South Dakota

Why South Dakota health care is the nation's second most expensive • South Dakota Searchlight

Published

2 years ago

June 9, 2024

Why South Dakota health care is the nation's second most expensive • South Dakota Searchlight

Several months ago, Forbes, a respected business and economics publication, released an analysis of the “The Most (And Least) Expensive States for Healthcare 2024.” A striking — and concerning — finding was that health care expenses in South Dakota were the second highest in the nation.

The multiplicity of payers and the differing demographics of populations in diverse geographic areas make measuring and comparing total health care costs across different regions a highly complex undertaking. Nonetheless, the findings in the Forbes article have been supported by other research.

An extensive and very interesting paper was published several years ago by the Health Care Pricing Project. This analysis looked at both Medicare costs and private insurance expenditures in 306 health care regions across the U.S. In that study, private insurance expenditures in the Sioux Falls region were the 14th highest in the nation but Medicare expenditures were near the bottom (275th out of 306). The huge difference can be explained by the fact that Medicare prices are set by the Medicare program, whereas each private payer has to negotiate prices with the individual providers.

In eastern South Dakota, there is intense competition between two large health care systems. One could reasonably expect that costs would be lower. The results show that just the opposite is true.

How can this be? The reality is that the economics of health care do not follow the principles that govern prices in standard consumer markets.

For a conventional consumer market to function efficiently, multiple suppliers need to compete based on price and the quality of products available. Consumers need to have full understanding of both product quality as well as the price charged. They need to be free to switch suppliers if they find a “better deal.” They should have the freedom to “shop around.”

So how does all this apply to health care?

First, and probably most basic, health care providers rarely compete based on price. In fact, unless patients make an effort to ask, the price of a service may well not be known until the bill arrives. Since so much of health care is paid for by third-party payers, patients often have little incentive to ask. Additionally, there is little motivation to “shop” for the best price even if that is an option available to them, which it may not be.

Furthermore, if patients do have prices to compare from competing providers, they sometimes have skepticism about low-priced services. They may be concerned that providers have “cut corners” or that the service is less trustworthy. This follows directly from the fact that, unlike most consumer goods, patients usually do not have access to objective information about the quality of the actual service being considered. They usually rely on broad provider reputations or word-of-mouth evaluations. Such sources can provide helpful perspectives but are often lacking in specifics about particular procedures, individual providers, etc.

Treating health care as a commodity has not driven costs lower

Shopping around to get the best deal makes good sense if one is buying groceries or gasoline, but it presents major problems in health care. Limitations imposed by insurance networks are real. More basically, moving from one provider to another hinders continuity of care and raises the risk of important past history being overlooked or serious risks going unnoticed. Additionally, multiple payers with multiple sets of reimbursement rules have led to administrative complexity and enormous administrative costs.

From the provider perspective, competition all too often leads to duplication of facilities and services. Rather than refer patients/customers to a competitor, each one sets up their own service. This can be a logical action from a business perspective, but in highly technical services such as organ transplantation, small volumes raise the risk of above average cost and poorer outcomes. Competition, instead of promoting lower cost and better service, actually does the opposite.

Paying for health care services is an exceedingly complex undertaking. In the U.S., health care expenditures are the highest in the world, even though we have significant portions of our population who are not getting care. Commitment to conventional market principles has served us well in much of our economy. It is clear, however, that it is not serving us well in the health care.

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South Dakota

Nebraska volleyball to play regular-season match in South Dakota

Published

4 hours ago

March 3, 2026

Press Room

Nebraska volleyball to play regular-season match in South Dakota

Nebraska volleyball will play South Dakota State in a regular-season match in Brookings, S.D. The Huskers will face the Jackrabbits on September 2 at First Bank & Trust Arena.

Nebraska finished 2025 with a 33-1 overall record and was ranked No. 3 in the final AVCA poll of the season. South Dakota State was 23-5 and was the Summit League regular-season champions.

These two programs have faced each other before. They played a spring exhibition match in May 2025. The Huskers were victorious by a 4-0 sweep (25-18, 25-19, 25-17, 25-19).

Harper Murray led the Huskers in kills with 12, while also earning seven digs, five blocks and two aces. Andi Jackson delivered a double-double on the day, finishing with 11 kills and 10 blocks.

Nebraska is scheduled to play two exhibition games this spring. The Huskers will face Iowa State in Sioux Falls, S.D. on April 11 and Creighton in Omaha on April 17.

Contact/Follow us @CornhuskersWire (https://twitter.com/CornhuskersWire) on X (formerly Twitter) and like our page onFacebook (https://www.facebook.com/CornhuskersWire) to follow ongoing coverage of Nebraska news, notes and opinions.

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South Dakota

SD Lottery Powerball, Lotto America winning numbers for March 2, 2026

Published

16 hours ago

March 3, 2026

Press Room

The South Dakota Lottery offers multiple draw games for those aiming to win big.

Here’s a look at March 2, 2026, results for each game:

Winning Powerball numbers from March 2 drawing

02-17-18-38-62, Powerball: 20, Power Play: 2

Check Powerball payouts and previous drawings here.

