So, I guess I'm a big fat snob

You and I have posted about this before -- remember how I have used the term "benefactor," as being necessary if one is to make use of a state form of Medicaid (such as MediCal) and Dr. Keshishian.  The "mutually exclusive" part is that most of the time, if a person has the $4k for his revision program fee, one wouldn't qualify for Medicaid.  I said in the past that I knew of a person here a while back who was planning to get it with him using Medicaid, and she said her boyfriend was going to pay the program fee, but then, as far as I knew, she dropped off the board.  You said she did in fact get the surgery.  I am not sure we were referring to the same person, but I was happy to hear that it was possible and had been done. 

Ah...it was just the way you wrote it or the way I read it.  I'll paraphrase and you correct me if Im wrong.

"Having MediCal pretty much means you don't HAVE $4000...because if you DID have $4000, you'd be disqualified from MediCal for having too much money."

Yes, there was someone who DID have a boyfriend who was, and then was not, going to pay...I don't know how that part worked out but she did have surgery.

Yes, I think that is usually the case (the part in quotation marks).
One way it could theoretically be possible to get a revision to DS with Dr. Keshishian using MediCal would be if the patient is a recipient of a supplemental needs trust (http://en.wikipedia.org/wiki/Supplemental_Needs_Trust ), and the trustee(s) approve(s) the payment of the program fee.  I've never seen mention of a special or supplemental needs trust being used though, in the time I've been on this message board, as I think they are somewhat rare.
 

 About five years ago, I attended a wls seminar with my sister...just on a whim.  My sister decided to have the band put in, and probably lost about 30 lbs in total and has gained it all back plus some. She's had more problems than I can count with her band.  NOW, we are both going for wls, and she is choosing RNY while I have opted to have DS.  I asked her why she wanted that particular wls and she said that is what all of her docs have reccommended.  I've told her about this site, asked her to research them all and then decide what she thinks is best......but so far no luck in changing her mind.  Reading the main board just reinforces my decision to have the DS.  IMO I have one shot at this and the DS is what makes the most sense for me, even with the extra worry about it being a more complicated and involved surgery and even with the risk of all the comorbities involved.  I am evolving into a surgery snob myself.....LOL