In all the clamor regarding whether health care should be nationalized, probably a good place to start to understand how nationalized health care is actually being delivered in the US is to review the workings of the Indian Health Service (IHS). (see http://www.ihs.gov/index.cfm)

The IHS currently provides health services to approximately 1.8 million of the 3.3 million American Indians and Alaska Natives who belong to more than 557 federally recognized tribes in 35 states. The agency's 2010 budget is $4 billion. The IHS operates 33 hospitals, 59 health centers, and 50 health stations. Thirty-four urban Indian health projects supplement these facilities with a variety of health and referral services. That's what $4 Billion buys!

The IHS has its detractors who are are not satisfied with the efficiency of IHS. Indianz.com, a website for Native American news, feels Native Americans are "suffering" at the hands of IHS. (Indianz.com: 8-20-07, Jodi Rave: Indian Health Service Inadequate), and that the IHS is underfunded and necessary services unavailable.

Good or bad, this is national health care as practiced by the federal government. The IHS has been in operation in is present form since 1954, so it's had 55 years to mature.

So, if we increase the size of the IHS by a factor of ten, and apply that 900% increase across the nation, to service the "uninsured population," why won't that satisfy the main complaint from the Administration? That expansion of IHS would result in an expenditure of $40 Billion per year, which is a lot cheaper than all the other proposals floating around.

Originally Posted by SteveZ

...So, if we increase the size of the IHS by a factor of ten, and apply that 900% increase across the nation, to service the "uninsured population," why won't that satisfy the main complaint from the Administration? That expansion of IHS would result in an expenditure of $40 Billion per year, which is a lot cheaper than all the other proposals floating around.

And it wouldn't surprise me at all if the cost to the native Americans covered by the program is zero. The the $4 billion cost wouldn't even be offset by any premium revenue. Of course, the quality of care and the "scale up" questions remain open issues if something like this is to be considered as a "public option".

On the first question, if it's good enough for the native Americans, it surely shouldn't have to be materially upgraded to cover the 40-50 million who have been scraping by with no healthcare insurance at all.

Originally Posted by Villages Kahuna

And it wouldn't surprise me at all if the cost to the native Americans covered by the program is zero. The the $4 billion cost wouldn't even be offset by any premium revenue. Of course, the quality of care and the "scale up" questions remain open issues if something like this is to be considered as a "public option".

On the first question, if it's good enough for the native Americans, it surely shouldn't have to be materially upgraded to cover the 40-50 million who have been scraping by with no healthcare insurance at all.

Indeed!

It's a lot easier (and cheaper and faster) to ramp up an existing operation with a history of labor ratios, logistics, procurement management and all the other business facttors, than it is to reorganize from one business model to another.

Granted, it's not a sexy solution, but it's building on 55 years of services delivery, with the basic organizational infrastructure already trained and in place.

And no lobbyist or party hack gains an advantage at taxpayer expense.....

As a RN who worked in North Dakota, we worked with the BIA system allot. The BIA is the Bureau of Indian Affairs. I did go to a reservation when we ran clinic there. There was an amount that was given for health care and when that money ran out - they waited. If you needed elective surgery, you waited until the next round of monies came in. Emergencies did not wait. It reminds me of what the Canadian system seems to be. Thanks