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MARK TRAHANT Austerity |
At a Billings hearing in May, Sen. Jon Tester expressed frustration about the management of the Indian Health Service.
The Montana Democrat said: “We need to live up to our trust responsibility and offer tribes the health care they deserve. Ongoing issues around service delivery, transportation for critical care, billing and reimbursement issues abound. We need to prioritize these issues and solve them.”
Tester, of course, is chairman of the Senate Indian Affairs Committee. So his call for improving the agency is worth considering.
Then again, when former Sen. Byron Dorgan (D-ND) was chairman of the same committee, he also held hearings and published a report about the poor management record at IHS. “The investigation identified mismanagement, lack of employee accountability and financial integrity, as well as insufficient oversight of IHS' Aberdeen Area facilities. These issues impact overall access and quality of health care services provided to Native American patients in the Aberdeen Area. Many of these issues may stem from a greater lack of oversight by the area office and IHS headquarters fostering an environment where employees and management are not held accountable for poor performance.” The year was 2010.
So what kind of progress has the Indian Health Service made during those four years? Unfortunately that’s the wrong question.
In the blink of an eye, the very structure of health care has changed and is continuing to change dramatically in the United States. Yet the structure of the Indian Health Service is the same.
Take the name: Indian Health Service. On the agency’s web page it adds the descriptive line, “The Federal Health Program for American Indians and Alaska Natives.” (more…)