On my way to work today, I passed a patient of mine and his family on the freeway. I was surprised to see that they were driving a Jaguar. The surprising thing is that they are covered medically by you and me through Medicaid.

Now, I know that care must be taken to not be too judgmental. Perhaps a close relative died and left the Jaguar to the family. Maybe it was borrowed from a friend–although I thought that I had seen them in this car earlier in the year but it was only a glimpse at that time. Borrowing a friend’s car can happen once but rarely twice–especially his prized Jaguar. Maybe they were test driving it.

I am more suspicious however, of how good a job our government officials are at evaluating true need. Who determines whether the person applying for state medical coverage is actually qualified by poverty, by laziness, or by fraud?

I was once asked to perform a sports physical on “a couple of poor kids” from a local school. The parents were going through a divorce and there wasn’t any money available to pay for the exams. The kids really wanted to try out for the team so someone in my office offered my services. We were shocked to see the mother drive up to the door of the clinic and unload the children from her HUMMER!