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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
http://www.commonwealthfund.org/
~/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@ gmail.com. )
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 goldenandbillings.0@gmail.com.
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
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lleception bleacher
August 4lh seating but
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Come celebrate
with
at their wedding dance and
reception at Kevin's shop!
119 4th St. NW, Beach
Friday, July 28 • 5 pm -
?