Fraud?

AdamLabo's picture
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I am sure most have dealt with this in almost every state in the union, but
who knows someone who makes very excellent money and doesn't pay for medical
insurance?  More specifically, who is accepting Medicaid for their family
and make easily $100K per year?

This is a small pet peeve of mine.  I know a person of the medical
profession, a doctor to be exact, who is married and has two children. 
The husband is a "starving artist" and more recently a college
professor.  This doctor easily, very easily, earns over $100K a year, yet
her family all have Medicaid for insurance.  Now, don't get me wrong, if
you can't afford Medicaid... by all means, get it!  Nearly 45 million
people in the United States
did not have insurance in 2005, and they can't afford it.  So how does
someone who makes decent money qualify for Medicaid?

A member of my personal family applied for Medicaid a few years ago.  Their
annual income was barely $15,000 and they were denied.  Technically they
were not denied, they were told that they would receive it if they paid $408
per month.

One more case to illustrate where I am headed:  I recently took care of
a teenager who fell off of a golf cart and fractured her wrist and sprained her
ankle.  One of my co-workers made a comment about what a way to start the
school year off (as school started a couple of days later).  Well the Mom
says, "I know, and I have to send her off to boarding school
tomorrow."  So in friendly conversation I mentioned that I thought
that it was expensive and wondered if it was worth the expense.  The Mom
tells me that it costs $14K per year and that she is sending two children this
year.  That is $28K!  Nearly my annual wage at this point! 
Again, in friendly conversation I said, "Now make sure you take it easy
out on the golf course and with those carts."  To which mom replied,
"Oh it wasn't on the golf course.  We own a home out on the lake with
a cabin out behind it.  We were headed down to the cabin when she fell
off."  So later on, as I am completing the paperwork, lo and behold,
they have Medicaid.  Come on!

Now, I want you to understand, I strongly believe in some type of a National
Insurance System.  I think that there is no reason why every person in
this country shouldn't be insured.  I also want you to realize that I
don't, and would never, treat anyone any different based upon what type of
insurance they have.  I don't care what type of insurance they have; I
still get a paycheck regardless.  I am just more upset that I eek out a
living with my wages, I have 6 children and they all need medical care at some
point.  I don't qualify for Medicaid because I "make too much"
money.  I am quite content paying for my medical insurance, at nearly $300
per month, and getting less from my insurance company than people on Medicaid
(that's another subject for another day).

More importantly I am upset that in the two instances listed above, and in
many other instances, that we as the public are left to pay the bill for
someone who can clearly pay for their own insurance.  I find it disgusting
that some people are allowed to "cheat" the system.

So, off my soap box and back to reading all the other posts. 

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fallon's picture
Managing Director of Progressive U

When I was like 14 or so my mom ended up with cataracts. She couldn't see to work and didn't have insurance to cover the surgery. She was bringing in a grand total of 400.00 a month in child support during that period and when she applied for Medicaid so she could have the surgery and go back to work, she was denied. She was right at 90% blind at that point, but they didn't feel it was severe enough to stop her from working. When they told her that my older sister hopped up and asked where to apply for welfare. They approved her Medicaid the next day and within the month, she'd had her first correction surgery.

It amazes me that people who truly need Medicaid, even if only for a little while, are denied, but those who could easily afford private insurance are accepted into the program for ever.

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~Fallon~

"Do not be too moral. You may cheat yourself out of much life. Aim above morality. Be not simply good; be good for something." Henry David Thoreau

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comradesquirrel's picture

i really don't understand how these people end up qualifiying for medicaid...do you think you could give me some more details? the very idea of it is pretty upsetting!

--stacie

clintondevingeterre's picture

Your title of the post is exactly right, practices like you mentioned, based on the information provided, are fraud.
I doubt that such people are "allowed to cheat the system." If the people you mentioned are not qualified for Medicaid and still recieving benefits, they are breaking the law.
I am sure you are aware of this, but I just want to drive the point home that the examples you mentioned are not the results of the Program, but the manner in which it is administered.

Member of the Progressive U Alumni Association

I'm with comradesquirrel on this one. How are they qualifying for Medicaid?

Common sense is as rare as genius. ~Emerson

AdamLabo's picture
Volunteer for the Progressive U Alumni Association

Honestly, I have no clue. I am certain that they have Medicaid, because they are required to show the ID when they register in the hospital.

Yours in Crisis,

ER Adam

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