I have long felt that managing medical information is more important than cost – as the incredibly bad communication results in an incredible amount of cost. Build a system that actually knows what it is doing and does what it should, and you’d save a whole lot. Your daughter sadly paid the price for the non-system we have.

I don’t know what I think about a single payer system. It just seems we change from greedy people running healthcare to bureaucrats doing it. Government and politicians can help us come to a solution, but they are not themselves the solution.

Yep, I have. I went two winters without central heat (where it gets down to 10 and 20 below) and several months without adequate sanitation. Using your oven to heat your trailer is not a good idea, btw.

However, I never asked anyone for anything, I just kept working and going to school and barely staying afloat. I have one serious chronic illness, and used my hard-earned money from my two jobs to pay for meds and stuff out of pocket. I probably had a lower standard of living for those 2 years than most of my patients ever had. It was even to the point of my neighbor who hunted deer coming over to give me extra meat so I had meat to eat.

I’m guessing they at least have a functioning toilet and heat. I think I have plenty of credibility to comment on layzeeness and apathy because I had neither and got out of poverty just fine and am better for it. This woman, despite having no obligations, couldn’t even call to make her own appointment—she expected someone to do that for her. It’s representative of the whole problem with welfare—entitlement, apathy.

As for “access to health care”, note how she went to the ER with a canker sore. Seems her access to health care was just fine. If she didn’t have any access to health care for this problem, she could have gone to the pharmacy or taken tylenol for the problem like everyone else or, gasp, SUFFERED with her 10/10 lip pain until it went away. I suppose you think everyone on welfare should have access to the highest and most expensive level of care for a common problem that no reasonable person would seek any health care for, but I don’t. Again, with the apathy, she hadn’t even bothered to try to go to a clinic even though clinics that accept medicaideurs are everywhere.

We forget that people get this way—apathetic and unable to think for oneself— because welfare is so “accessible”. There is a certain % of the population that will keep using whatever is given to them rather than doing things on their own until such opportunity is taken away.

If you want to see how welfare affects people, come to the ER. You’ll agree with me after very few shifts.

And who are you to judge from a short encounter who is and isn’t fit for financial assistance? You claim that the money is going to the “able bodied” but you don’t actually know what underlying health problems that someone might have just from looking at them. Just from looking at me one would have no idea that I have asthma, and that sometimes a brief jog to the bus stop when running late is enough to send me into a serious asthma attack. Because I look healthy. I’m young, and try to stay athletic as a preventative measure. Though I now have insurance through a state program for low income individuals and familes (the state purchases policies in bulk and gives them to those who qualify for a very low monthly payment), I spent months on a waiting list. When I was at my poorest, and uninsured, I spent time worrying about whether or not I’d be able to buy food, pay rent, or stay in school should I get injured or sick. I have badly sprained both my ankles (four years apart) and been unable to afford a doctors visit or ER visit either time. Also, poor people, even ones that aren’t seriously mentally ill (does that mean no assistance/care for the non-seriously mentally ill? So the schitzophrenic gets care but the person with panic attacks doesn’t?) or obviously physically sick deserve access to care that they can afford, as a way to stay healthy and continue to be productive. If that care is cobbled together through clinic and ER visits because they can’t afford anything else, then thats how its going to happen. This doesn’t mean that these people are lazy, bad or less worthy, it means that they’re using whatever resources are available to them to gain access to some level of care. While it does strike me as ridiculous that Dr. Rob’s wealthy suburban patients feel comfortable spending a couple hundred dollars a month on car payments, but feel weird spending $150 at the doctor (though, it does feel frustrating to spend money at the Dr’s office and leave w/o answers, particularly if you don’t have insurance helping you cover the costs), such individuals are increasingly atypical in an environment where thousands of people a month are losing their jobs, their insurance and their means of paying for any healthcare not covered by their insurance.

IMO the solution to this would be a single-payer healthcare system. From everything I’ve read this system would lower the cost for both Doctors and Patients (though I could be wrong on the lowering-the-cost-for-Dr’s side of things) while providing universal access to people of all income levels. Because health care shouldn’t just be for those with insurance or those who are wealthy enough to pay, and poor people shouldn’t have to pass a “sickness test” in order to be deemed worthy of getting aid to see a doctor (as Nurse K suggests). Access to health care is up there with food, shelter, and education as something that all humans should have the right to have access to at a price they can afford.

Your gripe is people misusing the system. My gripe is people complaining about my charges when they spend way more than that on suburban frivolities. They think nothing about going under the car payment for a Lexus (or even Toyota), but feel like I should somehow be willing to charge far less.

