Subsidize It…You Get More of It
In the comments to this post on health care, commenter TJIT left this little gem of a link that has the, supposedly true, conversation between an ER doc and his patient.
Me (after reading triage sheet and rolling my eyes): Hi, I’m Dr.____. I’m the doctor in charge of the EMERGENCY Department tonight. I see that you came by AMBULANCE. What was so bad that you had to call 9-1-1 at 3 AM to be rushed to the EMERGENCY ROOM by AMBULANCE? What is your MEDICAL EMERGENCY? What is your LIFE OR LIMB THREATENING problem??
Patient (clueless to the sarcasm): Oh, I think I’m pregnant again.
Me (thinking that this clueless girl still don’t get it): You must be in a lot of pain or bleeding severely to come in by ambulance, huh?
Patient: No. I just didn’t have a ride.
Me: So you’re not having any pain or vaginal bleeding?
Patient: No, no pain. No bleeding.
Me: Did you take a home pregnancy test?
Patient: I didn’t have one.
Me: You know they sell them at Walmart. They’re open 24 hrs.
Patient: Well I couldn’t go to Walmart in the middle of the night.
Me: So you took an ambulance?
Patient: Yeah, but my insurance will pay for it.
Me: Insurance? It says here that you’ve got Medicaid.
Patient: Yeah, that’s my insurance.
Me: No, dear. Medicaid is not insurance.
Patient (quickly interupting me): Yes it is! That’s my insurance!
Me: No, dear. Medicaid is not insurance. Medicaid is a government hand out! It’s only called insurance if you’re paying for it.
Patient: Well, what ever! Medicaid will pay for it.
Me: Good grief! You didn’t have to take a $400 ambulance to the hospital for a simple pregnancy test.
Patient: But I didn’t have a ride.
Me: You could have taken a cab. Surely you got $20 bucks for a cab. And those pregnancy tests are under $20 bucks at Walmart ya know. $400 bucks ambulance ride versus $20 bucks…You could have save us tax payers a lot of money, ya know.
Patient: My insurance will pay for the ambulance.
Me: Good grief! How many times do I have to tell you that Medicaid is not insurance? And it won’t pay for nonemergent problems.
A quick 5 seconds physical exam. Push on the belly, no pain. Scribbled the discharge instructions and handed to patient to sign:
Go to local pharmacy and buy a home pregnancy test. Follow up with your medicaid assigned gynecologist if positive. If having pain or vaginally bleeding, return to ER.
Patient: So you’re not gonna run a test to see if I’m pregnant?
Me: No, a possible pregnancy is not a medical EMERGENCY.
Patient: But my insurance will pay for it.
Me: Not if I don’t order it. And even if I did order it, Medicaid…Oh never mind, just go to Walmart or any drug store and get yourself a home pregnancy test, alright. They’re the same urine pregnancy test that we use in the hospital anyway, and it’s much cheaper, too.
Patient (indignantly): So how am I gonna get home now? I got 4 kids at home.
Me: Well, you should have thought about that before you took an ambulance. Surely you didn’t think that we would admit you to the hospital for a possible pregnancy, did you? Your kids are not at home by themselves are they?
Patient: You’re a mean doctor!
Me: No I’m not! If I was, I wouldn’t have ask about your kids. They’re not home alone by themselves are they?
Patient: No, they’re with a friend of mine.
Me: Alright. I’ll see if the charge nurse can help you with a cab voucher home. There’s also a cop here from your part of town. Maybe he can let you hitch a ride home in a while.
Nope, if you subsidize medical care, you certainly don’t get people abusing the system like this. James really needs to add a rolling-eyes icon for posts like this.