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The medicaid problem is just a symptom of a much larger illness. There are many medical costs that are justified. Good people get sick and need legitimate care. However there is a huge amount of waste that goes on daily.
1. Inefficency in health care delivery - duplicated tests, unnecessary tests and medications (patients demand , poor record transfer and communication, and sometimes just laziness etc.)- not to mention the fact that we are not computerized enough for our needs.
2. Spending on medically futile care in patients that have poor/ grave prognosis. ( I dont want to be too controversial at this time- but healthcare providers know what Im talking about)
3. Drug company extortion - need I say more
These are some of the main issues. I can go on.
As for medicaid patients - I have worked in medicaid clinics before and a lot of these patients are not the best. They dont take there medications , they miss appointments , they are very demanding and they suffer from what I call the --The American Syndrome - Obesity, fast food addiction, laziness, no drive, and Drug addiction.
I would like to point out that there are many medicaid patients that are hardworking, health conscious people and that this is one heatlhcare provider's anectdotal opinoin. I ask that you talk to other doctors or nurses that have worked with these patients.
In 10 - 20 years, maybe sooner - medicare will pay the same rates as medicaid. (all you baby boomers - get ready for that)
More to come. I welcome any opinions on what I wrote.
The medicaid problem is just a symptom of a much larger illness. There are many medical costs that are justified. Good people get sick and need legitimate care. However there is a huge amount of waste that goes on daily.
1. Inefficency in health care delivery - duplicated tests, unnecessary tests and medications (patients demand , poor record transfer and communication, and sometimes just laziness etc.)- not to mention the fact that we are not computerized enough for our needs.
2. Spending on medically futile care in patients that have poor/ grave prognosis. ( I dont want to be too controversial at this time- but healthcare providers know what Im talking about)
3. Drug company extortion - need I say more
These are some of the main issues. I can go on.
As for medicaid patients - I have worked in medicaid clinics before and a lot of these patients are not the best. They dont take there medications , they miss appointments , they are very demanding and they suffer from what I call the --The American Syndrome - Obesity, fast food addiction, laziness, no drive, and Drug addiction.
I would like to point out that there are many medicaid patients that are hardworking, health conscious people and that this is one heatlhcare provider's anectdotal opinoin. I ask that you talk to other doctors or nurses that have worked with these patients.
In 10 - 20 years, maybe sooner - medicare will pay the same rates as medicaid. (all you baby boomers - get ready for that)
More to come. I welcome any opinions on what I wrote.
Will we see an improvement in service in the next 5, 10, 20 years?
Sounds that both (companies/individuals) must do their part to reach a goal that will benefit everyone.
Thank you for the last posts. madmd- can you give an idea of what should be done- from a providers prospective? My brother does pro- bono plastic surgery for people who need burn treatment/trauma surgery. He mentioned that the "American syndrome" you speak of is the reason drs in med school dont want to do cardio-thoracic surgery- bcs the patients willl smoke and eat at McD's every week-anyway- However- that is a prejudicial calibration that insurers use- If patients try their best to get well- and have testicular cancer (an example- there is a young person at work- he is 20 years old-it is heart breaking) people like him should be protected- If they take their meds. follow drs orders etc. The US system is lagging WAY behind-I think.
This is a major issue and I thank everyone who has positively contributed here.
sunny
Last edited by dreamofmonterey; 04-06-2007 at 11:03 PM..
Reason: sp
I have worked many years in medical offices/billing. This is an issue that burns me! Alot of the problem with Florida Medicaid is that the majority of the people are abusing the system. They lie about their income or circumstances to receive Medicaid benefits. People that don't really qualify are stealing from those that really do need the help. If Florida would actually investigate these crooks they would see how much $ is being wasted that could help those that really need it. I personally know young women that would cry "single mom" to receive benefits..yet they somehow had the funds to buy breast implants. And none were "single". They had their men but were wise enough to not get married..therefore, they could say they were "single". I've heard people brag how they get free food and medical care from Florida yet they were living in a brand new pool homes in Cape Coral, driving brand new vehicles, buying the finest clothes and taking expensive vacations a couple times a year. Everyone knows how to "work" the Florida system. And those people are ripping off us tax payers and stealing from those in real need. And everyone knows this, yet nothing is done about it.
