I’m at UCLA Why did they drop this? Here is my guess Medical patient (LA Health) comes to ED with fever right lower quadrant pain and tenderness. CT shows appendicitis. Path on appendectomy specimen shows appendicitis. Admission denied: not medically necessary. Patient calls me in extreme distress after being told this by his insurance company In other postings I related the story of responding to an ED consult in the middle of the night, doing a full H&P, removing a foreign body and providing follow up. Reimbursement $40. Medical (Californias version of Medicaid) is unsustainable given that it reimburses for less than the cost of health care delivery. That the solution to the uninsured was to expand Medicaid in the ACA was a joke to any clinician who deals with these realities.