At what point are adults responsible for themselves?

[scrapbookworm]

I know what you mean. I'm finding it hard to feel sympathetic to someone who buy laptops, gaming systems, this gadget or that gadget, yet does not have the money to maintain their house and yard in a livable condition and wants others to provide the service for free. Don't tell me about going out to eat and a shopping trip (for non-essential items), and then in the next breathe complain about how you can't afford this or that. It's all in the priorities. Of course, we all want to live to the fullest. But not when it is going to be inconveniencing others (or taxing the public assistance systems).

But, I do recognize that with someone who smokes, drinks, or does drugs- there is a chemical addiction there. And I would say the vast majority of people do not have the strong will power to say "I need my medications this month more than I need these cigarettes". And besides, they know that they can seek public assistance or charity to get the medications- there is no charity for supplying cigarettes or booze. In essence, he's getting the 'best of both worlds'. He can be irresponsible with his income by spending on cigarettes, and he'll be able to find someone to take care of the essentials.

 

[PatsMom]

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.

Wish I had your insurance plan back when I was going through about 20 different quit smoking attempts! My plans have had incentives for going to the health club/gym but absolutely nothing for smoking cessation. In fact, on one of my doctor's office visits where I asked about side effects from Zyban, she coded part of the visit as smoking cessation counseling and my insurance company refused to pay for the "Procedure". I have literally spent thousands of dollars over the last 25 years on various smoking cessation products, classes, etc.

The last drug that came out, Chantix, is what worked for me. But I paid 100% of the cost of the drug.

Giving up smoking is hard. I was never in a position where I would have to choose between smoking and paying for medications, but I kind of think there were times when I would have chosen the smoking.

I imagine it is very frustrating to work in a job that involves seeing people abuse the systems in place to help them. But I don't know how you stop it. No one turns away a heroin addict looking for medical treatment for other disorders. Nicotine is just ad addictive.

 

[Darsa]

I think I shall choose to stay out of this argument. This has been hashed over ad nauseum, and it just raises my blood pressure. I tend to agree with the OP tho. That's all I'll say

(I have a sister in law who has two kids and lives off the state while she "goes to school", probably for the rest of her life or until she can't get away with it anymore. She smokes like a freakin' chimney, and always has her coffee, but her kids eat ramen noodles and whatever is cheapest at the store; certainly not expensive fruits and veggies...)

 

[inkedupmomma]

I think I shall choose to stay out of this argument. This has been hashed over ad nauseum, and it just raises my blood pressure. I tend to agree with the OP tho. That's all I'll say

(I have a sister in law who has two kids and lives off the state while she "goes to school", probably for the rest of her life or until she can't get away with it anymore. She smokes like a freakin' chimney, and always has her coffee, but her kids eat ramen noodles and whatever is cheapest at the store; certainly not expensive fruits and veggies...)

that is staying out of it?

 

[brerrabbit]

I will probably get blasted for this one but here goes anyway. Not to comment on this one situation but on these situations in general. It really boils down to a finacial decision for we as a people. What is human life worth, and how much money are we as a society willing to spend to preserve life? Sound harsh? It is, but then again decisions like that are made every day. When reviewing saftey specifications for buildings, manufacturing plants etc. designers, engineers and others constantly look at redundant saftey features and what the additional cost will be vs what is the odds of an occurance happening and what the cost of it will be. In some way actuaries for insurance companies do it every day of their lives.

If we were told by the federal government that we need to protect every life in America and as a result the cost of governmental provided healthcare, combined with social programs, and all other forms of governmet aid combined resulted in a 60% marginal tax rate to cover the costs, would you oppose it? Or would you say that people need to be more responsible for their own health? Currently we are moving to a national healthcare and the latest polls indicated that a majority of Americans oppose it. Have we not as a country sort of already made that economic decision? We don't want to pay for it. Now when we boil the arguement down to one individual who for the moment associates a face, and a person with that arguement then some will say no, as a caring people we have to offer the free meds, and in the end what difference does giving one person free meds make?

The situation is the same, at a micro, or macro level.

 

[DWGal210]

OP, that must be hard. I sympathize with those fighting addictions but I do see where the OP is coming from.

