What’s Next for Health Care? Confused Congress Should Look to Indian Country

Indian Health Service is a great example of health care run and managed by the government. Let’s use it to figure out what works and what doesn’t.

...Seven years ago, when I started writing a lot about health care, I did so because I saw the Indian Health Service as a fascinating example of government-run and -managed health care. As we began this debate, I thought, let’s figure out what works and what needs work.

Mark TrahantBut I was way wrong. IHS is no longer only a government-run system. Much of the agency is now a funding mechanism for tribal, nonprofit, and urban operations. And that’s where so much of the innovation and excellence in Indian health exists. We need to know more about what’s working and why. Yet Congress (and the public narrative) continues to think of an IHS that no longer exists. At least not entirely.

This might be a moment to focus on the latter part of what the agency does, improving the flow of funds and adding more of our people to insurance rolls. Here’s the thing: We cannot do anything about universal health care. At least not yet. But we can have universal health care for Indian Country. It’s a huge task, but the ACA remains the law, and it’s only a matter of execution (not a policy debate)....