Step right up--bring your own marshmallows to this flaming, BUT

[Horse with no Name]

very rarely do I see such an egregious injustice and I have to get it off of my chest.
Had a patient this week. Her father is one of the richest men in town. Owns several businesses and properties.
She gave birth to a beautiful baby boy. She and her husband live in one of the nicest areas of town.
The gifts brought for this baby were fit for a king. The take-home outfit alone must have cost hundreds of dollars.
Quilts that were worth hundreds, flowers, wreaths, the whole works.
She was truly a beautiful girl. Expensive haircut, fingernail and toenails done, tan, very nice teeth (the kind that aren't cheap).
Anyways...everything about her said "High Maintenance".
So, when I was filling out her paperwork to go home, it was noted on her papers that she was on Medicaid.
First I thought...hmmm...but went on about filling out the papers.
When I took her and her baby down, her husband was driving a brand new Jeep Commander--the one that resembles a Hummer. Still had dealer tags. I know these things aren't cheap.
Anyway, she started bragging about since she was having a baby, she had to trade in her sports car. And oh, by the way, her husband had to buy a new extended cap truck too--since their previous cars weren't "fit" for a family.
I'm sorry--I am as liberal as they come--but I think her being on Medicaid sucks.
People are DYING because they don't have access to healthcare, yet, she can afford not one but TWO "minimum" $30,000 vehicles ...yet can't afford to pick up the tab on having a child or at the very least, paying a monthly insurance payment.
There is just something wrong with that...:just shaking head:

[babylonsister]

1. What could her justification be for being on Medicaid? For the

record, I think it stinks to high heaven, too.

[Horse with no Name]

5. The only thing I can figure

is that everything is either in her Dad's name or they lied.
It is a fairly small town--and even though Medicaid is state-funded, she may "know" someone at the Medicaid office who told her how to get it.

[nashville_brook]

16. fraud investigation

who you like and or trust?

i have a good friend who does fraud investigation for all sorts of state aid -- vehicles are a BIG tip off. you wouldn't beeeelieve the stories she tells me of the well-heeled stealing from the poor like this. it makes me ill.

no harm in alerting your local fraud folks -- if you're wrong, hey, no big deal. usually people don't even know when they are being investigated... at least until it gets to a certain point.

[nashville_brook]

17. google: report medicaid fraud (and your state)

there should be some sort of confidentiality provided or anonymous tips method.

[Tellurian]

18. Rather than speculating scenarios..

wouldn't it be incumbent on you to report what information you have to your supervisor? Although at best, you've only had superficial contact with the patient and feel the need for clarification to insure that patient is not fraudulently collecting benefits, she is not legally entitled to?

[BlueCaliDem]

31. Rich people are shown as "penniless" on paper if they create corporations...

...behind which they can hide.

I know a man in Southern California who makes a very GOOD living creating corporations for wealthy people who hide their millions in hundreds of corporations, divisions and subsidiaries making them look absolutely penniless, personally.

He had two Mercedes, one huge Yacht, corporate credit cards which carry higher limits than personal credit cards, four gold and diamond Rolexes, tailor-made suits, a multi-million dollar mansion in Orange County, all he does is sell the corporations idea while his wife is a part-time elementary school teacher!

But on paper, he was as poor as the homeless man in the backallies of Los Angeles!

Each of his four daughters have already profitable corporations funded by his older ones, and he made corporations for them when they were born using their names; example: Laura Enterprises, Inc.

Under our current tax system, a corporation's first $50,000 dollars after taxes, and expenditures, is TAX FREE. Not like us paycheck working stiffs that pay taxes on the very first dollar we make!

If a corporation's profits threatens to go over that magic number, they simple create another corporation which will show loss, and this goes on, and on, and on since there are no limitations to the number of corporations people can create.

Creating a corporation is relatively easy and can be done in a single day in Nevada, and costs less than $500 dollars to set up.

Relatively unknown is, that each and every movie made is a corporation! This, to be able to bankrupt the debt if the movie turns out to be a wash. Corporations are still allowed to eliminate their debt while Chapter 7 is all but non-existent today.

Wealthy people game the system by becoming "dependents" of their own corporations where they hide their wealth, and those cars could be the fleet division of one of their corporations, for example. A division can be named anything, and function to be anything (i.e. Oral Hygiene, Car fleet, Boat Fleet, Cell-phone account, etc.).

