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Golden Valley News
Beach, North Dakota
July 27, 2017     Golden Valley News
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July 27, 2017
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July 27, 2017 Golden Valley News Page 3 H Ithcare ranked lower than most nations One thing I haven't heard much in this latest healthcare debate is that the U.S. has the best health system in the world. That's different from the last two times around. When the nation debated the Clin- ton health plan in 1994 and the Af- fordable Care Act in 2009-2010, a huge talking point for politicians and special business interests opposed to reform was, "The American system is so good, why change it?" It's different this year. Maybe that's because the public realizes America doesn't have the best, and their own interactions with what American healthcare has become tell them a different story. The old talk- ing point doesn't compute any more. Of course, we've all had some good experiences. And we generally continue to believe that the money we spend on super expensive tech- nology and medicines equates to good care even though evidence shows those costly interventions may not deliver as advertised and actually may be harmful. However, taken as a whole and measured on several dimensions, in- cluding access to care, administrative efficiency, equity, and health out- comes, the U.S. compares poorly rel- ative to other industrialized countries. In its latest study comparing the U.S. with 10 other countries - the United Kingdom, Australia, The Netherlands, New Zealand, Norway, Sweden, Switzerland, Germany, Canada, and France - the U.S. ranks dead last. This is the sixth time since 2004 that The Commonwealth Fund, which supports Thinking About Health columns, has done such a sur- vey. "Each time we have managed to be last," says Eric Schneider, a senior vice president of the Fund. I've been writing about these ~/media/files/publications/fund-re- port/2017/jul/schneider_mirror_mir- ror_2017.pdf surveys since they began, but this time the findings re- Thinking about heal th By Trudy Lieberman Rural Health News Service N. D. Matters By Lloyd Omdahl ally grabbed my attention, especially this: In the U.S. 44 percent of people with incomes below the median - about $55,700 in 2015 - reported that the cost of care prevented them from getting medical treatment they needed. Twenty-six percent of those with incomes above the median also said financial barriers prevent them from getting care. That means that the high deductibles and high coin- surance that most health plans now require makes it hard to pay for care. By contrast in the U.K. only 7 per- cent of people with low incomes and only 4 percent of those with higher incomes said they had trouble getting care. Yes, that's England, the nation whose National Health Service has been much maligned by American politicians over the years. In this latest survey, the U.K. ranked number one overall and was judged the best when it came to eq- uity and the process of care - preven- tive care, safe care, coordinated care and patient preferences - and third when it came to access. People in Britain seem to be doing OK despite all those queues for services Ameri- cans have heard about from the media. When it came to equity, access to care, and health outcomes, the U.S. ranked last, which also challenges the common assumption we have the best care in the world. The U.S. has given a lot of atten- tion to healthcare over the past decade, and the positive changes made by the Affordable Care Act have substantially decreased the number of uninsured and provided generous subsidies to help them buy coverage. I would have expected our rankings to improve. I asked Schnei- der about that. He explained that the lack of uni- versal coverage is a barrier and the cost of care is still too high for too many Americans, even if they have insurance. Families with incomes in the middle ranges of eligibility for ACA subsidies - incomes of around $60,000 or $70,000 - get small sub- sidies and face high deductibles and other cost-sharing, a trade-off they must make if they can afford only plans with low premiums. Our complicated system of get- ting medical bills paid and the end- less negotiations between providers and insurers - in other words, the ad- ministrative hassle - is also a huge drawback. Fifty-four percent of U.S. primary care doctors said insurance restrictions made it hard to get needed treatment for their patients, Schneider said. "That's a big prob- lem." The U.K., Australia, and New Zealand shine on this dimension. Schneider said that if the U.S. changed the way it pays providers, used fee schedules and global budg- ets - an amount a country, group, or hospital decides it will spend on care - the public would benefit. Just as important, Schneider told me, was the lack of U.S. investment in primary care compared to other countries where primary care is more widely and uniformly available. They dedicate a greater percentage of their medical workforce to that kind of care rather than specialty care. The U.S favors expensive specialists. So does the U.S. do well on any- thing? Although we ranked last on overall health outcomes such as life expectancy at age 60, there were bright spots such as breast cancer survival and fewer hospital deaths for heart attacks and stroke. Those few achievements are sim- ply not good enough. ( What's your biggest beef with the healthcare system? Write to Trudy at trudy.lieberman@ ) Hat Tips By Dean Meyer nt count down from last year North [)akota's spring pheasant wildlife," Gross