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Mark Trahant: IHS isn't broken, just underfunded
Thursday, July 9, 2009
Filed Under: Health | Opinion

Note: Follow Mark Trahant on Twitter. He is attending the Indian Health Service consultation in Denver, Colorado.

"Dr. Donald Berwick is one of the nation’s leading authorities on health care quality and improvement. He’s president and CEO of the Institute for Healthcare Improvement. He’s also a clinical professor of pediatrics and health policy at the Harvard Medical School and a professor in the Department of Health Policy and Management at the Harvard School of Public Health. Berwick has been on boards ranging from the American Hospital Association to an elected member of the Institute of Medicine. ABC’s Medical Editor, Dr. Timothy Johnson, calls him a “beloved” voice.

Berwick uses that voice to say look at the Indian Health Service as a model for what the U.S. system could be. “The Indian Health Service can, and will be, one of the leading prototypes for health care in America,” he said at a National Indian Health Summit in Denver on July 8.

First, think about the money. Health care costs are double what the amount spent in other developed countries. And for that money, Berwick says, the “American health care is not the best in the world. It’s not even close.” Indeed he calls the current health care system a “low-value” enterprise, one that strips money from both family and government budgets.

Then there is the IHS. “The Indian Health is trying to deliver the same or better care with half the funding of other systems in the United States,” he said. Spending by IHS is even less than other developed countries. Berwick said he didn’t want to underestimate the resource challenge – and he’d be the first to say IHS needs more money – but at the same time the IHS’ ability to execute is “stunning.” The very nature of the agency’s under-funding has resulted in a discipline that’s “an example for us all.”

There’s a paradox: The Indian Health Service isn’t broken, it’s significantly under-funded while the national health care system is both over-funded and broken."

Get the Story:
IHS is the model (Mark Trahant 7/8)

Related Stories:
Mark Trahant: Indian health care at the local level (7/8)
Mark Trahant: IHS could be a model for reform (7/7)

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