PROMISES, PROMISES: Indian health care needs unmet

[Trumplestiltskin 5,791]

simplified ... the gov't made an agreement with a people and welched on the deal. the "problems/barriers/under_etc_etc" are just excuses.

That does seem to be your reasoning.

And I was right in mine - that you see nothing wrong with using this rather unique example as a relativistic argument to justify a party political soundbite.

I'm not promoting "party politics" as you infer.

the gov't agreement has crossed many party lines multiple times over the years and still is unresolved. the gov't needs to fix it's broken promises if it wants some margin credibility.

Its clearly implied Natty - the old "big government is bad", "government can't plan a piss-up in a brewery" are blatant cliches.

[natty bumppo 297]

simplified ... the gov't made an agreement with a people and welched on the deal. the "problems/barriers/under_etc_etc" are just excuses.

That does seem to be your reasoning.

And I was right in mine - that you see nothing wrong with using this rather unique example as a relativistic argument to justify a party political soundbite.

I'm not promoting "party politics" as you infer.

the gov't agreement has crossed many party lines multiple times over the years and still is unresolved. the gov't needs to fix it's broken promises if it wants some margin credibility.

Its clearly implied Natty - the old "big government is bad", "government can't plan a piss-up in a brewery" are blatant cliches.

in this matter ... yes the gov't ... I like your choice of words here .... the "government can't plan a piss-up in a brewery"

other gov't issues/topics may and/or may not have a different credibility

[Peikko 1,575]

Here's another good one for you.

Government are rubbish at, well just about everything except providing a standing army? What solution would you provide for all those currently unable to afford health care? How do you reduce the burden on those who pay insurance for health care so that they are not encumbered by the expensive waste of resources from:

Doctors being paid per surgery, not by performance (ie the quantifiable outcome of healthier citizens)

Massively over bureaucratic system (not sure what the % is, but it's grotesque compared with single payer systems)

Funding those who refuse to/can't afford to purchase insurance.

All of these things currently mean that people are denied access to good health care on a daily basis and all these things lead responsible people into poverty and debt. This is the reality, so please, give at least an outline on how to fix these problems without government intervention. Quite honestly, I don't give a stuff how it happens, whether provided by government of private insurance but provided it needs to be.

[catknit 144]

Geographically isolated populations are badly served in ALL systems. Sadly, most of those getting less than adequate care are in geographically isolated situations. Private health care wouldn't touch this with a barge pole.

Much the same with Australian aborigines - much to BY's Chagrin.

Though there are similarities with people living in rural India, China, Bangladesh etc.

The same supposedly holds true with the northern most reaches of Canada too.

There is a very successful model already in place in the US for running decent government managed healthcare system on a large scale.

http://www.washingtonmonthly.com/features/...01.longman.html

and

http://www.slate.com/id/2216711/

"Phil and I have publicized this story repeatedly because no one else seems willing to—no one, that is, except for experts on medical economics, to whom the VA's superiority to other health care delivery systems is boringly old news. The general public doesn't know about it because nonexperts harbor a deep resistance to believing it. This stems in part from confusion over the well-publicized scandals involving Walter Reed Army Medical Center, which even many Washington policy jocks think (mistakenly) is part of the VA hospital system. (It isn't. As the name implies, Walter Reed is run by the Army.) It also stems from a conviction that has seeped deep into the political culture that anything run by the federal government must be inferior to market-based alternatives. The Obama administration and Congress are utterly terrified that in crafting health care reform they will run afoul of this infantile prejudice. They will therefore move heaven and earth to avoid acknowledging the VA's pioneering use of computerized medical records, its avoidance of the justly lamented fee-for-service model (VA physicians are salaried), and the efficiencies it realizes by treating patients over the long term. The implications of this success are too terrifyingly pinko. The VA is, after all, a system in which the role of insurer, physician, and hospital are all assumed by the U.S. government. The Bush administration did its patriotic best to diminish the VA's record of success by withholding necessary funding and vastly expanding its use of private contractors, an experiment that, according to a recent article by Tara McKelvey in The Nation, is off to an unpromising start. But the VA's own doctors and hospitals continue to provide a distressingly positive model for health care reform.

Baucus and his staff recently met privately with experts from the VA to learn about these achievements, but he isn't about to put any of these folks in front of a TV camera. The rationale for excluding the VA from the hearing was that because it is run separately from the rest of the health care system, the VA probably won't be affected by any delivery-system reforms Congress enacts. But that's absurd. The hearing was an attempt to seek out models for reform. The VA hospitals represent the most successful large-scale reform in the delivery of health care that this country has seen in decades. But—shhhhh!—let's keep that between you and me. I've probably said too much already."