said. "In addition, last ant broods starting to show up around population index is down 14 percent year's production was below average, the countryside," Gross said. "I am from last year, according to the State so we entered this spring with a lower hopeful production on all our upland Game and Fish Department's 2017 than average number of adult upland game birds this summer will be aver- spring crowing count survey, birds." age." RJ. Gross, upland game manage- While the spring number is an in- Pheasant crowing counts are con- ment biologist, said the number of dicator, Gross said it does not predict ducted each spring throughout North roosters heard crowing this spring was what the fall population will look like. Dakota. Observers drive specified 20- down statewide, with decreases rang- Brood surveys, which begin in late mile routes, stopping at predetermined ing from 6 to 10 percent in the pri- July and are completed by September, intervals, and counting the number of mary regions holding pheasants, provide a much better estimate of pheasant roosters heard crowing over "December and January provided summer pheasant production anda two-minute period during the stop. a rough start to winter, with record what hunters might expect for a fall The number of pheasant crows snowfall and extremely cold tempera- pheasant population, heard is compared to previous years' tures making it less than ideal for all "Currently, we have many pheas- data, providing a trend summary. Hoeven: RMA committed to have adequate adjustors WASHINGTON - Sen. John Ho- ing claims due to the high volume of fashion, which the administrator even, R-N.D., says he has secured a requests during the drought, Hoeven committed to do. commitment from the head of the called Heather Manzano, acting ad- "In such an uncertain time, our Risk Management Agency (RMA) to ministrator for the RMA at the U.S. farmers and ranchers need to know ensure there are loss adjustors to as- Department of Agriculture. The sen- that their policies have them cov- sess drought damage in North ator urged Manzano to hold insur- ered," Hoeven said. "By securing ad- Dakota. ance companies to their contracts and ditional loss adjustors, we can After learning that agriculture ensure they provide adequate per- prevent delays for our producers and producers were facing delays in mak- sonnel to address claims in a timely provide peace of mind." Burgum waives hauling permit fees BISMARCK - As part of ongoing Dakota. efforts to help farmers and ranchers hit The fees waived by the order in- hard by extreme drought conditions, clude the $50 seasonal hay hauling Gov. Doug Burgum signed an execu- permit fee; $15 fuel permit fee; $20 tive order waiving fees for drivers of trip permit fee; $20 oversize permit fee commercial vehicles hauling hay, and a related $15 service fee; and the water and livestock supplies in $35 interstate single-trip permit fee drought-affected counties of North and $300 annual interstate permit fee. Plumbing 221,000 North D kota nonvoters According to Secretary of State A1 Jaeger, 590,955 North Dakotans were eligible to vote in the 2016 election but only 349,945 (61.29 percent ) appeared to cast ballots. That means 221,000 were "no shows." Why? Researchers at the Pew Research Center report that these non-voters are politically estranged. Their re- search indicates that nonvoters dis- like politics, claim that voting is ineffective, that their one vote doesn't count and that there is no difference between candidates. They say they are too busy to vote. In some cases, there are le- gitimate reasons for missing an election but in most cases it reflects alienation with the process. How- ever, alienation may not be the right term because alienation sug- gests nonvoters are interested but fr~ustrated. The fact is they are not i~terested so they aren't frustrated. Look at the profile of those who do vote. Consistent voters have more than high school degrees, have more household income, are older, more successful in their ca- reers, and more community- minded. We do not have good poll data in North Dakota to evaluate voter par- ticipating and nonparticipation but following the suggestion of Secre- tary of Defense Donald Rumsfeld in the Iraqi War, let's go to specu- lation (war) with the facts (army) that we have. In 2016, the 10 counties with the highest turnout were Billings, 84 percent; Slope, 74 percent; Bow- Hello, You know just when you thought there was nothing left in the world to write about, up jumps an idea. It happened to me while watch- ing the Olympics. I know, I know. I've written about the Olympics be- fore. Remember when Shirley and I did the ice skating routine to "Achy Breaky Heart"? In our over- shoes and Carharts on the Stock dam. Shirley never did fully re- cover from that. But that was the Winter Olympics. This was sum- mer! Swimming. Maybe Shirley and I could do the synchronized swim- ming. She insisted I start out alone. I complained vehemently that alone would not work. But as I floun- dered around trying to turn a som- ersault, I realized she might be right. Water polo. I convinced her we could play water polo. It may bring down my blood pressure and per- haps we would lose a little weight. I found out they play in water over their heads and that idea quickly died away. Running. No way. Hard on knees. Diving. No way. Scared of height. Gymnatics. The rings! Have you ever seen a 280-pound fat man try to hold himself up on the rings? Shirley even smiled at that. Perhaps the pommel horse. Yeah, right. Help us celebrate 98 years! The Legion in Beach will be celebrating its 98th birthday with