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Blog: Rationing health care in Indian Country and United Kingdom


"Dr. Berwick, now appointed to a US panel to shape US heath care, is an admirer of the UK system of health care, which includes limiting or rationing of it’s care.

So this week, two stories are coming out of the UK on health care.

This will undoubtably be publicized by the right to criticize the Obama Health Care plan, which no one really knows anything about, but which is supposed to include a lot of regulations telling docs who to treat and how to treat them, or else.

Yet for those of us who worked for the US Federal government, none of this is new.

If you are Native American, and rely on your medical care at an IHS clinic, you may only be able to get one or two drugs per category. Emergencies and life or limb threatening surgery will be paid for, but if you want a knee replacement, even seeing an orthopedist might take time. If you have a local IHS hospital with the needed specialist, you might wait for an appointment. If that takes too long, or if your area doesn’t have a specialist there or an outside specialist holding regular clinics there, it means 1) finding a specialist who will take you (the payment tends to be low, so many will only see emergency cases). 2) getting the funding committee to okay your visit. This can take weeks for non emergency care. and then 3) waiting for a specialist appointment. In rural America, specialists are busy, so if it’s not an emergency, you might have to wait a month or two for an appointment.

So essentially, if you could use a knee or hip replacement, the wait will be long.

Obesity surgery? We rarely referred, even though our obesity rate was high and Diabetes was epidemic."

Get the Story:
Nancy Reyes: Medical Rationing: UK versus IHS (Blogger News 7/26)