Small rant: "I can't afford Motrin"

I just got up and took my OTC cold medicine plus some ibuprofen and a big glass of water. Because that's what you should do for most crud. I thought, hrm, for probably less than $1.50 I just averted what many of our ER patients will pay $1200 or more for---or, rather, taxpayers will pay for them to do so. And many will do it at the finish because they either want pain medication or, wait for it, a prescription for Tylenol or Motrin. You see, they can't AFFORD Motrin, but their medical card will pay for it with a prescription. (I was baffled by this when I was new to the ER and not yet jaded and cynical.) Now people, I am not bitter about patients who are genuinely flat-ass broke and sick. The ER is a safety net, and sick people need to be able to come there. I believe that. I'm just sick of the blatant abuse and entitlement. By abuse and entitlement, I mean people who are using Medicaid/Medicare, smoke a pack of cigarettes a day, and regularly run up $1000 ER bills on the public ticket so they can get a prescription for a $3 OTC medication. How is that not ridiculous? I try to be compassionate and see some reason or commonality in every single patient I see, but this is wearing very thin.

Plus, I feel irresponsible for not pointing out, "Look, you need to quit smoking anyway. That's probably why you have this URI to begin with, and it's costing you a fortune. If you went one single day without smoking, you could buy the ibuprofen." That would be the best health education I could probably give. But I NEVER point it out. Why? Because it would hurt my patient satisfaction scores and possibly my hospital's reimbursement---we're all about customer satisfaction. The sad thing is that some people probably actually haven't thought of that and would change their behavior, but I have no way of knowing who would appreciate the idea and who would feel unfairly judged and complain about me.

This system is just BROKEN. Bad.