Winning Lotto America numbers from March 2 drawing

03-08-17-24-34, Star Ball: 06, ASB: 02

Check Lotto America payouts and previous drawings here.

Winning Millionaire for Life numbers from March 2 drawing

28-41-42-50-55, Bonus: 02

Check Millionaire for Life payouts and previous drawings here.

Feeling lucky? Explore the latest lottery news & results

Are you a winner? Here’s how to claim your prize

Prizes of $100 or less: Can be claimed at any South Dakota Lottery retailer.
Prizes of $101 or more: Must be claimed from the Lottery. By mail, send a claim form and a signed winning ticket to the Lottery at 711 E. Wells Avenue, Pierre, SD 57501.
Any jackpot-winning ticket for Dakota Cash or Lotto America, top prize-winning ticket for Lucky for Life, or for the second prizes for Powerball and Mega Millions must be presented in person at a Lottery office. A jackpot-winning Powerball or Mega Millions ticket must be presented in person at the Lottery office in Pierre.

When are the South Dakota Lottery drawings held?

Powerball: 9:59 p.m. CT on Monday, Wednesday, and Saturday.
Mega Millions: 10 p.m. CT on Tuesday and Friday.
Lucky for Life: 9:38 p.m. CT daily.
Lotto America: 9:15 p.m. CT on Monday, Wednesday and Saturday.
Dakota Cash: 9 p.m. CT on Wednesday and Saturday.
Millionaire for Life: 10:15 p.m. CT daily.

This results page was generated automatically using information from TinBu and a template written and reviewed by a South Dakota editor. You can send feedback using this form.

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South Dakota

How South Dakota officials have reacted to ‘massive’ US attack on Iran

Published

1 day ago

March 2, 2026

Press Room

How South Dakota officials have reacted to ‘massive’ US attack on Iran

South Dakota’s Congressional leaders are praising President Donald Trump for his action of joining Israel for a missile-launched attack this weekend in Iran, with the intent to target and dismantle Iran’s nuclear capabilities and demand regime change.

“Our objective is to defend the American people by eliminating imminent threats from the Iranian regime, a vicious group of very hard, terrible people,” Trump said Saturday, Feb. 28, calling the strikes, “a massive and ongoing operation.”

Trump has since faced scrutiny for a lack of clarity about the timeline and overall goals of the war, and acting without the direct approval of Congress, which has the power to officially declare war for the U.S. Lawmakers are also in heated debate about whether the Trump’s decision may violate the Constitution, with Democrats calling for a war powers resolution vote to stop the effort, according to multiple military outlets.

Ayatollah Ali Khamenei, Iran’s supreme leader, was directly targeted, a Middle Eastern official told USA TODAY. Khamenei was killed in the attacks on Feb. 28, according to Israeli sources who told USA TODAY, CNN and Reuters. He was 86 and had led Iran since 1989.

Iran retaliated with drone and missile strikes, hitting American and Israeli targets, including a U.S. Naval base in Bahrain. Iran said its enemies would be “decisively defeated.”

At least four Americans and an estimated 200 other individuals have been killed, and an estimated 700 injured as of March 2.

President Trump said he expects more to come.

Here’s what South Dakota Congressional leaders, along with former South Dakota Gov. Kristi Noem, who now sits at the helm of the Department of Homeland Security as secretary, have to say about what has been named by the administration as Operation Epic Fury.

U.S. Senate Majority Leader John Thune

“For years, Iran’s relentless nuclear ambitions, its expanded ballistic missile inventory and its unwavering support for terror groups in the region have posed a clear and unacceptable threat to U.S. servicemembers, citizens in the region, and many of our allies,” said Thune, a Republican, the morning of Feb. 28 in a comment from his office.

“Despite the dogged efforts of the president and his administration, the Iranian regime has refused the diplomatic off-ramps that would peacefully resolve these national security concerns. I commend President Trump for taking action to thwart these threats,” Thune said, thanking Secretary Rubio for providing updates on these issues throughout the week.

“I look forward to administration officials briefing all senators about these military operations,” he said. “I commend the bravery of the servicemembers carrying out these operations and pray for the safety of those in harm’s way.”

U.S. Sen. Mike Rounds

Rounds, a Republican, said Trump took “the right course of action” when handling the strike.

Rounds later congratulated the United States military and Trump on the death of the Iranian leader, stating the moment “offers a path for a more peaceful Middle East.”

U.S. Rep. Dusty Johnson

Johnson, a Republican and the lone U.S. representative for South Dakota, stated the Iranian regime “is full of theocratic thugs and is the world’s largest state sponsor of terror.” He said Trump had given multiple opportunities to change direction.

“I’m praying for the safety of America’s servicemembers, and our allies involved in Operation Epic Fury,” Johnson stated on social media.

DHS Secretary Kristi Noem

Noem, who left her governorship after she was appointed secretary at the beginning of Trump’s current term, took to social media as well, stating she was actively monitoring any potential threats against America.

“I am in direct coordination with our federal intelligence and law enforcement partners,” she said.

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