This doesn't relate to healthcare - but a gal at my church told me just recently about something similar. They were given information about struggling families in the area (ages of kids, etc) & collected donations and went to the families' homes to bring the items. It wasn't every home, but she told me later it was hard to go into homes where kids were barely getting 1 meal a day and wearing clothes & shoes that were falling apart, but seeing their parents and other adults with iPhones, big screen TVs, brand-new clothes, etc. She said it was hard to see their "loved ones" placing more importance on stuff rather than feeding & clothing their kids.

 

[simba20]

All for the same reason those truth.com ads exist. Let's go after big bad tobacco and forget that smoking is a choice. But then they whine, well tobacco companies added harmful and addicting chemicals that make it difficult for some to stop -- hence truth.com continues to play their ads. Sigh.

Can I sue Coke or McDonald's for adding additives to their products for making them yummy and addictive? Or what about the fact that they price their products so low that's it's far cheaper to eat out at Mickey D's versus getting a healthy meal somewhere else.....or what about the fact that soda and fast food advertising is soooooo prominent and I cannot get away from it, can I make it law to ban those ads??????

Sorry it's hard to regulate stupid and free will.

 

[spacemermaid]

I'm staying out of the debate, but would like to recommend something that heped me quit smoking to those here who want to quit smoking. I used this great non prescription herb/vitamin stuff called "Smokeaway" & was able to quit pretty much painlessly. It costs about $70 & the first few days of quitting were pretty "trying", but after that, it was so easy to not smoke anymore! I've been quit for 6 months now. (I'm in no way affiliated with Smokeaway, I just wanted to pass the info along so anyone else who wants to quit can try it...I wish I'd known about it when I tried to quit before!)

 

[The Mystery Machine]

Wait. Are we on the same side?

Pretty much.

I think in America, most of us do not live a healthy lifestyle either by choice or forced choiced for that matter. Whether it is smoking, eating, living, stress, lack of healthcare, ignoring your health concerns, etc...

Although people are trying to "live off the grid" and grow their own food.

So the OP's question was adult responsibility. I think we should always be responsible however it seems that we are just not getting it as a collective.

In other words, as Art Bell would say, we are a "Class Zero" planet.

 

[castleview]

I hear you OP. Last week, I was working at the food bank and a young girl of around 19 came in to get about 2 carriages worth of food. She had her cigarettes hanging out of her pocket. But actually I ended up getting angry at her family that wasn't there.

She needed help filling out the paperwork since it was her first time at our pantry. As I'm going down the list, I ask how many people in the house. She said herself, her newborn, her mother, two aunts and an uncle. I asked what the sources of income were. She said that she gets money from the state for her baby and one of her aunts was mentally disabled but worked part-time so they get disability and her paycheck. And that was it.

We finished and started bringing the food out to the car and then I noticed her baby was in the car all by herself…and it was HOT out that day. I didn't want to do this, but explained to her that's not a good idea because although something can happen to the baby, more likely someone would call the police. She was a very nice girl and looked at me like she never thought about that.

It was quite annoying that six people were in the home and they are depending on a disabled aunt and a baby for money. It was quite infuriating that not one of them came to help this girl either.

Sorry for getting slightly off topic, but it was the first thing I though of after reading OP's post.

 

[C.Ann]

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.

This is all that you know about this man.. Nothing else? Family? Friends? Where does he live? What kind of work did he do before he retired? Do you know anything else about his life up to this point in time? Did he fight in any wars? Is he a recent widower? Does he go to church? Does he help others in his spare time - maybe at a homeless shelter? Does he live in a homeless shelter?

I understand your frustration - to a degree - but I don't understand your haste to pass judment on someone you know next to nothing about..

 

[tammymacb]

I actually started out in an inner city high risk labor and delivery unit at a medical center. Switched to a suburban "princess" unit and lasted exactly 7 months. Went back to the action.

Like I said, I see people like this all the time. However, HE got under my skin. I would describe him as a "pro" system player. Our physician ( who is the sweetest guy in the world, hence the social worker and free meds ) actually described him as "kind of a troll"

I didn't start this thread to get the healthcare debate going again. I just feel like if as an able minded adult, he choses not to buy and take his meds, I should not be forced to buy them for him.

