South Dakota
What the reaction to a tragic shooting tells us about health care • South Dakota Searchlight
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.
GET THE MORNING HEADLINES.
Families in South Dakota work hard. We sacrifice a lot and ask very little from the people who govern us. We expect honesty, careful budgeting, and leadership that puts our interests above politics.
In his recent budget address, our governor painted an incomplete picture. He celebrated good results but did not explain what and who made those results possible. South Dakotans deserve more than selective storytelling. We deserve the truth.
South Dakota
Rep. Dusty Johnson backs Senator Rounds push for investigation into mail service in South Dakota
RAPID CITY, S.D. (KOTA) -Congressman Dusty Johnson is backing Senator Mike Round’s push for an investigation in postal service delays in South Dakota.
Johnson took to social media saying Senator Mike Rounds was right to ask for an investigation into postal service delays in South Dakota. Rounds had previously sent a letter to the postal service’s inspector general asking for her to find the cause of mail delays in South Dakota. Rounds said in his letter he has heard from hundreds of constituents across South Dakota. Johnson opened up with KOTA Territory News about his support for the investigation.
“I think the postal service is a terrible disaster,” said Johnson.
Johnson noted that in the past the service did what he said was a pretty good job. Johnson says despite sending letters and making phone calls with the postal service, he has not gotten any answers.
“I have asked if I can come down to one of their facilities, get a tour so I can better understand what’s going on behind the walls. They have refused to even let me, a member of congress, come learn about how they conduct their business. And so, this appears to be an enterprise that A, is not improving, B, isn’t communicating why there, why there failing and C doesn’t even appear to be particularly interested in getting better,” explained Johnson.
Rounds has pointed to the problem as being that mail traveling across or into South Dakota taking indirect routes. Rounds previously took a meeting with the postmaster general however the senator appears not satisfied with the outcome.
Rounds wrote in part in his letter, “I expressed my concerns about this to the Postmaster General (PMG) Steiner who downplayed such issue existed in South Dakota.”
In a letter sent to Rounds in October, Postmaster General David Steiner said that fixing issues at central region plants in Chicago, St Louis and Kansas City will likely improve outcomes and that at the time it was something the USPS was actively working on. The postmaster general acknowledged poor performance for first class mail at the beginning of the year and mid-summer but noted that it has since improved. During the week ending September 19th for South Dakota’s postal district, about %93 percent of first-class mail was delivered on time and roughly %97 percent was delivered within one day of its expected arrival. The postmaster general said he wanted to focus on the %3 percent that’s not getting to its destination on time.
“It may be only a small percentage of the mail, but because we deliver hundreds of millions of pieces each day nationally, the raw number is large,” wrote Steiner.
Steiner emphasized that some mail in South Dakota has always left the state for processing before going to another part of the state. The postmaster general explained that some mail requires certain sorting equipment and therefor some mail travels to plants with the right equipment.
The postmaster general also maintained in his letter that mail going to and from the same area in South Dakota is not leaving the state.
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