Location: Lots of sun and palm trees with occasional hurricane :)
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SouthFloridaNative. Much of what you say is true but the MAJORITY are not like that. Also, the abuse is not exclusive to Florida Medicaid. It happens all over. I've been in the field in NYC and Florida. Florida is not alone, trust me.
SouthFloridaNative. Much of what you say is true but the MAJORITY are not like that. Also, the abuse is not exclusive to Florida Medicaid. It happens all over. I've been in the field in NYC and Florida. Florida is not alone, trust me.
DCF Making Phone Discount Application Available Online
People applying online for state assistance such as food stamps or Medicaid will now be asked if they want to get discounted basic telephone service, which they are entitled to get under federal law.
The federal Lifeline program entitles people who get certain types of government help to receive a basic telephone service discount of at least $13.50 per month from the federal Universal Service Fund. But right now only about 12 percent of eligible Florida households are receiving the discount.
A new effort by the state Public Service Commission and the Department of Children & Families is aimed at boosting that number.
Now, anyone applying for certain programs through DCF's online application will be prompted as to whether they want to apply for the phone discount.
Healthcare is a difficult subject and there are so many variables.
I never heard that the Canadian socialized medicine system worked. When I was living in NY we had patients every day crossing the border because they could not get good or timely care in Canada. I don't think that's changed. Now I live in Miami and we have international patients, mostly from Latin America, who come here explicitly because they can't get good care in their countries. And we have our own American people who go to Dominican Republic, Costa Rica, Columbia, even Cuba if you take all your own supplies and know "someone" there, only because our dollars go a whole lot further over there.
The problem with healthcare here is like everything else, we want to have our nice homes, cars, good schools, and live the life. But we have to pay big bucks for those things. Physicians are no different. They are in debt up to their eyebrows from med school, they have families, they've put in a lot of years to become a doctor, and they want to hop on the gravy train.
I don't know. The hypocratic oath says one thing but everyday life says another. I don't think it's the physicians themselves, most of the time, who will refuse care based on finances. It's the administration/management because you do have to buy equipment, pay for locale, staff. How do you provide services if you don't have what it takes to do it? Third party insurances do NOT pay all the bills. That's where the self-pay patient gets screwed and that is wrong. Self-pay is subsidizing Medicare/Medicaid/HMOs and that's almost illegal. It's discrimination at least. Why should the non-insured have to pay such high amounts just because you aren't one of the lucky ones that has coverage?
The Medicaid population definitely gets shoved aside. There aren't as many appt. slots available, as quickly. I have SEEN where patients with Medicaid are put on the back burner. I also think sometimes that most do not take advantage of preventive care and then more time and expense is needed. The Medicaid fee schedule is a joke and healthcare cannot survive on it. Just like you can't survive on a job that pays $6.25/hr. Some things end up being neglected.
You have nursing homes that charge $5K/mth per person. Yes, those are nice, clean, have caring staff for the most part, you have activities, they are regulated and the patients/families paying that kind of money have specific expectations in return, and they know how to make noise.
Medicaid facilities are run down, short staffed, have less than the best qualified staff, patients are cared for haphazardly, may or may not get the correct medications. It is sickening.
I don't know what the solution is. I don't believe in discriminating due to financial classification but it does happen.
But they wont change the sheets- (this is person who fought in the war- defending the US!!) No- it isnt the fault of the workers- who have no money- the institutions MUST be held accountable.
Obviously, the govt MUST intervene. If THEY expect people to serve the country-then they need decent facilities (not like Walter Reed- patients getting bitten by rats) It is a disgrace that we live in the richest nation, and our veterans are being treated like garbage. It is unforgiveable.
What about universal medical care, works in Canada, will it work in the USA?