It isn't an infallible system - some hospitals in the system have had high profile issues specifically with instruments. But it is a working model that shows actual promise...

[JimandChristy 1,689]

I see the scaremongering continues from the Republicans...."The best in the World"

Private Enterprise is destroying the Health Care system, they leech off millions of Americans and deny access to care at any given opportunity.

Edited June 16, 2009 by JimandChristy

[Ban Hammer 13,334]

Natty - this has to be the most lame reasoning ever.

Totally discounting the unique problems that affect Native Americans, their under-representation in our political structure and the cultural barriers and practical barriers separating them from the rest of the country (all of this is addressed in the article BTW), there is no commonality between the deficient implementation of a legacy program based on a 200+ year old treaty to proposed healthcare reforms for the majority.

And again - European style "socialized" healthcare is not what is currently being proposed (nor is it what Obama proposed during the election campaign) so arguing against it is somewhat pointless.

commonality = the gov't implementing and operating the health care program for both population segments. the older implementation is a failure with a small segment of the population. how will this be different with the larger population? cause it will simply be a bigger failure?

Ummm yeah - because it will be totally... like.. um.. yeah... the same plan.

But sure - if you want to use a badly served, underrepresented population of unique circumstances as an analogy to the rest of the country, go right ahead.

It may sound reasonable to you, but it sounds quite silly to me.

They can't help it, remember Republicans are the masters of scaremongering....

and the democrats are the masters of promising us something that won't work.

[Ban Hammer 13,334]

A more relevant comparison would center on Medicare and Medicaid, not the shortcomings of the Indian Health Service.

The thrust of the plan that Obama is pushing, and what will likely be his legacy on this issue (I think), is the addition of a public insurance option. The Indian Health Service (and indeed the VA) is a completely different and separate federal entity. No plan for a large-scale expansion of government-run health care is even on the table. In fact, it's not even close to the table.

Applying anecdotes of inadequate care delivered in remote areas by an underfunded federal agency to the current broader situation is more than a little clumsy.

how many anecdotes does one need to realize that government controlled healthcare in the usa sucks?

inadequate care - who's fault is that - the governments!

underfunded federal agency - who's fault is that - the governments!

and while it may be true that the recipients of this are in remote areas, are we going to shrug off shortfalls in care due to the beneficiary being in a remote area/sucks to be them attitude?

[Peikko 1,575]

Again, details please of a credible plan that does not rely on government intervention in some form. Thanks.

[Ban Hammer 13,334]

Again, details please of a credible plan that does not rely on government intervention in some form. Thanks.

what are you blathering about now? the story is about government provided healthcare.... why don't you explain how government provided healthcare can get better without government intervention?

[Empress of Groovy 373]

A more relevant comparison would center on Medicare and Medicaid, not the shortcomings of the Indian Health Service.

The thrust of the plan that Obama is pushing, and what will likely be his legacy on this issue (I think), is the addition of a public insurance option. The Indian Health Service (and indeed the VA) is a completely different and separate federal entity. No plan for a large-scale expansion of government-run health care is even on the table. In fact, it's not even close to the table.

Applying anecdotes of inadequate care delivered in remote areas by an underfunded federal agency to the current broader situation is more than a little clumsy.

how many anecdotes does one need to realize that government controlled healthcare in the usa sucks?

inadequate care - who's fault is that - the governments!

underfunded federal agency - who's fault is that - the governments!

and while it may be true that the recipients of this are in remote areas, are we going to shrug off shortfalls in care due to the beneficiary being in a remote area/sucks to be them attitude?

You've ignored my first two points.

Correct me if I'm wrong, but aren't you making a connection between government-run (which is not a viable proposal right now) health care and the proposed public insurance option that is a real possibility? This public option will likely resemble Medicare, not the IHS or the VA. That's why I suggested examining the problems associated w/ Medicare.

If you're simply stating that the IHS is coming up short in some areas and that the federal government needs to step it up to adhere to its obligations to this population, I absolutely agree with you. The shortcomings of VA facilities have also been well-publicized over the years. But these issues--the public insurance option, and facilities/services controlled and funded by the federal government--are separate, and your comments suggest that they're one and the same.

[Trumplestiltskin 5,791]

The pertinent question here would be whether a public insurance system will lower costs. Universal coverage sounds great on paper, but it was the same criticism that was raised during the election campaign.

