Scene 1: Young, poor family in my office with their 3-month old. I am a pediatric cardiologist, and I tell them that their child needs heart surgery, and soon. Since they qualify for Medicaid and it will cost them nothing, they should sign up as soon as possible. I schedule admission to the hospital for the following week.
Scene 2 (the following week): All preparations are in place for the baby: operating room time, ICU bed, nursing staff, instruments, and so on. The parents arrive with their baby. Because they have not signed up for Medicaid, the hospital will not be paid. We go ahead with the procedure. The baby does medically well, but the hospital does poorly in the pocketbook.