Rule 1: Complex, modern healthcare is very expensive to provide regardless of the system used to fund it. Constant advances in technology and capabilities, combined with an aging population drive the costs even higher.
Rule 2: There is no such thing as the perfect system under which everyone is happy, and wherein no one ever lacks or falls through the cracks. The Canadian health system tends to provide very good emergency care, but has longer wait times for routine items. It ain't perfect.
That being said, could a Canadian model work in the US? Technically such a system could be instituted for probably the same overall cost as the current private system. Monies saved by businesses and individuals from health insurance premiums would disappear in the form of the increased taxes necessary to fund the system.
From a practical standoint, there are many obstacles, the first of which is the inherent nature of people to resist change. It's the old "it worked for my grandfather so it's good enough for me" school of thought.
There would also be a large resistance from people currently with ample insurance coverage who would view a tax increase as government forcing them to pay for the well-being of "those damn welfare bums".
Also don't discount the very powerful outcry sure to be heard from insurance companies, doctors, and medical corporations whose major interest is in protecting the corporate bottom line.
A socialized medicine system could certainly work in the US, just as it has succeeded in most modernized nations.
The real challenge is to find a core group of politicians comitted enough to the concept to brave the possible loss of their elected positions in the name of equal access for all. That could prove very difficult given that a politician's most important task is to get re-elected. Don't look for major changes anytime soon.
Floridabound09 wrote:
Quote:
If I remember Canada struggled with it at first because they sorted and seperated people who they felt made too much money, you cannot do this, it has to be a total package.
This may or may not have been true in some provinces in the early days of universal coverage, but currently all eligible persons have equal access to services. Eligible persons are usually those who are either Canadian citizens or Permanent Residents who have maintained a residence in their province for a set number of days per year.
Additionally, in Ontario, once a person attains the age of 65, most prescription medications are provided free of charge or for a very low dispensing fee, depending on the income level of the person. My father is a long way from a charity case, but even so, he pays $7 per prescription.
Health care is administered by each of the 10 provinces, so there are actually 10 similar but different programs in use. Some provinces have instituted some form of financial recovery method to help fund the programs. Here in Ontario, home to 1/3 of the Canadian population, a health care levy is collected in conjunction with your income tax return. The levy exempts people with taxable incomes under $20,000 and then rises according to income level.
Taxable income between $25-$36K has a levy of $300; $48-$72K has $600; and the maximum payable is $900. Compared to private insurance premiums, the levies are peanuts, but are still viewed by many as an unjust tax grab.
I believe other provinces have systems whereby people accessing the system are charged a small ($5) user fee when they visit the hospital or doctor's office. No one is turned away, though, if they don't have the $5.
Last edited by Cornerguy1; 04-18-2007 at 09:58 PM..
Reason: hewlett packard keyboard insists on making typos!
It seems a crisis is brewing in Florida, because it is becoming increasingly difficult for Medicaid patients to find doctors willing to take them on. In Naples, finding a specialist willing to accept new patients is exceptionally difficult. The problem lies in reimbursement from the State, the average office visit can cost a doctor upwards of $80 dollars. However, the state's Medicaid reimbursement is $32. That amount makes it difficult to cover the cost of operation, including utility bills and staff salaries.
This got to change or we all will experience this problem sooner or later....
The real issue lies with the fact that the Feds ONLY supply funding for Medicaid to ILLEGAL ALIENS. They basiucally don't give a crap about poor Americans.
That is why our medical system sucks. The illegal suck up every dime off the system.
Illegal women for example, are taking up SO much of our medical services, American women cannot get the care they need. It is a revolting situation. Thank you Bill Nelson and Mel Martinez for creating and refusing to deporting these people. You dumb idiots wnat to give an amnesty to these people so they can continue to use every dime of the American health care system that was designed for America's poor.
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DCF Making Phone Discount Application Available Online
5 k a month to take care of your grandfather-
That is the future of America!
You dumb idiots wnat to give an amnesty to these people so they can continue to use every dime of the American health care system that was designed for America's poor. 
