Indian Health Service: Creating a Climate for Change
Executive Summary
IHS is a very complex organization that serves the American Indian and Alaskan Native population. Effective health services for American Indians and Alaskan Natives had to integrate the philosophies of the tribes with those of the medical community. Because not all tribes signed treaties with the United States some people with Indian heritage were not eligible to participate with the federal government programs. Eligible people with Indian heritage were provided various services throughout the IHS programs; however, some IHS locations did not have the necessary equipment or facilities to provide comprehensive services.
With the changing external environment and new demands, increasing need for services and shifting political picture, IHS must change internally to increase efficiency, effectiveness and accountability. IHS is very dedicated to respecting the local traditions and beliefs of tribes. IHS has not developed an adequate third-party payor system, has difficulty recruiting and retaining healthcare professionals and the population IHS serves has health status below the rest of the US. IHS must focus on implementing the Indian self-determination in order to increase the health status of the population to gain continued congressional funding and support.
IHS wants to put healthcare back into the hands of the tribes. This is difficult because each tribe has different concepts of health and it is difficult to accommodate such a wide variety. Because of the scarce resources it will be difficult to determine which decisions and services should be centralized rather than decentralized. In order to implement the change, IHS should provide honest and open communication about the changes and how they will affect each tribe individually. IHS should also be responsive to criticisms and the individual traditions of each tribe. IHS should evaluate tribal satisfaction and health status outcomes to monitor the progress of the change.
IHS is a very complex organization that serves the American Indian and Alaskan Native population. Effective health services for American Indians and Alaskan Natives had to integrate the philosophies of the tribes with those of the medical community. Because not all tribes signed treaties with the United States some people with Indian heritage were not eligible to participate with the federal government programs. Eligible people with Indian heritage were provided various services throughout the IHS programs; however, some IHS locations did not have the necessary equipment or facilities to provide comprehensive services.
With the changing external environment and new demands, increasing need for services and shifting political picture, IHS must change internally to increase efficiency, effectiveness and accountability. IHS is very dedicated to respecting the local traditions and beliefs of tribes. IHS has not developed an adequate third-party payor system, has difficulty recruiting and retaining healthcare professionals and the population IHS serves has health status below the rest of the US. IHS must focus on implementing the Indian self-determination in order to increase the health status of the population to gain continued congressional funding and support.
IHS wants to put healthcare back into the hands of the tribes. This is difficult because each tribe has different concepts of health and it is difficult to accommodate such a wide variety. Because of the scarce resources it will be difficult to determine which decisions and services should be centralized rather than decentralized. In order to implement the change, IHS should provide honest and open communication about the changes and how they will affect each tribe individually. IHS should also be responsive to criticisms and the individual traditions of each tribe. IHS should evaluate tribal satisfaction and health status outcomes to monitor the progress of the change.