MovieChat Forums > In America (2004) Discussion > Health insurance situation not realistic

Health insurance situation not realistic


I cannot understand if the dad is just driving a cab and the family can only afford living in a rundown walkup, why the mom could not get insurance through a Medicaid waiver for pregnant women. Why the bill for over $30,000?

(Okay, the plot around the bill magically being paid off would not work, but other than that?)

Can a cabbie in New York really gross over $3500 month?

http://www.health.state.ny.us/nysdoh/chplus/who_is_eligible.htm

reply

I don't know about New York, but in Illinois, where I'm from, you cannot get any type of Medicaid, welfare, food stamps, or any government assistance if you are married. Single...yes. (again...I'm only speaking of IL. NY might be the same way...not really sure)

As for cab drivers, it depends. They rely alot on tips. So it is possible to gross that much, but as I said...most of it would be tip money.

reply

Note that the cutoff for a family of four is the same $3500 a month, though I think the fetus is counted as well, so the cutoff could be as high as $4100 for Moms & Babies, an expanded (higher income limits) Medicaid program.

Even if dad made big bucks as a cabbie, his wife could still qualify briefly for Medicaid while pregnant and postpartum, and even if they were not legal immigrants.

"Medicaid Presumptive Eligibility (MPE) Program

"What is MPE?

"MPE is a program for pregnant women. MPE offers immediate, temporary coverage for outpatient health services to pregnant women who meet income requirements. There are no co-payments or premiums in MPE.
How do I get MPE?

"You must go to an MPE provider. The MPE provider will decide if you can get MPE. To get MPE, the provider must verify that you are pregnant and you must tell the provider your family's gross monthly income. If you are pregnant and meet the income requirements for MPE, you can get MPE.

* You do not have to be a citizen or a legal immigrant to get MPE.
* You do not have to have a Social Security number to get MPE."


States call expanded programs for pregnant women by different names but they come from either the SCHIP or Medicaid or a combination of the two programs, and sometimes with separate state legislation, e.g., California.

http://www.allkidscovered.com/pregnant.html#momsbabies

States like S-CHIP because the feds pick up 75% of the bill, states 25%, I think. The states certainly pay less for an SCHIP kid or pregnant mother than for taditional Medicaid folks, with states having to pay at least 50% of the bill under traditional Medicaid match.

Food Stamps and Welfare are a totally different ballgame with much lower cutoffs than the health care programs, available to only those having only 1/3 to 1/2 the income of those in SCHIP.

reply

dont forget the family went into the united states via canada illegally

reply

That's not totally true about Illinois. I lived in Chicago in the '90s, and both of my kids' births were paid for by Illinois public aid. My wife and I were married, no problem there. The public aid card also enabled you to get WIC for your kids--cheese, milk, juice, etc., food basics on a monthly basis.

That being said, it's conceivable that they might not know about available assistance. Plus, they were undocumented aliens, which would make getting assistance more difficult.

It kills me how everyone is so quick to judge this movie, which was inspired by real experiences of the writer/director, who himself moved his family from Ireland to NYC in the early '80s.

reply

Undocumented? What do you mean? Did they lose their Irish passports, drivers licenses and all the other pieces of paper one collects in an industrialized society? No, you just can't produce the word I-L-L-E-G-A-L. Try saying it once or twice. It's not that hard and you will feel better dealing with reality.

Judging movies is part of what these boards are for. It makes not a whit of difference by whom or what it was inspired. That does not immunize the work from criticism. While it is not a documentary it certainly isn't a fantasy piece. It is fair to evaluate the movie both artistically and practically. This includes the behavior of the characters and the "real" people on which they were based.

reply

Undocumented. Having no documents. What's wrong with saying that? It's just as accurate as the label you want to use.

reply

No it's not. As the poster said, of course they have documents. Just not the documents that allow them to be in the United States legally. Therefore, they are ILLEGAL ALIENS from Ireland, asking me, not a relative or friend, to pay medical bills for them. Do you think I can move with my wife to Ireland without legal immigration papers and pop out a kid on the Irish taxpayers dime? Just wondering how stupid you are. Seems to be very.

reply

Do you think I can move with my wife to Ireland without legal immigration papers and pop out a kid on the Irish taxpayers dime? Just wondering how stupid you are. Seems to be very.


Yes, actually I believe you could and it would certainly be possible in the UK.

reply

They could, but they'd have to apply for emergency immigration when caught and risk deportation regardless.

In the Rep.Ireland they'd be expected to contribute to medical costs too.

reply

You are wrong. It's easier to get free aid if you are an illegal alien. You don't have to prove anything. Legal immigrants have to meet all kinds of requirements. In fact, my wife is an immigrant, now naturalized American citizen, I had to swear I would support her and that she would not use welfare, medicaid, etc. If she was illegal, free ride. See, that's how it works.

reply

I'm sure they would gladly give up their "free ride" for legalization.

reply

Yep. And a car thief would probably give up a stolen Chevy for a new Lexus. However, he is not entitled to either.

reply

Here in Louisiana you can get Medicaid if you're married because my cousin's wife gets it (her husband doesn't work either. They live off of his mother). Not really sure how long she'll be able to stay on it. She got Medicaid when she went into the hospital for an emergency situation. That may end in a year because it might be only temporary, but I'm not really sure.

reply

Maybe they were unaware of Medicaid benefits and how to get them. You'd think the billing lady would have brought it to Johnny's attention, though, if the hospital expected to be paid at all. Or maybe he saw it as charity and was too proud to ask-?

