Health care in America is a failing proposition. An estimated 47 million Americans do not have health insurance. And yet Health and Human Services Secretary Kathleen Sebelius calls the health care of Native Americans a "historic failure." What about health care in the rest of America?
The new head of the Indian Health Service, Dr. Yvette Roubideaux, was not as harsh. She said, "It's clear that there's a call for change and improvement in the Indian Health Care Service, and it's also clear the IHS has been significantly under-funded for many years. The staff of Indian Health Service has been doing the best it can with limited resources, and in some cases they are providing excellent quality of care with limited resources."
Sen. Max Baucus (D-Mont.), the man in the Senate leading the way, said that Congress will pass comprehensive and meaningful health care legislation this year. He compared the legislation as the most sweeping since the New Deal of Franklin Delano Roosevelt. "It's gonna pass. It's gonna happen. There's no doubt about it," he said.
The efforts to introduce universal health care can be traced to the days of Woodrow Wilson and more recently to the political fiasco during the Bill Clinton administration in 1993 and 1994. The most powerful opposition to universal health care can be found in the medical profession and the insurance companies. They present a formidable lobby on Capitol Hill.
Those Americans opposed to it compare it to Canada's or Britain's health care systems, which they say are nothing but socialized medicine. The Indian Health Care system, deemed a "historic failure" by Sebelius, has also been labeled as socialized medicine, and the fact that she would label it as a failure does not place much faith in an even larger universal health care system. It just seems that every time the federal government takes total control over anything, failure is almost assured. Watch out General Motors.
Key senate committees will begin writing legislation this month. President Barack Obama expects to have a bill on his desk by the end of the year, and he is confident that universal health care will become the law of the land.
If this legislation passes, how will it impact the Indian Health Service? If all Americans are provided health insurance, will that include Native Americans? How will it affect the Indian hospitals in urban areas and out on the Indian reservations?
President Obama has called for an increase in funds for Indian health care of 13 percent in Fiscal Year 2010. This would bring the largest funding increase in 20 years to the Indian Health Service. Will the introduction of universal health care change any of this?
There is not a Native American alive today who has not witnessed the many shortcomings of the Indian Health Service, but as Dr. Roubideaux has said, most of the failures were due to an extreme shortage of funds.
An article in Time magazine asks some important questions. Will there be a big, new government system? How can a nation already deeply in debt afford healthcare reform too? Can we really cover everyone? And if so, what will be covered? How will we bring down the costs? With a deficit nearing $1 trillion dollars, this last question is very relevant.
I believe Secretary Sebelius and Dr. Roubideaux are stepping into a situation that, for the first time in the history of the Indian Health Service, will be dramatically swayed by what is happening on the national scene. Fighting for funding every year for the Indian Health Service was a given. It was an ongoing battle that never changed, and the IHS was often the loser. But with universal health coverage looming on the horizon, the funds now available will become even more stretched because the federal government will be looking for ways and means to cover health care for everyone, not just the Indians.
Some experts predict the cost of universal health care will be somewhere around $1.5 trillion. Drastic budget cuts in other areas will have to occur in order to free up more money to cover the costs. As I asked earlier, how will that affect the Indian Health Service?
This brings us full circle to the old saying, "If you think the government can solve all of our problems ask an Indian."
Tim Giago, an Oglala Lakota, is the publisher of Native Sun News. He was the founder and first president of the Native American Journalists Association, the 1985 recipient of the H. L. Mencken Award, and a Nieman Fellow at Harvard with the Class of 1991. He can be reached at editor@nsweekly.com
© 2009 Native Sun News
It doesn't take extremely deep analysis to comprehend that universal healthcare for all residents can provide better, quicker care for Native Americans than the irregularly funded IHS system which, by the way, does not serve non-documented Natives and drastically underserves Urban Natives. Under universal healthcare, my people could finally receive fair treatment without our identity being questioned or our sovereignty being jeopardized.
As to Mr. Giago's implied question whether Americans possess adequate intelligence to imitate the CIVILIZED nations who have made Universal healthcare work to the overwhelming satisfaction of the majority of their populations, I decline speculation.
Even with polls at 72% in favor of a single payer system the Health Care Industry Lobby in DC still has more power, money and will than the American People.
If the American People really want this they need to take a good hard look at Iran and take to the streets.
