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Friday, January 14, 2011

Why States' Medicaid/Social Services Are Going Broke

1. EBT (food stamp) cards pay for junk food and sodas plus have a cash spending limit each month depending on what your level of benefits is.

2. For most patients Primary Care Physician = Emergency Room

3. Most patients have a complete lack of personal care/responsibility/hygiene

4. If meds are "free" why change eating habits and exercise?

5. Why stop smoking if inhalers are "free"?

6. Multiple patients with repeat trips to clinics/ERs for venereal disease treatment.

7. New baby = more benefits

8. Have a heart attack/stroke/other coronary event? The hospital will fix you up and give you meds for "free"!

9. Wreck your kidneys with poor self-care or drug abuse? Dialysis is "free" and so is the transport to and from the dialysis center.

10. Don't have a car? An ambulance ride is "free"!

11. Don't want to take responsibility for your kids or interact with them in any meaningful way? Psych meds and ADHD meds are "Free"! As an added bonus you and your new baby daddy can use these medical grade amphetamines to get high and sell some on the side for extra spending cash.

12. Want to be a 350 pound slob that smokes pot and eats Cheetos all day? Have a baby of unknown parentage and everything you need is "free"! (none of the states drug test for eligibility, all you have to do is say no one in your household is on illegal drugs)

13. Want to piss your pants and put on a crazy show for a social worker? Just do it and everything is "free"!

14. Have your daughter or granddaughter get pregnant from unknown parentage then call social services and tell them she is an unfit mother and that you will foster the child to keep it with the family and the state will give you over $100,000 in monetary compensation to "foster" the child income tax free plus you get food stamps and healthcare all free! (actual amount varies by state but it is is pretty close to a six figure tax free income in every state and it works with any foster not just one of blood relation)

15. Somebody turns you in for claiming two kids and no man living in your 3 bedroom state paid for apartment? Have your man crash at someone else's house for a few days and get both kids for a couple days to cover the case worker visit and lie lie lie about how you have no idea why someone would turn you in because you are the greatest mother on the planet!

16. Get a prescription for 100 count boxes of diabetic test strips and resell them on e-bay/craigslist/some other sale site or try to return them to a store that sells them without a receipt with some stupid story about how these aren't the right ones for your machine to get cash back.

17. Wanna get high? Go to the ER with a "hurt back", "pulled muscle", "other random terrible pain" and get a handful of narcotic pain pills. It's all "free"! Added bonus: this may be repeated multiple times at multiple ERs before the ER docs or pharmacy figure out your game and stop giving you narcotics.

18. When that trick stops working find a shady pain management clinic and claim you have "sciatica" so you can get an assload of oxycodone/morphine/hydromorphone for your pleasure and resale.

19. Don't want to pay for Tylenol or Motrin OTC products? Go to the ER and get a prescription because that way it is "free" at the pharmacy. Added bonus: Some states allow the billing of OTC items like toothpaste, diapers, baby wipes, shampoo, soap, deodorant, etc. at the pharmacy on your prescription card so you can get those items for free and resell them later depending on your level of benefits.

All of these examples are based on actual things I have witnessed in the grocery store and things I have heard people talking about at the grocery store, pharmacy, Wal-Mart, and Target while shopping.

Example 15 is a person I know that has been turned in to social services for fraud on 4, count em 4 separate occasions and each time she gets the kids, has the boyfriend stay at his mom' s for a few days, and schmoozes the case worker. She is always let off the hook and had the balls to tell one of her children she couldn't get married until he turned 18. What a cunt!

Example 14 is a lady that fosters 3 to 4 kids (no blood relation) at a time and uses the money from the foster program to buy and rent Section 8 housing. (Section 8 housing is welfare housing paid for by the state) I probably don't have to mention that all of the kids she fosters are on serious ADHD and antipsychotic meds. Turning her in to social services also yields no results.

One of the ER pain pill junkies was mentioned in a previous post about Ultram (tramadol) addiction.

These are just a few small examples of the atrocities that entitlement programs breed...and they do breed... This has not touched on fraud by unscrupulous medical offices, medical supply firms, etc. that also cost an assload of taxpayer dollars. These entitlement programs also breed stupidity because the kids only have to go to school one out of every 9 or 10 days depending on the state and I guarantee most of them only show up every 9 or 10 days. With "No Child Left Behind" policies this means that a lot of kids are being pushed through the system and are doomed to graduate high school (if they make it that far) and not be able to read beyond a fifth grade level. We as a society are doomed unless entitlement programs get military strict and stop paying for unnecessary bullshit like junk food and ER visits for Tylenol and Motrin prescriptions.