Rich people's houses could be under the "real estate" division, and their incomes, if they play it right, is funneled directly into an offshore corporation account making them look poor all the while living the high life, and paying minimal---if any---taxes.

Also, corporations out-live people, thus there is never any probate to worry about when a father passes on, and leaves his children everything. That's why I don't understand why Bush is pushing for killing the Estate Tax, unless it's for the small amount of money uber-rich people leave in cash to their undeserving, pampered future class of American aristocrats. I don't put it passed them to be so money-greedy that they don't even want to pay taxes on that!

That's why the "sales-tax to replace income tax" is unfair to working America.

Rich people living through their corporations can have their corporations also buy stocks, and bonds, and even all goods from lobster to filet mignon sales-tax free. If things go bad, they bankrupt the debt and start anew the very next day. Of course, beforehand, they make sure there's another corporation or subsidiary ready and waiting to "take over" the assets of the bankrupting corp so debt collectors won't get a cent.

We "unincorporated" schmucks have to buy at our local grocers with our already heavily taxed dollars, and pay sales tax there too, and if we're in debt, we can't create another "us" in order to hide our assets from debt collectors, and the tax man.

Fascism at it's finest!

[durtee librul]

47. Had a 'friend' once

who pulled this same shit - her reasoning? "Well, I paid taxes and my momma and daddy paid taxes and this is just our way of getting our money back."

[Monkeyman]

2. And my Brother Veterans are dying hmmmm

Budget cuts are killing veterans does not make since does it

[leftofthedial]

3. shut up and quit complaining about your betters

you're just lucky they let you live in their country



seriously, I'm with you. how does she qualify for Medicaid when nearly 50 million Americans have zero coverage?

[mike_c]

4. this is one reason we need universal health coverage for EVERYONE...

...in America, regardless of income. Let the well off pay their fair share through taxes, and give all Americans equal access to quality health care. I don't have any problem at all with those folks (in your OP) being able to take advantage of government health care benefits-- I just want those benefits available to all.

[LeftyMom]

6. Well, report her for cheating the system.

People like her make it harder for people who really need the help to get it.

[Horse with no Name]

7. I can't

I'm privy to the information only because of my job.
It is privileged information.

[likesmountains 52]

8. I work in health care too...and I think we're obliged to report suspected fraud..

[Horse with no Name]

11. only if the hospital is doing it,lol

That is the law--thanks to Bill Frist.

[likesmountains 52]

26. Oh! I think you're right! I just know we have to take "ethics" review

about fraud/abuse...but it is only about if we see the hospital billing fraudently...maybe an anonymous request for a review in this case?

[Ilsa]

9. I'm thinking something like WIC might be okay for her if her husband

and she were between jobs, but I tought Medicaid looked at annual income. I wonder if they are cheating the federal income tax system as well, and if the father (now "Grandpa") is supporting the three of them, aren't there limits to the gifts of $5000 per person and then they have to declare it as some sort of income or something?

ITA, Horse. This sucks. Sometimes I tink some people actually get ahead by working the system like this.

[stonecoldsober]

15. I think it's at least 11K per person per year.

[mcking]

10. If she's not actually married

and not working, I can see how she could be eligible during her pregnancy and for 60 days afterward. Medicaid rules are much looser for pregnant women and infants. If an adult has no income, regardless of whether her parents COULD (and/or SHOULD) be supporting her, Medicaid coverage is an entitlement for pregnant women who meet the income requirements.

However, if she's married and her husband has an income that allows him to buy a new car (not just getting money from Dad and Mom), I don't see how she could legitimately be eligible for Medicaid.

Incidentally, in Oregon at least, if the (unmarried) father has access to family medical coverage through his job, the state will go after him to cover the child.

[Ms. Toad]

48. Medicaid often covers not only

pregnant women and infants, but children at least to age 12 on special income based programs (i.e. they don't take into account assets).

Father's income (whether or not married) counts toward whether the child can be covered. Can't take granddad's assets into account since he isn't legally obligated to support grand baby - but gifts to the parents - if legally married - or at least the mother - if not - should be reported as "income" during the reporting period in which they came in.

[upi402]

12. There needs to be caps on benefits for income AND wealth

These people can burn in hell. Republicans that I know are on the dole and useless, yet bemoan the poor, socialized medical,government safety nets, etc.

They just figure they should take full advantage lest a lower class, lazy, shiftless type uses their precious tax money.

Thank you OP, I have seen similar abuses. Republicans, all of them.