As far as the $30,000 bill, I was guessing at least $20,000 when I realized how long Sarah would be in there and the complications she and the baby were facing. When I had my daughter, I was sick and had to stay in the hospital for about 3 weeks. My bill was about $32,000 (thank God my insurance paid it all).

reply

Most of this movie - the financial struggles, the baby - the hospital bill unpaid - ALL happened - it is TRUE - just google Jim Sheridan interviews - and actually what happened in real life did not make the movie because no one would believe it - one of those situations where life is stranger than fiction. Jim's wife wrote a long and impassioned letter to the head of billing at the hospital - explaining their poverty, their plight and the woman took care of it - she deleted the bill - she made it disappear. Gone. A human being reaching out to another human being and it worked. This movie is wonderfully powerful and really touches on loss and struggle and forgiveness.

reply

I rather doubt that even the head of billing (which is not the CFO) has the authority to make a bill "disappear." This is fraud and essentially means that everyone who paid their bill made up the difference. Nothing heroic about spending other people's money. See Congress for details.

reply

Ah, feel the compassion!

Ya know, the U.S. is chock-full of Christians, yet they never seem to comment on all the various forums.
'I got mine, gimme more, & *beep* everybody else' is decidedly NOT Christian...

reply

Christians in the U.S. (and U.S. society in general) are the most generous people in world bar none. You seem to think that the only giving that counts is that which is routed through the government bureaucracy. And where do you think the government gets all the money to distribute?

Christians comment, it's just that the comments don't match up with what you think they ought to be. You are right in your last (the *beep*) comment. I have never heard a Christian utter such a sentiment. Note also that it is rather easy to be munificent with other peoples' money.

reply

you seem to think that only christians pay taxes. of course, seeing that churches are tax exempt is something you most likely support. can you support your claim about christians being the most generous? probably not without using statistics from a christian website.

note also that it is rather easy to think yours is the only money people are munificent with. i'd say it is rather easy to profess to be a christian when you have no intention of living up to the ideals. christians use the term 'my tax dollars' more than any other group, bar none. (see how silly that sounds without backing it up??)

'God is a kid with an ant farm' Constantine

reply

Remember it was back in the 80's and it was like that for a lot of people.

reply

[deleted]

Part of the whole subtext of the movie was that they were illegal immigrants. It was implied although never really explained this was why they were in somewhat bum-around jobs (Johnny chasing the acting dream and driving a cab, Sarah working in an ice cream shop despite being a teacher).

I think it also had to do with why the kids "had" to go to a Catholic school -- supposedly they could dodge some of the paperwork at a private school rather than a public school (although I have nieces/nephews in a Catholic school and their parents have to fill out plenty of paperwork, birth certificates, etc etc).

It certainly did not seem like Johnny and Sarah were devout enough Catholics that sending the kids to Catholic school would have been an absolute must (especially considering tuition is not exactly cheap, and was not cheap in 2002 or 1982 or whenever you want the movie to be set).



================

4) You ever seen Superman $#$# his pants? Case closed.

reply

In response to the OP and some replies, the health care situation really took away from the realism in the movie's plot, because coming from Canada they would've had universal health care whether they were employed or not if they had stayed in Canada - even illegal aliens are given health care for the most part on an interim basis. If they were able to get a car and register it etc., it means they had some form of citizenship or at least a status that would allow them health care of some form. So for them to leave for a "better" life and go to a place where they had no health care provided for them would definitely be a huge step backwards and seems a bit unrealistic. If the mother and father were willing to leave and put their whole family at risk, especially after it was clear life wasn't getting better, that would be an extremely selfish step.

I'm from Canada and I'm not saying things are "better" up here, but I can tell you that of the many Canadians I've known who have chosen to move to the U.S., none have left without ensuring their employer was providing an HMO. We can assume an Irish family that was living in Canada long enough to save some money and get a car (which most likely meant working legally) would know it was silly to leave for a more uncertain life, especially since it's not like the father couldn't have gotten an acting job in Ontario (where the car's license plate was from). This seems like a big problem with the plot. It's a great movie, but I think they needed to address why a "poor" immigrant family would leave a country with living standards just as high as in the U.S. and put themselves in a position where they were in poverty and had no health care. It's never explained. Going from Canada to the U.S. isn't necessarily going "upwards" as far as living standards, but more like going sideways, or in their case downwards since they went from having universal healthcare to none. If the father put his family through all that just to try and act then he was the most selfish father on the face of the planet. The whole movie's plot kind of didn't make sense due to this. I think it could've been written differently to get around this (having them just go straight to the U.S. from Ireland), but them starting in Canada and then leaving didn't make sense financially at all, since losing the healthcare was essentially what put them through all of those troubles once the wife got pregnant.

reply

The explanation is that they did not know she would get pregnant. And they didn't think of health insurance when leaving. It is not something people think about, as he might have assumed it wouldn't be an issue until he was actually faced with the issue. But I agree that they should have thought everything out before leaving. If anything he should have left his family in Canada until he got a permanent job in New York.

reply

Yes, excellent point, he should've left his family and gone by himself until he smoothed things over.

reply

They were practically illegal immigrants. WTF. and its 3500 combined income.

Heath Ledger Come Back,
This isn't funny, at all.

reply

[deleted]