USD Magazine, Spring 1992

One way things are going to change is with students like Judy Rich, who will complete her mas– ter's degree in nursing administra– tion at USD in May. Rich, who was recently at Goodyear's office to study the business aspect of the practice, is one of a growing number of students who recognize nursing as a business. She has combined nursing with business courses in her degree program. Still, insurance packages often stress treating illness rather than maintaining good health, Peterson says. "Why aren't we using our money to prevent, as well as treat? My own insurance will cover a costly liver transplant at Green "A lot of American

health-care system - patients who want all the treatment she can provide, but aren't willing to pay for her time; community members willing to come to her when they are sick but unwilling to attend free educational programs aimed at keeping them well; and a reim– bursement system so low that she can't afford to treat MediCal patients because she can't see the volume of patients it would take for her to recoup her operating costs. Goodyear views her private prac– tice as a learning process and a way of proving that nurses can make it on their own - as employers, not employees. But the learning process has its problems. "The public will not pay for health maintenance," she says. "They value it. They talk about it, but they will not put out the money to pay for it. It is a symptom of our society. As long as the employer was paying for everything it was used and abused, but people are not willing to take on the respon– sibility for their own health care." Goodyear also must try to balance her income with the cost of run– ning her private practice, an espe– cially difficult task when people are willing to listen to her advice about preventive medicine but aren't willing to pay for it. "If you could see what it is costing me to operate this practice - the cost of malpractice insurance, workers' compensation, just the cost of having an employee - you would think it is absurd. Things have to change."

Hospital, but it won 't cover the cost of an annual physical for a well person." D espite all the proposals, it is the consumer - not the physicians, insurance companies or even the Republicans or Democrats - who holds the most power, Rodgers says. Though people often are afraid to question their physicians about why certain tests were ordered or how much a procedure will cost, as consumers they ulti– mately will be the ones deciding how much they need and how much they are willing to pay. "Americans want to get the best possible care available," Rodgers

workers have ootten

used to the idea

that health care is

owed to them - that it is arioht of the American people.

But is it the

responsibility

of the employer, or is it society's

- Miriam Rothman