Obamas plan isn't half as radical as its being made out to be (a papering over the cracks, if you will). Mccains plan to do away with employer tax breaks for healthcare was radical, but he didn't address the cost issue other than to suggest that a magical confluence of market forces would somehow result in cheaper, more affordable healthcare.

Kinda wish people would familiarise themselves with what is on the table before t start spouting clichés about socialism and government failure.

Is obama's plan going to fix the core problems of the current system? Probably not - its only real focus seems to be on getting more people covered. Not a bad start but it does have the wishy washy smell of compromise about it.

[Ban Hammer 13,334]

A more relevant comparison would center on Medicare and Medicaid, not the shortcomings of the Indian Health Service.

The thrust of the plan that Obama is pushing, and what will likely be his legacy on this issue (I think), is the addition of a public insurance option. The Indian Health Service (and indeed the VA) is a completely different and separate federal entity. No plan for a large-scale expansion of government-run health care is even on the table. In fact, it's not even close to the table.

Applying anecdotes of inadequate care delivered in remote areas by an underfunded federal agency to the current broader situation is more than a little clumsy.

how many anecdotes does one need to realize that government controlled healthcare in the usa sucks?

inadequate care - who's fault is that - the governments!

underfunded federal agency - who's fault is that - the governments!

and while it may be true that the recipients of this are in remote areas, are we going to shrug off shortfalls in care due to the beneficiary being in a remote area/sucks to be them attitude?

You've ignored my first two points.

Correct me if I'm wrong, but aren't you making a connection between government-run (which is not a viable proposal right now) health care and the proposed public insurance option that is a real possibility? This public option will likely resemble Medicare, not the IHS or the VA. That's why I suggested examining the problems associated w/ Medicare.

If you're simply stating that the IHS is coming up short in some areas and that the federal government needs to step it up to adhere to its obligations to this population, I absolutely agree with you. The shortcomings of VA facilities have also been well-publicized over the years. But these issues--the public insurance option, and facilities/services controlled and funded by the federal government--are separate, and your comments suggest that they're one and the same.

essentially, i'm saying that government run health care is portrayed quite well in this story along with how good washington's promises are. one may take what they want from it - i know what i get out of it.

[natty bumppo 297]

A more relevant comparison would center on Medicare and Medicaid, not the shortcomings of the Indian Health Service.

The thrust of the plan that Obama is pushing, and what will likely be his legacy on this issue (I think), is the addition of a public insurance option. The Indian Health Service (and indeed the VA) is a completely different and separate federal entity. No plan for a large-scale expansion of government-run health care is even on the table. In fact, it's not even close to the table.

Applying anecdotes of inadequate care delivered in remote areas by an underfunded federal agency to the current broader situation is more than a little clumsy.

how many anecdotes does one need to realize that government controlled healthcare in the usa sucks?

inadequate care - who's fault is that - the governments!

underfunded federal agency - who's fault is that - the governments!

and while it may be true that the recipients of this are in remote areas, are we going to shrug off shortfalls in care due to the beneficiary being in a remote area/sucks to be them attitude?

You've ignored my first two points.

Correct me if I'm wrong, but aren't you making a connection between government-run (which is not a viable proposal right now) health care and the proposed public insurance option that is a real possibility? This public option will likely resemble Medicare, not the IHS or the VA. That's why I suggested examining the problems associated w/ Medicare.

If you're simply stating that the IHS is coming up short in some areas and that the federal government needs to step it up to adhere to its obligations to this population, I absolutely agree with you. The shortcomings of VA facilities have also been well-publicized over the years. But these issues--the public insurance option, and facilities/services controlled and funded by the federal government--are separate, and your comments suggest that they're one and the same.

essentially, i'm saying that government run health care is portrayed quite well in this story along with how good washington's promises are. one may take what they want from it - i know what i get out of it.

I'll paraphrase what was posted earlier ... they see what they want to see ....

[Trumplestiltskin 5,791]

Natty - If people weren't seeing what they wanted to read here I imagine they wouldn't be using a false comparison for the purposes of propaganda and which has nothing to do with the reality of proposed healthcare reforms.

[natty bumppo 297]

Natty - If people weren't seeing what they wanted to read here I imagine they wouldn't be using a false comparison for the purposes of propaganda and which has nothing to do with the reality of proposed healthcare reforms.

so ... the "proposed health care reforms" have what to do with the OP, the plight of the tribes, and government broken promises?

let me guess ... continued broken gov't promises to be expected