I don’t apologize.

BTW, clinics I refer to have starting fees of $20 for the uninsured or those with low income and high deductible health plans. Maybe your patient should come talk to me; I’ll tell her where to get more affordable care. I’ll also access a database of pharmacy prices to tell her exactly where the cheapest script are for her. Then I’ll glance at her med list as a service to her and, from memory, tell her which meds have a reasonably similar $4 equivalent that she can ask for. There are many clinics that are starting to charge the uninsured the same as if the patient had Medicaid and getting charity donations and government grants to make up the difference.

If you’re really getting your panties in a wad, you should know that I spent a solid 3 minutes talking to that woman about the importance of having a community doctor and gave her my medical resources packet for low-income and uninsured people which does many things, including listing area doctors that accept Medicaid—not just listing them, telling how to get there, the hours, the conditions treated, etc. Who designed that packet for low income people? ME. I’m JUST a staff nurse and had to do no such thing. There is a strong theme of empowerment and every section tells you exactly what to do. The dental section says, “It is very hard to find a sliding-fee dentist with an open appointment, so don’t be frustrated if you have to make many calls!” The medication section talks about the $4 prescription plans and says, “If you can’t afford your medications, ask your doctor if you can be switched to one that costs less!” Seems like ‘no duhr’, but many people simply stop taking medications or give up right away in situations like this.

Also, maybe you’ll be happy to know that said packet has allowed me to speak to managers in my hospital and managers and leaders in my hospital system as a whole.

I work with these people every day, and it’s not a big secret that welfare users have greater than 85 emergency department visits for every 100 users PER YEAR, most of it for non-emergencies that can be seen at the clinic. The stuff I wrote about on my blog is very prevalent, that attitude of learned helplessness.

After my education moment, she was psyched to get a community doctor and asked me to make her an appointment. Just another example of learned helplessness. I told her it was as easy as picking up the phone and it was her job to find an appointment that fit her schedule. She looked at me like I just told her to take a bath in excrement, but she said she’d make the appointment herself. It’s hard to break the entitlement mentality and learned helplessness that welfare instills in people since birth, but I’m trying to do it with 2-3 minutes of education and my little packet. The ‘phone’ example is one example of something that I see every day. I can call 10 of my girlfriends in the lobby, but ask me to make an appointment, and somehow I can’t do that because I’ve always just gone to the ER when I need something.

So, you can say Nurse K’s a bitch, but Nurse K is trying to change these things that our welfare system has instilled in these people from a very young age by helping people make appropriate health care decisions that help our bottom line (48 million of charity care last year alone) as well as the patient’s well-being. Being outspoken goes a long way.

So bite me.

She is expressing frustration..that I’ll bet she doesn’t express to them. I worked in registration, closely with a community emergency room and I understand the frustration and we got nothing close to the abuse that inner city hospitals get.

I personally don’t say those things.

My own mother had/has MDCR/MDCD. She got it a while after she retired. She never once walked into an ED for anything. She was brought by ambulance a few times these latter years and 3 times last summer/fall but for true emergencies.

Fortunately for her… she had a compassionate internist agree to take her on as a patient even though his practice was full at the time and she had MDCD..which means they can’t bill any balances after MDCD.

I was in a departmental meeting at the hospital one afternoon, when a co-worker with disdain brought up MDCD patients and basically had the attitude that they were lowlifes.

With the Director of finance for all facilities sitting there…i quietly stated that my mother has MDCD. You could’ve heard a pin drop. She looked embarrassed and looked down.

I felt embarrassed saying it..but I spoke up.. because I KNOW…there are many people who have or do work hard.. but for what ever reason…they couldn’t make ends meet. I always feel bad when I hear the mDCD masses generalized and lumped into one… when there are good people too. Young, old and in between. Thank God for the help. GOOD people. And I have seen where they get the help they need, rise above their difficult circumstances, no longer need assistance and have become productive and give back to society.

I know we all know this.

But I think it is the generational MDCD abusers that are hurting everyone else…including themselves..but they don’t realize it or care.

Or the illegals that get everything free.

I don’t want to see anyone suffer… but if I saw some of what she sees all the time… it would be discouraging and frustrating and I am sure maddening. I don’t know nurse K at all… but I have a feeling…all that negative energy you see expressing her disdain for milking the system… I think she just as passionately throws herself into facilitating healing and emotional support of the truly ill. Just a hunch. (I’ve seen it at work)