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10 Governmental and Business Issues Stories in this chapter relate the role of the federal government in health care and business concerns of medical institutions. Some reveal how much the Frontier Nursing Service and its staff members, as well as local doctors and area residents, needed financial support. These stories also bring into focus the slowness of payments from Medicaid and Medicare and describe the receipt of food stamps. Many, many local residents, especially students, used to live without adequate food supplies, water, and adequate heating. The Frontier Nursing Service was often out of reach for some backcountry families. However, the FNS did take boxes of food and clothing to those they knew about and could reach. The federal government did so very much for these mountain people , but sometimes it was still not enough. Thankfully, the government did build a number of rather primitive houses for families truly in need. Also, during the Great Depression the federal government employed a lot of local men to work for the Works Projects Administration (WPA) and the Civilian Conservation Corps (CCC). Medicaid and Medicare I came to the Frontier Nursing Service in October 1965. Before that I had been a Sister of Charity and had been in India for six years. I came back in 1964 for reasons of health and left the order in 1965 and began trying to find a place that needed my particular set of talents. Frontier Nursing was recommended by a physician in Louisville, as they were looking for somebody very desperately at that particular time. I went on down there several months before I left the order. I was familiar with that part of Kentucky only by hearsay. I did have a pretty good idea as to what it would be like, since I had worked in relatively backward rural areas. I assumed it would be like what I was familiar with while in India. Dr. W. B. Rogers (or Beasley?) was getting ready to go to England for a DPH, DTH, or DTM, just whatever it was [doctor of public 230 Tales from Kentucky Nurses health degree, DrPH], and as he was leaving just about that time and they were interested in getting somebody to keep up the continuity. So I got there just shortly after he left and began working in the old hospital. The Frontier Nursing Service medical staff members filled out the needed forms and got things taken care of, and I signed them all by the thousands. Medicare was always behind [in] its payments to us. I remember one year I was there that Medicare sent us word that they had overpaid us $900 the previous year, and we hadn’t been paid by them for three years or something like that. What they overpaid us we’d never seen, because they were so far behind in their payments. So I know we were doing it, and I know I signed innumerable Medicaid, Medicare papers. Told by Dr. Mary Wiss to Dale Deaton, February 14, 1979; provided by the Louie B. Nunn Center for Oral History, University of Kentucky Libraries, Lexington Government Money The Frontier Nursing Service is unique in that it’s in a rural setting and it is isolated, and for someone like me who’s going to another rural setting in Nicaragua that is isolated, this is a good place to come to see how I, as a person, react to that, not only to the isolation but also to the independence that isolation gives you. They allow us to use our skills quite independently, not only in the clinics, but you also have to provide for yourself recreation, an hour’s rest and relaxation. I think the FNS prepares people for rural settings, and that’s why I chose FNS in the first place. Now that I’m leaving, I really feel it has been a good experience in that regard. With a lot of government involvement in health, nursing, and medical care, I think poor people are well cared for, and I don’t think anymore that we need to give large sums of [government] money just to take care of the poor. I think we need to give money to take care of the middle class, and because the third-party payments are paying the cost of everything. The reason why the cost has gone up is because we know we can collect a certain amount from the government. But we have to be uniform...


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MARC Record
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