Subject: Problem for boaters and APRS?
From:
Date: 12/27/2004 12:12 PM Central Standard Time
Message-id: . com
K4YZ wrote:
N2EY wrote:
Jim, is there some underlying reason why you feel it necessary to
insult me like this?
I didn't mean to insult you, Steve, I just didn't know what you meant.
How can you not?
This very same topic has been front page stuff in Newsweek, Time, etc, for
years.
Mr 28 and one of the others made their arrivals via EMS. Both of
Mr 28's visits were chauffered per the county. Again paid for by
SSI/Medicare. Mr. 28 is under 40 and "disabled" due an injury that,
oddly, prevents him from "working", but not from riding motorcycles,
drinking, and otherwise dissapating that check in a hurry.
So what you've got are people who manipulate the system and use the ER
for things that should be cared for by a primary care physician - or
just good ol' common sense.
And why should they? They've had "consumer advocate groups" led by the
ACLU, NAACP, etc etc telling them this was their "right" to do for decades now.
How do we fix the problem? Shut down all entitlements because some
people abuse them?
Almost...yes.
The only thing that would clean this up is to do a complete survey of
everyone receiving SSI or Medicaid. Just because you're not able to leap tall
buildings in a single bound doesn't mean you can't work at all.
Think I am exaggerating or making this up?
Not at all!
You are most cordially
invited to join me any weekend that I work and spend the evening.
You've got my e mail address...drop me a line. I'll set it up.
What percentage of ER visits would you estimate are legitimate, and
what percentage are manipulations of the system?
Better than 30% are truly inappropriate uses. More on occassions. This
past weekend we saw an average of 60 persons per day. On both days "cold or
flu symptoms" were the leading chief complaint.
Social Security and it's ancilliary programs such as SSI and AFDC
actually promote single parent households
You mean because the benefits for two single people are greater than
those of a married couple? I agree 100%.
I mean because all you ahve to do is get pregnant without a spouse and
"you're in".
Note that the income taxes a married couple pay when both work are
greater than the sum of the income taxes of two single working people
making the same money and living together.
and perpetuate drug seeking
behaviour.
How?
Because they have "insurance" that allows them to go to almost any ER
unfettered. Federal regulations under HIPPA, The Health Insurance Portability
and Protection Act, enforces astronomical fines for healthcare workers who
cross-communicate information about patients without their consent.
These "patients" know that they can go to the ER, complain of "back pain",
and in all likelyhood will get an Rx for atleast 3 days worth of Lortab just to
get them out of the ER, and it's technically illegal for us to warn other ER's
that Joe Schmo is getting drugs here.
I work in four different ER's within a 65 mile radius, Jim, and I
personally know of at leat 12 people who frequent all four of them for the same
"complaint".
Oh...yes...JCAHO, the Joint Commission for the Accredidation of Healthcare
Organizations, has made it mandatory that we post signs telling people it's
their right to demand pain medicine. There's nothing on those same "notices"
that says the healthcare provider has the right to say "no" after having
examined you and determined that narcotics are not in your best interest.
Lastly, every Medicare/Medicaid participating facility is required by law
to post signs in the ER that tell the world that it is again their "right" to
receive "free medical examinations regardless of your ability to pay". These
facilities have the "right" to demand payment later, of course, but what do
they (the "patients") care? They just toss those deamnds in the trash since
they are not obligated to pay them. Mr 28 has an outstanding debt to my full
time employer of almost $40K just for ER visits alone in the last 3 years.
Since any healthcare facility that accepts
Medicare/Medicaid must also accept their rules, these "patients" are
allowed to continue these abuses almost unabated.
Why "work" when all they have to do is get pregnant, get "the
check" coming, and then their "insurance card" follows...Nice deal.
Or
find an MD who will certify them as "disabled"...There's a whole
Cottage Industry of trial lawyers who jump a the chance to help these
poor souls get thier checks rolling in. The recipients will get
"back
pay" checks going back to the first day they filed an applcation for
"benefits". The backpay can be as much as $12K to $20K once the
lawyers play with it for a while since these negotiations can go on
for
a couple of years. (Which begs to ask how is it they managed to get
along without the monies!)
I agree that they are all abuses of the system. But how do we fix them?
Do we just shut down SS?
Get Social Security back to what it was supposed to be..."Security" for
people in thier latter years against retirement. Not a freeloaders ticket to
the Pot-O-Gold.
By the way, YOU are paying for it.
I've been paying for it longer than you, Steve.
Perhaps.
Furthermore, any healthcare facility that accepts federal
entitlement payees (and 95% of all facilites must, if they want to
"do
business") must also accept federal regulations...Not a bad idea you
say? Federal rules are the reason most hospitals must charge $2.00
for
a Tylenol and $20 for a simple gauze dressing from people with "real"
insurance. Medicare says "we will pay you "this much" and you WILL
accept it, sorry if it's not enough to cover your real expenses...
It's called "cost shifting". The people who pay don't just pay for
themselves, they pay for those who don't pay anything.
Here in metro Philly, it is not too unusual for an addict in labor to
show up at a major hospital. Delivery is complicated by many factors
and baby has multiple problems, all traceable to substance abuse. Mom
and baby get good medical care, probably saving both their lives - at a
cost of a quarter million or so in medical costs alone. Then mom signs
herself out AMA and abandons baby to the care of the state. Often baby
leaves hospital by way of the morgue because the multiple problems are
simply too much and too many.
And in a year or two, if she's still alive, mom is back in the same or
worse condition.
I worked in West Memphis, AR for two years after I left the Gun Club. The
first month I was there one of the local baby factories was having her 3rd
child in the ED. Had a fourth while I was there, and was pregnant with number
five and due just about the time I left. Her primary concern was how long
would it take for the new kid's check to get started.
And we all pay for it.
Now - how do we fix it?
Clean house, Jim. A total top-to-bottom survey of every enrollee. And
legislation that allows us to cap their benefits or entitlement periods. We
have to allow ourselves the freedom to say "NO", and to demand that people
carry their own weight.
So, Jim, please do NOT presume to ask me "where" we are in
reference to the current state of Social Security... I see it every
day. You're welcome to join me for a shift if you're really, REALLY
prepared to leave mad...
You are lumping all entitlement programs together, as if they're all
the same. They're not.
They're not all the same, but they are all being abused.
It's clear that *some* people manipulate and abuse the systems. They
obviously need fixing. But how do we fix them?
One step at a time.
Steve, K4YZ