Gwyn said...

We have reported for fraud before, and they're just "meh" about the issue.

I live right next to another state, which is WAY cheaper rent to live in (but taxes/insurance is much higher). We have pts that have the state I live in's Medicaid, but with an address/phone# in the other state. All because they pay for more stuff than the other Medicaid.

Bulrush said...

I don't know where you are getting your numbers from. I was a foster parent in Michigan around 2000. We didn't do it for the money, we were trying to help someone. We got about $300 per month per kid, which barely covered food, and nothing else.

MDB said...

I've seen multiple cases of abuse of the system in the time I was an intern and now a pharmacist. Another true abuse is in my town an elderly woman calls 911 for an ambulance ride to the hospital for shortness of breath or difficulty breathing. It has happened in the past with other patients who call like 5 times in a month or two period, often they are terminal patients though. This lady called 22 times in december alone and she goes to the ER, gets checked out, maybe a neb or two and then the hospital has to call the police to give her a ride home. A number of times she has met the ambulance outside her house and jumped in the ambulance. What pisses me, the cops, and the rest of the hospital staff off is that she smokes 2 packs a day and is on oxygen. It also doesn't help that each ambulance ride costs ~$600 as it is a private ambulance service and the woman has no insurance so all those rides and hospital visits are being charged to the taxpayer.

Josh said...

Great post. Now getting ready to get yelled at by people on medicaid.

Disgruntled Tech said...

So sad...all TRUE! My blood pressure goes through the roof every time I here one of them say, " I don't have to pay for my pills, they free." Before I can even stop myself I let them know the good people of NJ are picking up the tab for their pills.

I caught a kid last week trying to get over on me with a Tramadol Rx. He gave some bullshit lie that he needed to pay cash because he works on a boat and the workman's comp coverage wasn't active yet??? Yeah, my bullshit meter was off the charts on that one. Well, I ran it through his insurance and what do you know... he lied. Turns out he was pharmacy jumping and just filled a 30 day supply a week earlier right up the street. What really pissed me off was I was sick as a dog and he wasted my time. I nicely wrote DO NOT FILL UNTIL XX/XX/XXXX on top of the script and told him to leave. Ass clown.

Love the blog and that little vent actually made me feel better:)

Anonymous said...

I know you see the system abusers probably multiple times daily. Just please try to remember there are some good people in crappy situations, they have a legitimate need and benefits are temporary while they are working to get back on track.
Many times they are lumped with the abusers just because they have assistance or won't ask for help to keep from such accusation.

***Not receiving any benefits - 20+ years steady work in health care.

Anonymous said...

I used to work in a state agency that "helped families in need". It's supremely difficult not to become bitter because people would lie right to your face. We often KNEW of fraud but unless we could prove it and caught them red-handed within a certain time frame, nothing ever came of it.

I would frequently terminate people's benefits for suspected fraud and my SUPERVISOR would reinstate them to keep numbers up. So it's not just the families, its the whole system.

Anonymous said...

About those ADHD and psychiatric meds for kids in foster care - keep in mind that some of those kids are in the system with abysmal prenatal drug/alcohol abuse histories in their "parents," family histories of psychiatric illnesses, and neglect prior to foster care, etc.

My two foster (now adopted) kids NEED those medications to function.

Not everyone abuses the system. The people who do infuriate me - but some of us use the meagre benefits we have (e.g., health insurance for adopted, high-risk kids) to make the kids' lives better, in conjunction with quality time, stability, good special education services, and positive examples.

Our family = one adult working full time, no food stamps, no free housing, and two kids with legit special needs. Also, no expectation that things will be "free", stable, long-term primary care docs, and responsible use of medications.

But I have neighbors who could fit under probably 2/3 of your categories. Drives me crazy.

One more thing: Even when my kids were foster kids, the income wasn't that high. It certainly didn't cover the additional cost of two high-maintenance kids.

Anonymous said...

Not Medicaid here, but what about divorced women whose exes have to pay the kids' medical bills, and take the kids to doctors or the ER even if they aren't sick, just to soak him? I have a relative who used to do this, until the kids got old enough to tell her that they didn't want to live in doctors' offices, so that's how I know.

Anonymous said...

You fail to mention the honest families where perhaps one parent is disabled, and the other is working at a retail store after being let go in the economic downturn. You probably don't even notice the patients who are thankful for your help each day.

Big 'N Tasty RPH said...

When I write bitch posts like these I am only referring to the abusers not the 10% of people who are temporarily getting assistance until their situation improves or are permanently disabled or on a copay discount program because their social security and Medicare part d sucks.