At what point are adults responsible for themselves?

[tammymacb]

I work in a downtown ER and I see it all. Unfortunately, this stuff happens all the time. However, this guy really rubbed me the wrong way.

I took care of Mr X. He came in via EMS and his complaint was chest pain. His risk factors were high blood pressure, high cholesterol, diabetes AND he smoked a pack a day even though he'd had cardiac stents and a coronary bipass already. His insurance is Medicare and Medicaid.

Upon going over Mr Xs medications with him, he proceeded to tell me that he hadn't taken any of his home medications for a few days.. When I asked him why, he replied that he wouldn't get his "check" until the first of the month. ( Just BTW, Mr X is younger than my Dad who still works full time ) He said he couldn't afford his medications. I then asked Mr X "Don't you have Medicaid/Medicare? He got angry and said I do, but the medicine still costs money you know.. Yeah, like $4.00 for a 30 day supply. ( And yes, I do know how expensive meds can cost, but his meds were ALL available in cheap generics that would cost less than $10.00 per day.) But, he can't afford them. But he CAN afford a pack of cigarettes a day.

I told the doctor about the med situation. He made me hold Mr X until the caseworker could fill all of his medications for free.

Now, my question is. At what point does this adult male make the decision that I'd rather buy cigarettes than medication and we say, OK. Good luck? Why are we as taxpayers responsible to make sure he gets BOTH? I see it over and over and over again. And, like my opinion or not, if you CHOSE not to buy your meds and buy cigarettes instead, that is your problem. It really chaffed me to give him those free meds because he could afford them. He just wanted his smokes more.

Well, Mr X got his free meds and then told me he wanted me to call a cab and send him home on the hospitals buck too. Instead, I took him to the waiting room and sat him in a chair near the phone. I told him he could call anyone he wanted and I'm sure somebody would give him a ride but he wasn't getting a cab.

I'm sure I'll see him again within the month.

 

[Myothername]

Things like this make me so mad. We see it every day in my work. People may not be able to afford their medicine or healthy food but they sure can get their beer and cigarettes.

 

[FlightlessDuck]

I'm not sure I understand the question. Are you suggesting that his Medicaid and Medicare be revoked? Or that you don't provide medical assistance to him at all? Or that you don't "enable" him by filling his prescriptions for free?

By filling his prescriptions, aren't you keeping him out of your busy ER longer, thereby giving better help to other patients?

Certainly it is better to teach a man to fish than to give the fish to him, but how is getting the man a job the responsibility of the hospital?

 

[phorsenuf]

I'm not sure I understand the question. Are you suggesting that his Medicaid and Medicare be revoked? Or that you don't provide medical assistance to him at all? Or that you don't "enable" him by filling his prescriptions for free?

By filling his prescriptions, aren't you keeping him out of your busy ER longer, thereby giving better help to other patients?

Certainly it is better to teach a man to fish than to give the fish to him, but how is getting the man a job the responsibility of the hospital?

I think what she's venting about is the fact that the guy has money for cigarettes but not his medications, even though they would cost much less then what he spends on those. Instead he chooses to use the system to get his meds for free.

 

[Robinrs]

The day we figure out people and their BAD choices ... ... I'm still waiting for that day!

 

[Piglets Mommy]

I agree, it is frustrating to run into people like that man. My DH & I work hard to put a roof over our family's heads and food on the table, medical expenses, school supplies etc. Hmmm....I could plan another much-needed Disney trip, or see that all our other bills are paid. I choose to provide the basics first, and vacations and stuff later. Unfortunately, people like this guy are part of why our taxes keep going up, thus pushing said Disney trip back more and more. Sorry for the mini-vent...you just brought back one more of those "life's not fair" moments.

 

[tammymacb]

I'm not sure I understand the question. Are you suggesting that his Medicaid and Medicare be revoked? Or that you don't provide medical assistance to him at all? Or that you don't "enable" him by filling his prescriptions for free?

By filling his prescriptions, aren't you keeping him out of your busy ER longer, thereby giving better help to other patients?

Certainly it is better to teach a man to fish than to give the fish to him, but how is getting the man a job the responsibility of the hospital?

I'm asking at what point an adult male is responsible for his own decisions/actions.

He could buy his medications, but he'd have to buy less cigarettes. Or he could buy no medications and buy lots of cigarettes. Or he could buy no cigarettes and actually take care of himself ( not that it's going to happen ) But, if he choses option B, why should the taxpayers decide that he deserves lots of cigarettes AND meds. He's an adult and he's made his choice.

 

[daisyyy]

I think what she's venting about is the fact that the guy has money for cigarettes but not his medications, even though they would cost much less then what he spends on those. Instead he chooses to use the system to get his meds for free.

That's the way I read it.... I agree ! His choice was to spend money on something that is making his condition worse, than something that could help. Why not, taxes will pay for one of them.

 

[The Mystery Machine]

I work in a downtown ER and I see it all. Unfortunately, this stuff happens all the time. However, this guy really rubbed me the wrong way.

I took care of Mr X. He came in via EMS and his complaint was chest pain. His risk factors were high blood pressure, high cholesterol, diabetes AND he smoked a pack a day even though he'd had cardiac stents and a coronary bipass already. His insurance is Medicare and Medicaid.