[pinto]

13. Playing devil's advocate here. Most states, the home you live in, regardless

of worth is exempt. Cars are another matter, if they're in the recipient's name. There's usually a value limit on a vehicle for Medicaid eligibility without a share of cost. Maybe they were bought for the couple by the guy with the bucks (Daddy) and remain in his name, or she carries a share of cost due to the vehicles' worth? Could be the couple aren't married and don't legally share assets? Don't live together?

Gifts for the baby could be seen by Medicaid as an extraneous "blip" in the income profile, unless they're cash, and then reportable. Maybe the Medicaid eligibility is a dated entry in the chart?

I see your point about the apparent Medicaid inequity, and the appearance of fraud, but there just may be more to the picture than a nice car and a good haircut. :shrug:

Really none of my business, but my two cents.

[BlooInBloo]

14. So the saying goes, how do you think the rich *got* rich?

[Catherine Vincent]

19. Sounds like fraud to me. n/t

[nini]

20. somethings wrong here.. you can't own a home and expensive cars

and qualify for that. You must have assets under a certain amount - they're lying about something here..hmmmm

[nonconformist]

21. It may depend on the state, but generally assets don't factor into Medicaid coverage

It's determined strictly by current income.

[Maddy McCall]

28. Oh yes they do.

Look at federal Medicaid law again.

Assets ARE factored in on Medicaid.

[nini]

29. nope.. you cannot have a million dollar home etc.. and get aid

you can sell the home or borrow against it if need be. You cannot have more than a couple thousand in assets (cash, property etc..) to be considered someone in need.

[lumberjack_jeff]

30. In Washington, state medical is only income-tested.

If you have a low income, you're eligible.

http://fortress.wa.gov/dshs/maa/CHIP/2006IncomeStandards.html

I know nothing about other states.

If you can't afford medical insurance, it's probable that you don't have the ability to repay a home equity loan. Right or wrong, in this state you're not obliged to sell your house to buy medical insurance for your kids.

[nini]

42. those income levels wouldn't provide the lifestyle described above

but I see the distinction in home ownership etc.. that is good since it covers those who have fallen on hard times.

[lumberjack_jeff]

46. Undoubtedly, it's possible to game the system.

The parents could be trust fund kids. Inheriting doesn't preclude eligibility for state medical on behalf of their kids.

Given the op's description, I find this believable - not justifiable, but believable.

[GOPisEvil]

32. For Medicaid for pregnant women in Texas, there is NO asset check.

Only income eligibility. I assume that's the rule in all states.

[nini]

41. it didn't used to be that way here..

from what I've heard it's still difficult to get. I'm surprised to be honest with you about the apparent ease in other states.

[nonconformist]

22. I'm pretty sure that if at any point during a pregnancy you are without income...

Or very low income, you will qualify for Medicaid and once you are covered it will take you through the end of your pregnancy/postpartum period regardless. I could be mistaken, and it could vary by state, but I do know for a fact Medicaid works like that with children. If you qualify, your child is covered for 1 year, regardless of change of income.

Also, and this could vary by state as well, assets are not considered for Medicaid coverage. Only current income.

[Cleita]

23. I would report that to Medicaid.

You have to be pretty poor to qualify, unless they are hiding their assets with some legal tricks, like maybe the cars are in parent's names, and they work under the table jobs and don't claim taxes. Or they could be using an alias, maybe the identity of a dead person, to get the Medicaid. It sounds like some fraudulent goings on here. It's people like that who make it bad for the people who really need these social programs.

[flying_monkeys]

24. The trappings of wealth

don't mean the new parents are wealthy - - just that Grandpa is. The cars could be gifts or they could be financed (and I know many who qualify for aid while paying off a new car a few hundred a month at a time). The house they live in may be a gift from Grandpa - - and one can hardly count the expensiveness of baby's gifts against the new Mom and Dad....


Maybe Dad doesn't have a job that pays well. Maybe Dad is an struggling artist or a writer or makes weird sculptures out of tin cans... Medicaid is usually entirely based on income at time of application - - so they must have *some* kind of paperwork that indicated they were eligible.


Very possibly they are being heavily subsidized by her father to play dilitanttes - - in which case, they *would* qualify as they, themselves, have little or no income. I agree, this seems to be somehow "using" the system - - but one can't write laws excepting the offspring of some people from ever utilizing gov't programs they currently qualify for, right?