 

[Disneyfreak05]

We in the United States are not responsible for ourselves. When something goes wrong it is someone else's fault. Always is always will be . Then when they don't take reponsibility for it we find a lawyer a sue them. Why should we be responsible for ourselves when we can blame everyone else?!?!?!?!?!?!?!?!?

 

[tammymacb]

Don't think she was trying to advise, just offer up an option in a kind manner. You seem mad that no one is helping you out or giving you anything for free

I've never asked for anything free in my entire adult life. I've never even borrowed a dollar from my family. One thing I don't want is to depend on anyone but me. ( And my DH, but I depend on him only because I love him dearly, salarywise, I leave him in the dust )

 

[inkedupmomma]

I've never asked for anything free in my entire adult life. I've never even borrowed a dollar from my family. One thing I don't want is to depend on anyone but me. ( And my DH, but I depend on him only because I love him dearly, salarywise, I leave him in the dust )

the tone of your post just seemed awfully defensive anywho, I think she was just trying to be nice, not tell you what you should do

 

[Luvchefmic]

To the OP-

Back in the 1980's myself & my DH worked for a private ambulance service. Primarily a medical taxi for routine appointments (dialysis, chemo, etc) the company was paid by medicare/medicaid when the patient had it or other insurance. Every now & then a routine dialysis patient I remember would get annoyed if he felt we would be late for his pickup. He wouldn't even call the co. to cancel the transport. We would get to the house & his wife would be in the driveway waiting for us. "Bob" wasn't waiting he drove himself ..we knew that when we saw the car was gone. Co. didn't care they still got paid.

Financially he qualified for the service, we saw plenty of other people in the clinics that had to drive themselves. It was frustrating and yes sometimes we got upset when we talked about it. Abuse has always been going on. Really nothing you can do about it except try not to let yourself get too upset about it and focus on the patients that need you and appreciate the care.

 

[Pea-n-Me]

I think you will get different reads on this situation:

1) from people who aren't nurses and

2) from nurses

Oh wait, you'll get a third:

3) nurses who see it the way you see it

But before I offer you my opinion, I'm just going to say I don't know a nurse or other health care professional on this planet who hasn't also been frustrated at situations like this at times, including myself.

And personally I subscribe to the "teach me to fish I eat for a lifetime" philosophy (as opposed to "give me a fish I eat for a day") as well.

From a strictly NURSING perspective, you failed to see this man holistically and help him in the way he needed to be helped at that moment in time. You acted extremely judgementally and I was embarrassed as a fellow nurse reading your post. I am not surprised others here saw you as burnt out as truthfully, that's the way you sound to me also (and not necessarily not understandably, as I've worked in an inner city ER also and tertiary hospitals for over a quarter of a century so I know well what you deal with every day).

For one thing, many people like this have some form of mental illness - diagnosed or not; known to us or not. But more importantly, he's human and prone to all the mistakes and bad choices that all of us humans make - including you and me. Hospital policies and other regulations are usually based on research that's shown one thing or another. In this case, as a pp alluded to, it may just be that in the long run, providing patients with free pills and cab vouchers may just save health care dollars in other ways - it may very well simply balance out. Ideal? No. Obviously, smoking cessation would be great as well. But even with it, he may still find other things to spend his money on rather than his pills if he doesn't place a high value on them. So the problem of his not buying his pills is really one that's a lot more complex than it appears on the surface.

Now, I'd like to know what, exactly, you did do for this man, other than treat him angrily and send him on his way without a ride home? Here's your chance to redeem yourself - because I know down deep, you have it in there somewhere. Please tell me you treated him respectfully and compassionately in some way, and attempted to educate him in the best way you could given his individual and unique life circumstances...

 

[C.Ann]

I think you will get different reads on this situation:

1) from people who aren't nurses and

2) from nurses

Oh wait, you'll get a third:

3) nurses who see it the way you see it

But before I offer you my opinion, I'm just going to say I don't know a nurse or other health care professional on this planet who hasn't also been frustrated at situations like this at times, including myself.