Upon going over Mr Xs medications with him, he proceeded to tell me that he hadn't taken any of his home medications for a few days.. When I asked him why, he replied that he wouldn't get his "check" until the first of the month. ( Just BTW, Mr X is younger than my Dad who still works full time ) He said he couldn't afford his medications. I then asked Mr X "Don't you have Medicaid/Medicare? He got angry and said I do, but the medicine still costs money you know.. Yeah, like $4.00 for a 30 day supply. ( And yes, I do know how expensive meds can cost, but his meds were ALL available in cheap generics that would cost less than $10.00 per day.) But, he can't afford them. But he CAN afford a pack of cigarettes a day.

I told the doctor about the med situation. He made me hold Mr X until the caseworker could fill all of his medications for free.

Now, my question is. At what point does this adult male make the decision that I'd rather buy cigarettes than medication and we say, OK. Good luck? Why are we as taxpayers responsible to make sure he gets BOTH? I see it over and over and over again. And, like my opinion or not, if you CHOSE not to buy your meds and buy cigarettes instead, that is your problem. It really chaffed me to give him those free meds because he could afford them. He just wanted his smokes more.

Well, Mr X got his free meds and then told me he wanted me to call a cab and send him home on the hospitals buck too. Instead, I took him to the waiting room and sat him in a chair near the phone. I told him he could call anyone he wanted and I'm sure somebody would give him a ride but he wasn't getting a cab.

I'm sure I'll see him again within the month.

What if he was severly obese? You could make the same argument about food.

I would argue that obesity is worse than smoking on the healthcare system.

JMO

 

[Liberty Belle]

What do you suggest be done? And where do you draw the line?

 

[phorsenuf]

What if he was severly obese? You could make the same argument about food.

I would argue that obesity is worse than smoking on the healthcare system.

JMO

While I sort of get what you mean, it's apples and oranges.
People need food to survive, cigarettes are detrimental to ones healths.

 

[The Mystery Machine]

While I sort of get what you mean, it's apples and oranges.
People need food to survive, cigarettes are detrimental to ones healths.

No it isn't. You want to make it different to justify obesity. The result is the same. A drain on the healthcare system.

 

[jlder72]

I will not comment either way on this patient, but I will add this.

I am an RN also and have worked in a busy ER. I found myself becoming "jaded" to some recurring patient types and knew it was time to move my career on to another area of nursing. I have done that and am now more content and the patients are receiving the care they need.

You may need to look at moving on also.

 

[inkedupmomma]

not a good subject to post on here prolly..as it may get heated

My two cents, no one is perect, we are all human,and we all make mistakes. You don't know that man. You don't know why he is choosing cigs over meds. YOu can't judge people without knowing them. I suppose, no one should ever judge anyone in a perfect world lol. But really, it made you mad, but movie on, because really, you know nothing personal about this man, just that he smokes and chose cigs over meds. Not a great decision, but it was his.

 

[phorsenuf]

No it isn't. You want to make it different to justify obesity. The result is the same. A drain on the healthcare system.

Wait. Are we on the same side?

 

[FlightlessDuck]

But, if he choses option B, why should the taxpayers decide that he deserves lots of cigarettes AND meds. He's an adult and he's made his choice.

I guess that then the question is which is more cost prohibitive: For the hospital to take the loss on the meds, or for the hospital to take the loss for his treatment after his heart attack because he doesn't take him meds?

Certainly he should be responsible for himself, but it's a matter of pragmatism. You gotta pick your battles.

And how would that be something you regulate, anyway? Refuse to give anybody free meds?

 

[lovesmurfs]

No it isn't. You want to make it different to justify obesity. The result is the same. A drain on the healthcare system.

A bit off topic -- I agree, as someone who is overweight and has tried so many programs to lose weight that I can't even begin to list them all.

And yet, while my health insurance through my company will provide whatever programs (including nicotine patches, etc.) that I need to stop smoking (I've NEVER smoked), there is NO coverage for any medical weight loss treatment, program, or counseling, nor has there been with any of my previous employers' coverage.

So, yes, it's my fault I'm overweight. Yes, I've tried, am trying, and will continue to work to develop better eating and exercise habits. And my health insurance will continue to cover the symptoms of obesity through blood pressure medication or treatment of diabetes, if I ever need any of it, but it won't help me in any preventative measures in removing the underlying cause.

 

[tinatark]

This is only going to get worse - at least now for you to get medicare/medicaid = insurance without a JOB, you have to be disabled (or a child, or pregnant)... what's going to happen when everyone out there has health care provided to them, whether they work or not?

 

[Jennasis]

There are always those who will "work" the system. It's maddening isn't it?

As far as the cigarette issue, I say we tax them into the luxury item category! I want to see $20...$30...$40 a pack! Tongue firmly planted in cheek of course.

Doesn't Japan have some tax for being "unhealthy" or fat?

 

[NMAmy]

Was the gentleman provided with any information or assistance with smoking cessation? He has a nicotine addiction. It's not an easy addiction to break. And if money is so tight that I had to choose between a $4 prescription or a pack of cigarettes, it seems like that would be a pretty scarey place to be.

We have demonized smoking in this country to such a bizarre extent. I find it really odd since smoking was very commonplace when I was a kid. I'm not a smoker but I can still feel sympathy for those who are smokers.