Town and Country
Wednesday, August 26th, 2009The News Guy is hot on the trail of several complicated and controversial stories, none yet ready for public consumption.
But fear not. He will not leave you in the lurch, There are always some tidbits, none worth a major take-out on its own, but interesting in small doses.
Consider, for instance, the recent meeting of the Rural Sociology Association in Madison, Wisconsin. Like most gatherings devoted to rural America, this one seemed pitched mostly to the South and the Midwest; lots of talk about the pros and cons of ethanol. But there was also some information that could apply to small towns and rural areas everywhere, even in Vermont.
As reported by Bill Bishop in The Daily Yonder, several of the sociologists reported that their studies found that while rural and small town residents want to make money (who doesn’t?) that wasn’t all they wanted. It wasn’t even what they most wanted.
Terry Besser of Iowa State University studied “thriving small towns” which, she said, were more likely to be in remote areas than close to cities. That seemed to be because the more remote areas required more community involvement.
“You may have less income if you’re more remote, but you will have more connections,” she said.
Rural people who lived near a city were likely to work in that city, meaning they had longer commutes as well as weaker ties to the town they lived in.
Incomes were higher, but she said there was a sense that “people were just living in a place,” rather than really belonging to it.
On the other hand, residents of the tiniest towns and villages seemed less content than those who lived in slightly larger municipalities. In very small towns, she found (according to Bishop) “people burned out working on their communities. Communities of at least 5,000 residents ‘have an advantage over those 1,500 and below,”Besser said.
Similarly, Cheryl Burkhart-Kriesel of the University of Nebraska found that people moved to small towns in that state seeking “a slower way of life,” and closer ties with relatives. Only a third said they moved to take a higher paying job.
No doubt that’s true of many Vermonters. Not that anyone wants to be poor, or even low-income. But apparently a great many people have figured out that – contrary to what one reads in some circles – it isn’t necessary to be all that high income, either.
The lesson being that in pondering “economic development,” its costs, as well as the benefits ought to be in the mix.
Speaking of costs and benefits, here’s an item that the boys in biz school would probably warn against, as it comes under the heading of free advertising for the competition.
But have you noticed that there’s a new, on-line, newspaper in the state? It’s called vermontdailynews.com, and you are invited to Google away for it.
It isn’t really competition, since it: (1) concentrates on Chittenden County rather than statewide matters; and (2) seems to do little (or maybe no) actual reporting on its own. It aggregates nicely, though, and the photography is superb. Word has it that the guy who runs it is a photographer, but for some reason he doesn’t identify himself (or anyone else) in the “About” link.
Don’t be shy, fellas. Tell us who you are.
The health care debate is nationwide, and not specifically a Vermont issue, especially because it’s pretty clear that a substantial majority of Vermonters favor the Obama/Democratic approach to changing the system, if not changing it even more (you will note absence of the word “reform,” a word honest reporters ought not use; “reform” means “to improve by alteration.” Whether the proposed alteration is an improvement is precisely what is at issue).
But along with the other northern tier states, Vermont gets a little attention because it borders Canada, whose health care system is held up as a paragon of virtue by one side and as a sinkhole of horrors by the other. Many a Vermonter knows both: (1) a neighbor who sneaks over to Canada for less expensive prescription drugs; and (2) a wealthy Canadian who has come to the U.S. for elective surgery (paying for it out of pocket) rather than wait months to get the same treatment there.
How pleasing then to find a peer-reviewed, intellectually honest , comparative study of health care in the two countries by American and Canadian physicians and policy experts. It was actually a study of studies, and here’s how we know it’s intellectually honest: it says that for some ailments Canadians seem to get better treatment, but for others it’s the folks South of the border who get better results.
Anyone who resists the temptation to oversimplify and overstate his/her case should be taken seriously.
The study was limited to examining whether there are “differences in health outcomes (mortality or morbidity) in patients suffering from similar medical conditions treated in Canada versus those treated in the United States.”
Neither country “won” in every category. Even these folks, though, have to conclude that by and large the Canadian system serves its people better, not to mention a lot cheaper.
“Despite the limitations of the available studies, some robust conclusions are possible from our systematic review,” the report concluded. “These results are incompatible with the hypothesis that American patients receive consistently better care than Canadians. Americans are not, therefore, getting value for money; the 89% higher per-capita expenditures on health care in the United States does not buy superior outcomes for the sick.
“Canadian health care…produces health benefits similar, or perhaps superior, to those of the US health system, but at a much lower cost.”
But we knew that.





