IHS = model for healthcare

Correspondent DMarks asks:Is complete Federal control of health care the best thing to do?

Here is what can happen:‘Don’t get sick after June,‘ American Indians say

By Mary Clare JalonickOn some reservations, the oft-quoted refrain is, "don't get sick after June," when the federal dollars run out. It's a sick joke--and a sad one because it is sometimes true. Officials say they have about half of what they need to operate, and patients know they must be dying or about to lose a limb to get serious care.

Wealthier tribes can supplement the federal health service budget with their own dollars. But poorer tribes, often those on the most remote reservations, far away from city hospitals, are stuck with grossly substandard care. The agency itself describes a "rationed health-care system."Comment:  Fortunately, no one's talking about government-controlled healthcare. Except for Republicans employing their usual scare tactics, that is. It seems that no Republican is capable of discussing healthcare rationally.

What Obama and Democrats are talking about is adding a public option to our private healthcare system. This is completely different, although many right-wingers are too dense to understand the difference. I trust you're smarter than they are.

In addition, the IHS seems to have problems only because it's underfunded. Not because it's inefficient or government-operated. Again, these are different problems.

A fairer comparison would be with something like the Veterans Administration, which I believe gets all the funding it needs. Does the VA run out of funds at mid-year? Do veterans complain about the substandard healthcare the VA provides? Do they stick with private options because their public option is inferior?

I suspect the answers are no, no, and no.

Here's the real story on the Indian Health Service:

IHS is the model

An expert on quality calls the IHS a prototype for reform

By Mark TrahantBerwick uses that voice to say look at the Indian Health Service as a model for what the U.S. system could be. “The Indian Health Service can, and will be, one of the leading prototypes for health care in America,” he said at a National Indian Health Summit in Denver on July 8.

First, think about the money. Health care costs are double what the amount spent in other developed countries. And for that money, Berwick says, the “American health care is not the best in the world. It’s not even close.” Indeed he calls the current health care system a “low-value” enterprise, one that strips money from both family and government budgets.

Then there is the IHS. “The Indian Health is trying to deliver the same or better care with half the funding of other systems in the United States,” he said. Spending by IHS is even less than other developed countries. Berwick said he didn’t want to underestimate the resource challenge--and he’d be the first to say IHS needs more money--but at the same time the IHS’ ability to execute is “stunning.” The very nature of the agency’s under-funding has resulted in a discipline that’s “an example for us all.”What a surprise. For the umpteenth time, the Indian way of doing things provides a model for America to emulate. For most of history their medicine was superior to the white man's, and it still seems to be superior.

For more on the subject, see Different Views of Medical Care and Indians Gave Settlers Remedies.

Below:  One doctor who learned from Indians.