a FREE ice cream social at the Club, Sunday, Aug. 6, from 11 to 1. man, 74 percent; Sheridan, 74 per- cent; Emmons, 74 percent; Kidder, 74 percent; Grant, 74 percent; Logan, 73 percent; McLean, 73 percent; and Oliver, 72 percent. The 10 counties with the lowest turnout were Rolette, 40 percent; Sioux, 46 percent; Benson, 46 per- cent; Ward 52 percent; Williams, 54 percent; Stark, 54 percent; Grand Forks, 55 percent; Walsh, 56 percent; Pembina, 57 percent; and Mountrail, 57 percent. So do figures suggest that the voters in the high voting counties had the highest household incomes and the lowest turnout occurred in counties with the lowest household income and highest poverty rate? The only counties among the 10 with the highest household income that appeared in the top 10 voting counties were Oliver, Slope and Billings. Three out of 10 doesn't appear to be a strong enough corre- lation to conclude that household income determines voter turnout. In fact, three counties among the 10 with the lowest household in- come - Emmons, Grant and Sheri- dan - were among the highest in voting turnout. When it comes to counties with the highest level of poverty, we find three counties among the top 10 for turnout were among counties with the highest poverty rate - Emmons, Grant and McLean. Does age matter? Four of the counties - Sheridan, Emmons, Grant and Logan - with the largest number of persons 65 and over were also among the 10 with high- est turnout. So age could have been some influence. When we look at education, none of the 10 counties with high- est educational attainment (some college or more) were in the high turnout list while three counties - Sheridan, Kidder, and Logan - were among lowest in educational attainment but had the highest turnout. So the relationship be- tween educational attainment and turnout is weak. On the basis of this skimpy look, it appears that household income, age and education do not explain high voting counties with low household income, high poverty rates, older voters or lower educa- tional attainment. So what brings them to the polls? My theory is that frontier effi- cacy, the conviction that everyone can influence outcomes, permeates the electorate at all levels of pros- perity, age and education. We are still demonstrating the assertive- ness that was necessary to survive in a challenging frontier environ- ment. (We should point out that the south central "German" counties had higher voter turnout than the rest of the state. All of those Nor- wegians in Williams, Grand Forks and Minot didn't score so well; an ethnic dimension.) All are welcome to stop by and share the event. I watched intently for days. Try- ing to find a sport that the family could do together. Then there it was! Right before my eyes. A sport fit for all. A sport closely watched by sporting fans all across the world! Beach volleyball! We would go beyond the Olympic venue. We would have Couples Beach Volley- ball. I mean this is a sport meant for me. It is like peeking under the hoochey coochey tent at the state fair fifty years ago, except you don't have to pay for parking. And the carnies don't chase you away with a stick. We could afford the uniforms. They can't cost more than a few cents. Sunglasses would be the biggest expense. Also the biggest piece of clothing. With no rain the past several months, our hay field is pretty much a sand pile. There are a couple of the grandkids balls lying around here. Some net wrap off of one of Jeff's bales would form a net. The investment would be nil. Shirley was at a meeting. I Van or Bus Service Billings County Golden Valley County Distance of 160 Miles CALL: 701-872-3836 Our board meets at 9:30 a.m., first Tuesday of each month at 701 S. Central Ave., Beach. The public is invited! strung up the net wrap and marked off the court. Since Shirley is a lit- tle slow, I made the court pretty small. I thought I would surprise her, so I slipped into my beach vol- leyball uniform. Have you ever seen a 280-pound fat guy with a farmer's tan wearing a "Speedo"? Or whatever they call them. Trust me, if you haven't, you are sooooo lucky! . When Shirley drove into the yard, I was standing there boUncing a ball. Sunglasses, little pants that crept up my ..... Well, you know. Lace up boots .... the sand was too hot for my bare feet. What does it say about you spousal relationship when you wife looks at you and falls down on her hands and knees in laughter? That hurt. That really hurt. I'm going to go back in and watch the reruns of the Olympic volleyball. Serving! Later, Dean The deadline for submitted copy and stories and all ad orders is noon on Fridays. Call 872-3755 or e-mail To All Billings County Residents: I am notifying all of you that I am resigning as Billings County Recorder~Clerk of Court. My last day of service will be August 4, 2017. At this time, I would like to thank all of you for your gracious hospitality and support over my 30 years of service. Thank you for your faith in me as your elected official I am greatly honored to have served the people of this county. God bless you alL Respectfully submitted, Donna Adams on t Champions Ride Saddle Bronc Match SB,'rIIII}DAI', IUGuYr 5, Z017 Sentinel Butte, ND Calcutta & Sponsor Limited lleception bleacher August 4lh seating but 6:00pro @plenty of NI) Cowboy hillside Hall of Fame in seating! Medora -Admission Charged at Gate -Buses Welcome -Concessions Available Exit #7 on 1-94 16 miles west of Medom For tnore intb or tickets call 701-872--3745 or Come celebrate with at their wedding dance and reception at Kevin's shop! 119 4th St. NW, Beach Friday, July 28 5 pm - ?