I mean, technically, mega rich former CEO's who are unemployed for 6 months or a year ***could*** apply for Unemployment benefits, yes?


The programs are open to all who currently qualify for them.....

[GOPisEvil]

25. You live in Texas, correct? Here's who to call:

Call the Health and Human Services Commission Office of Inspector General's office. They will be more than to look into the matter.

800-436-6184, or use the online reporting form:
http://www.hhs.state.tx.us/OIG/index.shtml

[otherlander]

27. That's so messed up.

I know that kind of thing was a big problem for Head Start, too. Between the Republicans trying to cut funding and rich people taking advantage of the system... I don't know if it's gotten any better since the 90's.

[mentalsolstice]

33. Medicaid or Medicare?

If it's Medicaid then is sounds like fraud, as household income and property is taken into consideration for eligibility. However, for Medicare (you have to qualify for SSDI), eligibility is determined by the disability and whether or not you can work...your spouse could make a million dollars and it wouldn't matter. My husband does okay, but I can no longer work because of my disability. My SSDI (Soc. Security) helps us pay the bills that I used to pay when I was working. I'm eligible for Medicare, but don't take it because my spouse's health insurance is cheaper.

And you can't always tell by looks whether a person has a disability. I have a cute haircut, sometimes a tan (by bottle), etc., however, no manicures. And my disability isn't always obvious. Just to look at me, you wouldn't have me pegged for someone who receives benefits. And I would resent the implication that because I'm a recipient I have to look and dress poorly.

[XanaDUer]

34. Report it.

We don't want no stinking welfare queens 'round here.

[mentalsolstice]

38. Ouch?!

Such charity...

[XanaDUer]

44. Duh.

I forgot the sarcasm thingy.

[mentalsolstice]

45. Good deal! Sarcasm accepted! n/t

[chaska]

35. I think some of us forget what it means to be a Dem. We're about the poor...

and the middle class. First and foremost.

Just a reminder.

Be like Jesus ... in other words, FUCK THE RICH (and the wannabes)!

[LibraLiz1973]

36. I know EXACTLY what your talking about....

I work in child care and deal with something where the state will pay for child care for people who can't afford to.
In general, I think it is a fantastic program. WHEN IT HELPS THE PEOPLE WHO REALLY NEED IT.


Several Years ago I had a young boy receiving the state subsidy. His mother paid nothing (she qualified for no co-pay)
Meanwhile she had 4- yes, I said four- BRAND NEW Cadillacs during the time she used our program. She dressed herself and the child in top of the line clothing- had a manicure at all times, and went to the most expensive salon for her hair. She had an inground pool put in at her house, took a family vacation to PARIS for 5 weeks in the summer... And wore the most beautiful diamond jewelry you can imagine. She carried a different purse with each different outfit- and I know they were the real deal because One time she noticed I was carrying a Coach bag and she asked when I got it. I told her I had gotten it the night before at a purse party. She told me that it was cute, but she would never buy a knock off. She wore Jimmy Choos and shopped at Neiman Marcus. I used to scratch my head wondering how the F she was scamming the system like that.


This year I have another child who receives the subsidy in what I consider a suspect situation. His father drives a BRAND NEW Mercedes. One of the first times I met his dad I commented on how nice his suit was- he told me it was a Brooks Brothers.
The mother started out driving a Lexus but just got her new car (She was so excited!) It is a Range Rover. Absolutely to die for. Once again, the kid and the entire family dress unbelievably. The boy wears a new pair of shoes every week LITERALLY. Last week the dad told me they had bought new furniture the night before and couldn't wait the 8 weeks for delivery. I asked where they got it, he said Ethan Allen. FYI- Ethan Allen isn't cheap.

it really pisses me off because I know alot of families who need that subsidy BADLY and can't get it because there is only so much subsidy money to go around.

[dorkulon]

37. Universal health care solves this problem

because we would all be paying for and benefitting from it. There's no way to cheat that system.

[Cleita]

43. I know. We really have to get out and push for this now that

we have Congress back.

[Jamastiene]

39. No flames here.

I think you are right. Is there a place where you could turn that in to check that couple out? That's a shame. Meanwhile, many have no health insurance and cars that might not last through the winter. Never mind doing without heat and/or prescription meds or food.

[Warren DeMontague]

40. I'm not going to flame you. I agree, that sounds wrong.

The answer, in my mind, is not to take her off medicaid, but in essence to put EVERYONE else on it.

In other words, Single Payer Health Care. Now.