The US Indian Health Services has compacts with scores of Indian nations and its services cost too much while its services miss the target of exploding chronic diseases.
Diabetes, heart disease, arthritis, depression, suicide and cancers are among the growing number of chronic diseases exploding across Indian Country. More than 75% of the cost of US health care now goes to managing these diseases, and a like amount is being spent in Indian Country. The problem is that these diseases are all preventable. Little or nothing is spent on prevention, and it is in prevention that the diseases can be stopped and even reversed.
Denis Cortese, president and chief executive of the Mayo Clinic is quoted by the Washington Post as say, “We’re not getting what we pay for.” Of course Cortese is speaking to the country-wide expenditure for all of health care, but she might as well be speaking loudly about health care in Indian Country. Seattle’s Virgina Mason Medical Center chairman Gary Kaplan is quoted as saying, “Our health-care system is fraught with waste,” and he notes further that half the US expenditure of $2.3 trillion spent on improving health does nothing.
Of the $4.1 billion in funds requested for the Indian Health Service most cannot be said to contribute to chronic disease prevention. Indeed, such a tiny fraction of funds is allocated in support of the traditional tribal health systems that actually do prevent chronic disease and actually do reverse diseases like diabetes, heart disease, alcohol and drug abuse and depression that it can be said that the US government’s health system failure is complete.
Soon to be appointed Secretary in waiting Tom Daschel has a special obligation to work with Senator Tom Harkin and other like minded representatives in the Congress to fashion a New Indian Health System that is cost appropriate, directly addresses chronic diseases, integrates into the traditional health systems and demonstrates that health actually improves. The current system merely proves that one must wait until the disease is in full bloom before there is a health system response. This is backward thinking. Communities and health delivery systems must be pro-actively engaged to prevent disease from environmental causes, introduced processed foods, unnecessary convenience-making systems like moving escalators, and bad diets based on low incomes.
A Whole Health Indiah Health System is in order. We don’t need new ways to pay for a broken system. Indian Country needs a whole new health system, and the President Elect Barack Obama administration has a duty to respond to this important need.
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