"The last national health care reform conversation was one-sided when it involved Indian Country. The topic was simply how would change impact the Indian health system.

That conversation remains critical.

Reno Keoni Franklin, chairman of the National Indian Health Board, said at the Denver Indian Health Summit that the current funding model has created a crisis for California tribes. Because of the state’s financial implosion, it’s an outright conflict of interest for the state to tell tribes what’s a reimbursable expense under Medicaid and Medicare.

This very notion is a preview of the impacts that could come from any larger health care reform. If nothing else, tribes are major employers and that promises to be the foundation for health insurance mandates.

But that’s just the beginning. For example: On Wednesday Vice President Joe Biden announced a deal where hospitals will contribute $155 billion in savings in government reimbursements. Perhaps it’s a helpful contribution to the federal deficit on the national level – but what kind of impact will this, and other changes, make on an already under-funded Indian health system? It’s one thing to suggest cost-cutting in a system that costs twice as much as those in other developed countries; yet that same “savings” could be devastating when applied to the part of the system that takes frugal to a new level.

What if reform means a future insurance program – federal or private – further strips the funding base from the Indian Health Service? It’s absolutely possible that a new program would cover uninsured American Indians and Alaskan Natives – but without a full recovery for those costs to the IHS."

Get the Story:
Lessons from Indian Country (Mark Trahant 7/9)

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