Loudenburg: S.D. must strive to meet public health challenges

Loudenburg: S.D. must strive to meet public health challenges Loudenburg by David Lias Roland Loudenburg was destined to be someday become aware and involved in issues involving public health care.

His mother was a nurse; his father was a farmer highly concerned about water quality, the environment, and whether his livestock was receiving too many chemicals and drugs.

"I grew up with that conservatism about how we approach our food supply, how we approach our water supply," Loudenburg said. "Without knowing it I had developed a large interest in public health issues."

Loudenburg, director of program evaluation and population studies, and an assistant professor at The University of South Dakota School of Medicine, was keynote speaker at Friday's Dakota Hospital Association and Foundation Builders Club Community Leadership Luncheon.

The event was held at the Al Neuharth Media Center.

Loudenburg described many of the forces currently influencing health care in the United States and in South Dakota.

"I think it's best to make sure our perceptions are based on reality and based on solid evidence, so while we are making decisions on policy, we truly know what's going on out there," he said.

In 2000, approximately $1.3 trillion was

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spent on health care in the United States, he said. "Private health insurance covered about 34 percent of those costs."

Medicaid and Medicare together funded a third of those costs. Other public sources of medical funding came from the Veterans Affairs Department and workmen's compensation.

"Approximately 32 percent of those dollars were spent on hospital care," he said. "Twenty-two percent of those dollars were spent on physicians and clinical services. Twenty-four percent was spent on dental and other allied health services."

Prescription drugs accounted for 9 percent of health care spending in 2000, and 7 percent of total health care dollars was spent on nursing homes.

"As we age, I expect that number to rise," he said.

Loudenburg's statistics also show that hospitals are relying more on public funds.

"Public funds account for essentially 55 percent of the dollars going in to pay for hospital expenditures across the United States," he said.

This means that hospitals will need to increase efficiency and productivity, and re-design their patient care and delivery systems to address the changing needs of the population.

Hospitals will also need to develop strategic alliances that add value by partnering with other health care entities to do things better and cheaper while streamlining their own resources.

Loudenburg's talk addressed a number of issues, from bio-terrorism and the West Nile virus, to South Dakota's high number of smokers and, in many areas, its shortage of health care providers.

"We need to find ways to control costs, find ways to provide health care coverage to all, we need to continue to improve clinical care," Loudenburg said. "We need to address the issues of care to the aging, embrace cultural diversity and need to be prepared for new, locally emerging diseases.

"We have great health care in South Dakota, in Vermillion and in the United States," he said. "Can we do better and can we fix the problems? I would argue that we don't have a choice and we must."

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