Re-posting: Reflections on the effects of Medicaid from another Emergency Medicine Colleague

The link below is a Op-Ed on the effects of Medicaid, from the perspective of another Emergency Medicine Colleague.  It is re-posted here without his expressed permission, but I do also recommend his blog at www.edwinleap.com.  However, every word of it is true and echoes some of  my own personal experiences in emergency medicine over the past 19 years.

http://journals.lww.com/em-news/Fulltext/2014/04081/Second_Opinion__The_Toxicity_of_Medicaid.1.aspx


Fixes:  Probably none, as many of those involved  share the traits of ignorance, entitlement, and apathy.  Society for many of these people, exists only to serve them, and we dare not ask them to lift a finger in order to improve their situation, as the latter might have a negative impact patient satisfaction scores (God forbid).

Suggestions:

• Continue to provider excellent care services and thoroughly document the encounter. Above all, be courteous.  
• Encourage the use of primary care by increasing Medicaid provider reimbursements and dropping the co-pay for the primary care visits.
• Institute a co-pay for non-emergent ED visits.  Having a co-pay does not violate EMTALA. Nor does discharging a patient with a well-documented non-emergency medical condition to follow-up with the primary care provider.
• Stop writing prescriptions for OTC meds.  
• Never tell anyone that they're clogging up the ER with minor issues, abusing the EMS system by using it as a taxi, or that they could buy the OTC medicine for less than the cost of the pack of cigarettes in their pocket.  

Just a few thoughts.