Get organized.
Ever hear of SINGLE PAYER system?
We have it in Hollland and works great.
Its PRIVATE!!
And it works better than the rest of the country's for profit system.
Native Americans should continue to be very wary of the white man's systems (yes, I'm a white man)
and take all that beautiful casino money and build strong nations that serve themselves.
The point is 16% of the people DON'T PAY FOR IT AT ALL, and they should.
24% are inadequately covered, which means they too go bankrupt (that means they don't pay the bills) when they have catastrophic health care expenses.
So, that's 4 out of 10 people, 40%, whose cost can shift to everyone else if they have expensive catastrophic costs. And the baby boomers are getting older and more in need of catastrophic health care just as premiums have already more than doubled in the past 8 years.
In the US, The Emergency Medical Treatment and Active Labor Act also ensures public access to emergency services regardless of ability to pay. There is a $1,000 surcharge Now in health care premiums in the US to cover people who receive treatment in emergency rooms.
The number one best way to reduce the health care costs is to have everone pay into the system. That's what insurance does, right, spread the risks around!
Single-payer systems are not "socialized medicine" but "social insurance" systems, because doctors are in the private sector.
I do like the idea of having both a public and private option competing for America. If the private plans can't continue it will be because American's will eventually not choose them. That's a choice that we don't have now just like we don't have a choice now to pay for those emergency care visits and bankruptcies.
But under the current system, the only people who can get insurance either can afford to buy it themselves, or get it from their employer. What percentage of Indians fall into either of those categories?
Until Americans are willing to engage in healthier lifestyle choices to start with NO amount of insurance reform will "help" to increase the health and longevity of Americans.
For instance, a system that promoted preventative care [and therefore more actively promoted the lifestyle choices you mentioned], would go a long way towards helping people to see what you advocate at a personal level.
Standing back and delivering a blanket critique feels good [particularly if you happen to be healthy, can afford a healthy diet and are able to be active], but has little value.
Sure, it might require an ADDITIONAL initiative to, in a separate but related way, improve the IHS. But why couldn't that be done? And wouldn't it be easier TO improve the IHS within the context of a single-payer, universal health care system that guarantees quality health care to every American citizen?
In other words, don't just frame the question like, how will reforming the U.S. health care system help the IHS without, yes, acknowledging the fact that there may need to be an ADDITIONAL focus on IHS specifically to improve it, however.
"How can a nation already deeply in debt afford healthcare reform too?"
Heavy sigh (I get tired of explaining this over and over).
A) Our current health care system, ruled with an iron, we-don't-care-if-you-die-and-in-fact-TRY-to-find-loopholes-and/or-any-excuse-whatsoever-no-matter-how-ridiculous-and-unfair-and-unethical-to-deny-your-claims private, for-profit (GOT THAT? FOR PROFIT, **NOT** FOR PROVIDING-YOU-WITH-QUALITY-HEALTH-CARE) health insurance companies, is completely dysfunctional and eats up more than 16 percent of our country's GDP.
SIXTEEN PERCENT. TWICE what other western, industrialized countries spend. We're talking 2 to 2.5 TRILLION dollars.
Having said that, I dont know why anyone would think that universal health care would NOT apply to THE WHOLE population i.e indians as well. I would imagine that reform would only strengthen the IHS. Perhaps the author could clarify when/who suggested that indians would be EXCLUDED from a universal health care plan?? Otherwise this is seems like a panic that is being created for no good reason...
IHS has a VERY POOR record with regards to medical care of American Indians... It isn't THAT long ago that IHS was FORCIBLY STERILIZING Indian women simply because they WERE Indians. (In 1972 and 1973 roughly 1 in 4 female patients between the ages of 14 and 45 seen by an IHS physician either had a hysterectomy OR their tubes tied WITHOUT their consent... ) The faces may have changed BUT I very highly doubt that the policies will change one iota when it comes to IHS OR the BIA.
Which means that now I'm actually SAVING $500 a month for health care.
GOT IT?
So that's the cost aspect of it. Don't just pose the question like, oh, it's going to COST so much without talking about how much money gets SAVED.
And THEN we can have the argument about the QUALITY of the health care that would be provided, which is a whole other argument (which has also been proven to be better in all the other western democracies than what WE have right now).
They are, afterall, a corporate interest....