In spite of all the glitter, the dramatic headlines about stunning accomplishments and life-saving interventions as well as the raving of some politicians about the “best health care system in the world,” the U.S. health care system is, at its core, fundamentally dysfunctional.

How can I make such a provocative statement? The U.S. spends nearly twice as much per capita on health care as does any other developed country. In spite of this expenditure, 8-10% of Americans still have no health care coverage while most comparable countries provide health care coverage to all citizens.

Spending at this level would perhaps be acceptable if the population was in fact benefiting with better health outcomes. Here too we fall short. If we look at any of the usually cited metrics of population health such as life expectancy or infant mortality, the U.S. results are worse. Especially concerning is the fact that the U.S. rate of maternal mortality — women dying related to childbirth — is among the highest in the developed world and is getting worse.

U.S. residents increasingly express their dissatisfaction with the health care system. The Gallup organization recently reported that approval ratings on the quality of American health care are the lowest they’ve been in more than two decades.

All this has come to the fore with the recent tragic shooting of the CEO of UnitedHealthcare in New York. Though details continue to emerge, it appears the assassination-style killing was carried out by a young man intent on sending a message of both anguish and hostility toward the health insurance industry. He reportedly wrote in his notebook, “What do you do? You wack the CEO at the annual parasitic bean-counter convention.”

As disturbing and troubling as are the events surrounding the murder, the public reaction to it is similarly distressing. There has been a huge outpouring of support for the shooter almost as though he is being glorified as a folk hero. Additionally, online, there has emerged a range of merchandise (T-shirts, etc.) seeming to applaud the event. These reactions appear to confirm the broad-based unhappiness with health care services and how they are financed.

How can we understand or make sense of these developments? In the U.S., unlike many other developed countries, we have largely treated health care as a commodity to be bought and sold on a capitalistic, free-market model. In my view, this arrangement underlies many of the problems we have encountered.

I am not anti-capitalist. For a large part of the economy, this model has served us well. At the same time, I believe there are sectors of the economy where it does not work as well. We need to be smart enough — and tough enough — to sort out which is which.

In the classic capitalist model, profit and/or market share increase when the perceived value of the product or service increases. What we have too often seen in the health insurance industry is that in order to push up profits, the industry has restricted the services covered or, alternatively, has increased the barriers to receiving those services.  This has been highly successful from an industry perspective in that profits have soared, but for many patients who are all too often in a captive market, it has restricted or denied needed care.

What to do? There is no immediate, simple answer. It would seem, though, that the events of the last several weeks should serve as a wake-up call. We have serious problems that demand serious thinking and open-minded discussions.

The fundamental lesson from these events, I believe, is that when profit drives health care decisions, investors win and patients lose. We can and must do better.

Staff Reports

BROOKINGS – The South Dakota State women improved their win streak to six games on Tuesday night as the Jackrabbits blew out Dakota State 84-47.

SDSU (10-2) shot 47.2% from the field and was 7-of-21 from three. Brooklyn Meyer led the way with 16 points. Emilee Fox had 12 points and Katie Vasecka had 11 points. Haleigh Timmer had a double-double with 11 points and 11 rebounds. Kallie Theisen had eight points and eight rebounds. Paige Meyer had eight points and seven assists.

SDSU led 20-16 at the end of the first quarter. The Jacks then pulled away before halftime as they outscored the Trojans 14-4 and led 34-20 at halftime.

The Jacks would then take a 54-35 lead into the fourth. They made seven of their last eight field goals, while the Trojans made one of their final 10 shots. SDSU outscored DSU 30-12 in the final frame.

DSU shot 26.6% from the field and was 6-of-26 from three. The Trojans were led by Lilli Mackley who had 14 points. Angela Slattery had nine points and five rebounds.

SDSU dominated the glass, out rebounding DSU 57-35. The Jacks forced 11 turnovers and scored 15 points off of them. SDSU was 9-of-17 at the free throw line and DSU was 7-of-10 at the charity stripe.

SDSU will close out the non-conference portion of its schedule on Sunday at No. 6 ranked Texas. Tip off between the Jacks and Longhorns is scheduled for 2 p.m. You can watch the game on SEC Network+ or listen to the game on AM 570 WNAX.

Five South Dakota football players were selected to the AP 2024 NCAA FCS football All-America teams on Tuesday. 

Both JJ Galbreath and Mi’Quise Grace were named First Team All-Americans. 

Despite missing three games due to an injury late in the year, Galbreath was still a weapon for Bouman in the passing game. He started seven of the eight regular season games he played and was a constant threat for opposing defenses.  Galbreath ranked second in the conference in yards per catch with 17.8. His 20 receptions, 356 receiving yards and two touchdowns ranked second on the team. 

Grace was named the 2024 Missouri Valley Football Conference Defensive Player of the Year after leading the conference in tackles for loss with 17 and sacks with 9.5. In the regular season, Grace notched a pair of games with two or. more sacks and he had one sack in at least six games. Grace has amassed 18 tackles for loss with his 9.5 sacks, and 59 tackles.

In addition to the two first team selections, Joey Lombard and Dennis Shorter were named to the second team, and Charles Pierre Jr. was named as an honorable mention. 

Lombard is a four-year starter and a captain on the South Dakota offensive line. He started all 13 games at center for USD this season and has been key on the line that helped USD finish second in total yards and rushing yards. Shorter proved to be one of the top safeties in the conference this season. He finished the regular season tied for the most pass break-ups with 12 and ranked third on the team with 58 tackles. He also forced a pair of fumbles and two interceptions. 

Pierre Jr. was the first 1,000-yard rusher in the South Dakota Division I FCS era. He led the conference in rushing yards, with 1,073, rushing yards per game, with 97.5 per game, and he ranked second in rushing touchdowns with 15.

South Dakota will travel to Bozeman, Montana Saturday to face Montana State. Kickoff is scheduled for 2:30 p.m.