And personally I subscribe to the "teach me to fish I eat for a lifetime" philosophy (as opposed to "give me a fish I eat for a day") as well.

From a strictly NURSING perspective, you failed to see this man holistically and help him in the way he needed to be helped at that moment in time. You acted extremely judgementally and I was embarrassed as a fellow nurse reading your post. I am not surprised others here saw you as burnt out as truthfully, that's the way you sound to me also (and not necessarily not understandably, as I've worked in an inner city ER also and tertiary hospitals for over a quarter of a century so I know well what you deal with every day).

For one thing, many people like this have some form of mental illness - diagnosed or not; known to us or not. But more importantly, he's human and prone to all the mistakes and bad choices that all of us humans make - including you and me. Hospital policies and other regulations are usually based on research that's shown one thing or another. In this case, as a pp alluded to, it may just be that in the long run, providing patients with free pills and cab vouchers may just save health care dollars in other ways - it may very well simply balance out. Ideal? No. Obviously, smoking cessation would be great as well. But even with it, he may still find other things to spend his money on rather than his pills if he doesn't place a high value on them. So the problem of his not buying his pills is really one that's a lot more complex than it appears on the surface.

Now, I'd like to know what, exactly, you did do for this man, other than treat him angrily and send him on his way without a ride home? Here's your chance to redeem yourself - because I know down deep, you have it in there somewhere. Please tell me you treated him respectfully and compassionately in some way, and attempted to educate him in the best way you could given his individual and unique life circumstances...

Excellent post!

One of my very best friends who I met way back in junior high (we're both in our 60's now) has always worked as a nurse in prisons.. I can assure you that there were men and women in there for crimes that many would wish them dead for, but she was taught that part of being a nurse is "compassion without judgment" - and she followed that rule to the letter..

When nurses lose that ability, it's either time to choose a new career - or at least move to a department where the judgment wouldn't come into play as often..

 

[Liberty Belle]

We in the United States are not responsible for ourselves. When something goes wrong it is someone else's fault. Always is always will be . Then when they don't take reponsibility for it we find a lawyer a sue them. Why should we be responsible for ourselves when we can blame everyone else?!?!?!?!?!?!?!?!?

Excuse me? Way to paint with a broad brush.

 

[Liberty Belle]

I think you will get different reads on this situation:

1) from people who aren't nurses and

2) from nurses

Oh wait, you'll get a third:

3) nurses who see it the way you see it

But before I offer you my opinion, I'm just going to say I don't know a nurse or other health care professional on this planet who hasn't also been frustrated at situations like this at times, including myself.

And personally I subscribe to the "teach me to fish I eat for a lifetime" philosophy (as opposed to "give me a fish I eat for a day") as well.

From a strictly NURSING perspective, you failed to see this man holistically and help him in the way he needed to be helped at that moment in time. You acted extremely judgementally and I was embarrassed as a fellow nurse reading your post. I am not surprised others here saw you as burnt out as truthfully, that's the way you sound to me also (and not necessarily not understandably, as I've worked in an inner city ER also and tertiary hospitals for over a quarter of a century so I know well what you deal with every day).

For one thing, many people like this have some form of mental illness - diagnosed or not; known to us or not. But more importantly, he's human and prone to all the mistakes and bad choices that all of us humans make - including you and me. Hospital policies and other regulations are usually based on research that's shown one thing or another. In this case, as a pp alluded to, it may just be that in the long run, providing patients with free pills and cab vouchers may just save health care dollars in other ways - it may very well simply balance out. Ideal? No. Obviously, smoking cessation would be great as well. But even with it, he may still find other things to spend his money on rather than his pills if he doesn't place a high value on them. So the problem of his not buying his pills is really one that's a lot more complex than it appears on the surface.

Now, I'd like to know what, exactly, you did do for this man, other than treat him angrily and send him on his way without a ride home? Here's your chance to redeem yourself - because I know down deep, you have it in there somewhere. Please tell me you treated him respectfully and compassionately in some way, and attempted to educate him in the best way you could given his individual and unique life circumstances...

You just earned a lot of respect from me and I'm sure many others.