"The Indian health system is stuck in a world of conditional sentences. That’s a sentence with the phrase, “if … then.” If Congress passes health care reform, then …
There are many variables based on a complex grid of “ifs.”
The most important conditional sentences involve the Indian Health Care Improvement Act. There are slightly different versions in both the House and Senate bills. If the House language is the one to prevail, “then” means one thing. But that meaning changes if it’s the Senate version, or even if it’s a merged bill.
The Indian Health Care Improvement Act would probably not survive reconciliation because the bill would have to be narrowed in its scope.
But one thing is certain: Health care reform will not end with passage or even the defeat of the bills in Congress.
That said: The Indian Health Care Improvement Act remains the key step for reform within IHS.
“I think passage of the Indian Health Care Improvement Act is going to especially important because of the symbolism of its passage,” said Yvette Roubideaux, M.D., M.P.H., director of the Indian Health Service in an interview earlier this month. “It’s an act that will reaffirm the government’s responsibility updating and modernizing the Indian Health Service."
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