Steve Robeson K4YZ wrote:
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?
I just didn't understand your statement. Nothing more or less. That's
all, now it's clearer.
This very same topic has been front page stuff in Newsweek, Time,
etc, for
years.
I don't read those mags. Philly Inquirer makes them look like tabloids.
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.
That's not a shutdown at all, just a review. Sounds like a good idea to
me.
Just because you're not able to leap tall
buildings in a single bound doesn't mean you can't work at all.
I agree 100%.
Think I am exaggerating or making this up?
Not at all!
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".
IOW, a "marriage penalty". Exists in the income tax system, too.
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.
Which was partly fixed by Carter and then unfixed by Ronald "family
values" Reagan.
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.
Now that's just plain wrong, because medical personnel need as much
pertinent data as possible, for purely medical reasons.
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.
Is that one way Rush Limbaugh got his Oxycontin?
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".
How is Doc B supposed to avoid prescribing a med that is incompatible
with meds prescribed by Doc A if Joe S. won't release medical info?
Whenever I go to the doc, there's always a form allowing release of
medical info to other healthcare personnel and institutions "just in
case". I always agree and sign it, on the theory they should have the
info and I have nothing to hide.
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.
That's messed up, too. I guess nobody could say "no" to Rush, either...
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".
Examinations, or complete care?
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.
Because the ER can't toss anybody out.
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.
What about people who really are disabled?
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.
That's a start. But who gets to make the critical judgements, as in
Person A is really disabled but Person B isn't?
How do you *make* 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.
I agree 100% with your first step.
--
Here's one way abuse in a related area was stopped big-time:
The local transit agency *used to be* a target for injury claims. A bus
with capacity of 65 people would get in a midday minor accident, and
they'd get 90 injury claims from alleged riders. Etc.
Couple years ago they got tough in various ways. One was the
installation of cameras in various vehicles that would show who was
onboard. Of course not all the cameras were real - but who would take a
chance?
They also sent out plainclothes investigators to follow people with
hard-to-disprove injuries like "back pain". Then they'd go after fakers
for fraud, like the guy with back pain who couldn't work at all but
could singlehandedly unload his new bigscreen TV from the car and carry
it up a flight of steps into his house - while wearing the soft collar.
Both collar and TV paid for by guess who.
Most of all, they made a point of publicizing their efforts and
successes. Not only did folks lose their payments - some were sued
successfully for fraud. OTOH, their efforts have actually helped people
with real injuries file successful claims.
And the claims have dropped substantially.
Of course the initial efforts cost serious $$ and were not 100%
successful. But the long-term results were impressive. And it did not
take changes in the laws.
Maybe something like that is step two.
73 de Jim, N2EY