"There are two master narratives about the Indian Health Service.

First, everyone knows the Indian health system needs more money. Everyone, it seems, except the collective members of Congress who, when they write budgets, can’t seem to appropriate at least as much money as they do for the U.S. Bureau of Prisons.

And, second, critics say the Indian Health Service represents the failure of government-run care with complaints ranging from rationing to mismanagement of government funds. Just last week Sen. Tom Coburn, R-Oklahoma, repeated this narrative in his attack against the Senate’s health care reform bill. He again called the IHS “a failure.”

These two narratives stick because the truth is far more complicated. It’s hard to communicate a “yes, but” message in a political context. Yes, the IHS does ration care – but that’s because it has only so much money in its budget. Yes, the IHS isn’t perfect with its spending (or insurance billing operations), but is that also a reflection of its limited budget? We really won’t know the answers unless the agency gets adequate funding.

There is another story that deserves at least the same attention as the first two themes: The really remarkable efforts underway to improve quality for American Indian and Alaskan Native patients."

Get the Story:
Challenging the master narrative about government-run health care (Mark Trahant 12/14)

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