"What will the Indian health system look like a decade from now?

That’s an impossible question to answer. There is the potential of a court ruling striking down at least part of the Patient Protection and Affordable Care Act. And, there is always the possibility of Congress will rewrite the law (I view this as remote because there would have to be a Super Majority to enact something else.)

But in the meantime there is a new foundation already under construction. The building that will rest on that structure will not be the same as the one in place now.

Let’s start with the patient. Right now, according to the Kaiser Family Foundation, nearly half of all American Indians and Alaska Natives are either uninsured or rely solely on the Indian Health Service. But health care reform changes that. Big time. Beginning in four years, hundreds of thousands of people will become eligible for insurance through government programs (such as Medicaid) because of new income rules. This insurance can be used to pay for services at Indian health system facilities – or at competing health care centers. (Think about how many private walk-in clinics promise no waiting.)

Another huge change is that states have more at stake than ever in the success of the Indian health system. Let’s start with the premise that everyone who should be covered by these government insurance programs will be. (I know it’s a leap.)"

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What will the Indian health system look like? Answers are up to us (Mark Trahant 8/30)

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