to be working. People are going to be out of jobs and will need the emergency medical attention and not be able to afford it. You will of course, have those who abuse the system do what they do and I understand your frustration. But the Governor can see this potential problem coming and wants to be sure that those who truly are down on their luck can get the medical attention they require.It is all in good intentions and you cannot expect someone trying to fix every problem in the state to fully understand the inner workings of the emergency room. You can only hope that what she does works out, and that the right decisions are made that help this country out of the deep rut that we are currently stuck in.

    As far as Thomas Jefferson goes, didn't he once say " Health is worth more than learning"? That's a big statement from a man who relied on his intelligence. Maybe taking care of people is more important than you think.

  3. I have just Two Words for you...... Douglas County

  4. ok... so as a fellow er worker i would just like to add some clarifications... yes, they come in with a fever... that they've had for 3 hours!!! hmmm??? really??? doesn't anyone ever try motrin anymore? dayquil? some cough drops for that cough? oh, and my all time personal favorite... a woman brought her son in because he had... wait for it... chapped lips! sigh! have we not heard of chap stick and some good old fashioned water?
    i fully agree that the people who NEED assistance should get it but instead of being a help aid it is now as you said a lifestyle!
    the other night i had a 19 year old girl and a 21 year old guy bring in their 2nd child... happily suprised i was to see that they BOTH had a job at a fast food restraunt. GOOD FOR THEM!!! way to try and take care of yourselves! i wish some of these 20, 30, 40 and 50 year olds who have no excuse could take some guidence from these young adults!
    it's sad to see so many people come into the EMERGENCY room and waste time and money from people who don't have enough to give because of something that so obviously is not a situation that needs such dire care! if you have to call in advance to see if we are busy or if the wait is long... in the ER... then you do not NEED to come to the ER!!! PERIOD!!!