Nursing and Private Colleges

Let's start of the week with our first two questions.

Annie asks,

Why is nursing excluded from health care media reportage, health policy decisions, and from all discussions and major decisions about health care?

The only time we hear about nursing is when there is a story about the nursing shortage. When larger elements of health care are reported on, it is true that the people who do the majority of the actual "in the trenches" work caring for those in need are not the voices we hear from. I think that part of the answer is surely that nurses tend to come from and remain in a lower socio-economic class than doctors and HMO executives, and they tend to be female. When you look at the distribution of social power, these are folks who tend not to have it and therefore are not paid much attention by those who construct the news. Their line would most likely be that they want to talk to those who make higher-level decisions and for that you talk to the players we usually hear from.

I think this is changing, though, at least to some degree. The nurses made a lot of noise in California recently when their union shadowed the Governor and had a major effect on the political discourse. Yes, they had to work harder just to have their voice heard, but maybe this will help them get a seat more readily henceforth.

Anon asks,

What will happen to over-priced educational institutions if the economy continues to tank? Let us suppose there was a small liberal arts college which charges an obscene amount of money per year, and lets call it, for the sake of argument "GC." Let us assume a serious decline in economic production, and not merely a painful slowdown. Let us also assume people cannot barrow the money to pay, say, 30k a year, because the banks do not trust people to pay them back, nor can they pay out of pocket because their portfolio just collapsed, too.

A great question. There is no doubt that the current economic downturn will have effects on education at liberal arts colleges in a number of ways. There is no doubt that less expensive public universities may end up being the choice of some who would otherwise prefer the smaller classes, more personalized attention, and greater focus on skills like writing that you get at liberal arts schools. The problems in the stock market affect college's bottom lines which depend on their endowments which rise and fall with the market. Less money means fewer and smaller scholarships and financial aid packages and that affects students and the school.

Add to that the demographic situation we now face with the end of the mini-baby boom, the backside of the larger number of college aged students who are the kids of the baby-boomers, and you are looking at a double whammy for tuition-driven schools. Things could get very tough for institutions like GC in the coming years.

At the same time, an important lens through which to understand social phenomena is class insecurity. College is not merely an institution for education, it is also seen -- especially by parents -- as a necessary step in making sure their kids remain in the middle or upper middle class. People today are very worried that the next generation won't have it as good as their parents and they look to higher ed as a stepping stone up or at least a bulwark to prevent socio-economic backsliding. As such, liberal arts schools do have a certain cache that makes them even more attractive in hard times, an investment (yes, a very pricey one) that may pay larger dividends in the end. The community at a smaller school, the personal relationship with professors instead of teaching assistants, the focus on breadth and interdisciplinarity, the way teaching and not research is put foremost in the values of the institution are what you pay the extra money for and the question then becomes whether the advantages conveyed are worth the extra loan burden.