South Dakota
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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SIOUX FALLS, S.D. (Dakota News Now) – For the 14th consecutive season, SDSU is in the playoffs.
With a record of 8-4 they will host 8-4 New Hampshire.
A little over four weeks ago South Dakota State was undefeated.
On Saturday they snapped a 4 game losing streak.
The Jacks are happy to keep playing football.
Graham Goering, SDSU wide receiver said, “We’re just blessed for any opportunity we are given. I think having some losses, there’s really never a doubt there actually and I think just seeing our name on screen ignites a little fire for everyone on the team. So obviously just blessed and excited for new season.”
Head coach Dan Jackson said, “This team has been close and galvanized for a long time, but what I do think it does it breathes a little bit of new life in them and last four weeks have been pretty heavy for them because they have been giving us all they have while at the same time not getting results they wanted. For them to be able to take a deep breath and remember who they are, and remember we can win and win in big moments, I think we have a really confident team that feels amazing right now not only after that play but how they competed the entire game.”
SDSU hosts New Hampshire at noon at Dana J. Dykhouse Stadium.
Copyright 2025 Dakota News Now. All rights reserved.
RAPID CITY — The 2025 South Dakota state high school volleyball tournament came to a close on Saturday, Nov. 22, from the Summit Arena in Rapid City.
Below are the pairings for each match on Saturday in the three classes in action to put a bow on the high school volleyball season.
Seventh place
Sioux Falls Jefferson def. Mitchell, 25-22, 25-12, 25-10
Fifth place
Sioux Falls Lincoln def. Sioux Falls Washington, 20-25, 26-24, 25-22, 25-20
Third place
Brandon Valley def. Watertown, 25-15, 25-19, 25-21
Championship
Harrisburg def. Sioux Falls O’Gorman, 25-16, 25-16, 25-13
Seventh place
Rapid City Christian def. Wagner, 25-12, 25-16, 25-12
Fifth place
Clark/Willow Lake def. St. Thomas More, 27-25, 26-24, 12-25, 25-23
Third place
Sioux Falls Christian def. Hamlin, 25-19, 25-15, 25-18
Championship
Dakota Valley def. Dell Rapids, 26-24, 26-24, 24-26, 25-22
Seventh place
Herreid/Selby Area def. Harding County, 23-25, 23-25, 25-21, 25-13, 15-12
Fifth place
Gayville-Volin def. Parkston, 25-8, 26-24, 25-21
Third place
Northwestern def. Bennett County, 25-20, 25-19, 25-12
Championship
Chester def. Warner, 25-23, 25-16, 25-18
Class AA: Logan McGuire, Brandon Valley; Jersie Melcher, Brandon Valley; Josalyn Samuels, Harrisburg; Gabi Zachariasen, Harrisburg; Addie Siemsen, Mitchell; Sienna Sabers, Sioux Falls Jefferson; Julia Blom, Sioux Falls Lincoln; Mallory Schneider, Sioux Falls Lincoln; Londyn Smith, Sioux Falls O’Gorman; Lauren Venenga, Sioux Falls O’Gorman; Jade Jere, Sioux Falls Washington; Kynsee Russell, Watertown
Class A: Shelby Begeman, Clark/Willow Lake; Kelsey Hofer, Clark/Willow Lake; Samantha Kimball, Dakota Valley; Claire Munch, Dakota Valley; Madie Munch, Dakota Valley; Tenley Anderson, Dell Rapids; Madelynn Henry, Dell Rapids; Addison Neuendorf, Hamlin; Chloe Weber, Rapid City Christian; Leighton Scherr, St. Thomas More; Meredith Nelson, Sioux Falls Christian; Tavyn Sichmeller, Sioux Falls Christian
Class B: Peyson O’Neill, Bennett County; Reagan O’Neill, Bennett County; Lily Van Hal, Chester; Jacy Wolf, Chester; Paisley Dimmer, Gayville-Volin; Taylor Hoxeng, Gayville-Volin; Jordyn Rossow, Herreid/Selby Area; Ella Boekelheide, Northwestern; Ashley Haven, Northwestern; Keeara Oakley, Parkston; Jaycee Jung, Warner; Keira Steger, Warner
Our newsroom occasionally reports stories under a byline of “Mitchell Republic.” Often, the “Mitchell Republic” byline is used when rewriting basic news briefs that originate from official sources, such as a city press release about a road closure, and which require little or no reporting. At times, this byline is used when a news story includes numerous authors or when the story is formed by aggregating previously reported news from various sources. If outside sources are used, it is noted within the story.
GRAND FORKS — UND and South Dakota State kick off at 1 p.m. Saturday at the Alerus Center with both teams chasing an eighth win of the season.
Scoring recaps will be posted below.
UND 7, SDSU 0, 2:59 left: On fourth-and-1 from the 14, Jerry Kaminski takes a designed keeper up the middle and dives into the end zone for a touchdown.
UND 14, SDSU 0, 1:10 left: UND’s first play of a drive is an 89-yard slant pass from Jerry Kaminski to B.J. Fleming.
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