Idaho’s Rep. Mike Simpson, a Republican, asked a critical question Tuesday. It’s one rarely asked, let alone, answered. The question: Does more government money work?
Specifically, Simpson, the chairman of the House Interior Appropriations Subcommittee on Interior, Environment, and Related Agencies, was asking if recent increased funding for the Indian Health Service has made a difference.
Dr. Yvette Roubideaux, director of the IHS, went through the numbers at an oversight hearing. IHS appropriations have increased 29 percent since 2008 which, she said, is “making a substantial difference in the quantity and quality of healthcare we were able to provide to American Indians and Alaska Natives.”
For example: Contract Health Service dollars, money spent to purchase medical services outside of the Indian health system, has been increased by 46 percent since 2008. “Four years ago, most programs were funding only Medical Priority 1, or ‘life or limb’ referrals. Now, Dr. Roubideaux reported, “the increased CHS funding means that almost half (29 out of 66) of Federal CHS programs are now funding referrals beyond Medical Priority 1.”
That means that there is now money, at least some money, for preventative services such as mammograms and colonoscopies. “The increased CHS money also means that the IHS Catastrophic Health Emergency Fund, which used to run out of funding for high cost cases in June, now is able to fund cases through August,” Dr. Roubideaux said.
Simpson said: “You can get sick now up to August?” To which Dr. Roubideaux replied, that the phrase, “Don’t get sick after June,” has been incredibly effective describing the problem of what it means for a health care delivery system to run out of money.
Clearly more money in the contract health care (soon to be labeled in the next budget as “purchased and preferred care”) program is making a difference and most likely saving lives. But what about in other program areas? There the data is convincing as well. The Improving Patient Care program, a team based approach to care, has increased the number of sites to a total of 127 (adding 89). This has resulted in both quantity (empanelling 261,180 active patients in a primary care team up from 85,079) and quality (IPC sites show patient satisfaction increasing from 55 percent in April 2011 to 72 percent currently.)
IHS has provided more women mammograms, up from the low to mid-40 percent range to more than 50 percent.
No one thinks that there is enough money in the Indian health system. But in this one subcommittee there is bipartisan agreement that more government spending does indeed work and that the Indian Health Service could use more. This is dangerous talk in DC, the very words that strike fear, government spending is effective. (more…)