The Indian Health Service

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.

Conklin, T. P. (2002, Fall). Health Care in the United States: An Evolving System. Michigan Family Review, 07(), 5-17. Retrieved from

While many may argue that the Canadian health care system provides equal treatment to every Canadian, evidence shows that this is not the case. There are major discrepancies within the system regarding Indigenous people that need to be addressed including several factors such as: housing issues, stereotypes Aboriginals face and the lack of Aboriginal doctors.

Healthy communities depend on the promotion of collaboration between health care providers, equitable utilization of health care resources and access to care for disease prevention. The Affordable Care Act (ACA) has increased access to insurance, but has not necessarily contributed to increased access to care (Lane et al., 2012). Limited access to health care and insurance, along with socioeconomic status, ethnicity, race, gender, sexual identity, and age contribute to health care disparities in the United States ("Disparities," 2014). The Appalachian Region has many factors that increase the risk of health disparities among this population, including poverty, unemployment, limited access to care,

In 1976 the Indian Healthcare Improvement Act was passed. This act was meant to improve the quality of medical care available to American Indians, as well as lessen the life expectant gap for American Indians and Alaskan Natives relative to the rest of the United States. At the time the act was established, that gap was over 20 years different between the two groups. In 2001 this act expired and was not reestablished until 2009 when it was “rolled into the Affordable Care Act and made permanent” (Trahant, 2012)

The program is unfortunately similar to VA health care veterans receive. For example most facilities are overcrowded, patients have trouble getting necessary treatment, making appointments, even emergency wait room times are exceedingly high. Patients have even died from being shuffled from department to department while waiting for treatment (Sickly Service 2014) & (Katerine 2000). All of these issues come down to funding. Currently, the United States federal budget includes $5.1 billion for the IHS to support and expand the provision of health care services and public health programs for American Indians and Alaska Natives. This is after funding was cut by 800 million in 2013. Additionally, there is currently a proposition to cut another 300 million by 2019. With this budget, and a provision of health benefits to 2.5 million Native Americans and Alaskan Natives that must be provided. It comes down to an average cost per patient of less than $3,000, far less than the average cost of $7,700 healthcare nationally, or for the other major federal health programs like Medicaid of $6,200 or Medicare of $12,000 (NCAI

Access to the communities is provided year round by Wasaya Airline and airstrips that are maintained by the Ontario Ministry of Transportation. Of course, each Aboriginal community is unique with its own set of traditions and ways of healing but my observation after working within the communities for over ten years is that they all suffer from improperished conditions and substandard housing. The local economies are primarily based upon government services (Indian and Northern Affairs) (INAC) and small business. Most of the reserves have six hundred people or less, and each community has a nursing station. The nursing stations are well-maintained functional buildings built in or about the early 1960’s and are maintained by Health Canada. First Nations and Inuit Health (FNIH) maintains responsibility for primary care services in the majority of the northwest Ontario reserve communities. In the north, nurses are the primary care givers working in an extended scope of practice, and client care is centrally coordinated by nurses working within interdisciplinary teams. The majority of the nursing and medical staff working for FNIH in the Sioux Lookout zone are Caucasian and do not come from local communities. This could outwardly appear as a reinforcement of power relations in the racial identities. There is only very limited cultural training given to employees when they are employed by FNIH. Medical advice and

Indian Health Services (IHS) require patients to reside at certain area. If they leave the reservations of federal recognized tribe, they are no longer qualified for this insurance plan. Additionally, patients must visit IHS contracted providers and healthcare facilities. The plan will not cover services from the non-IHS providers and facilities (U.S. Department of Health and Human Services).

As president and CEO of the Asian & Pacific Islander American Health Forum (APIAHF), Kathy Ko Chin spearheads the organization's efforts to influence policy, mobilize communities and strengthen organizations to improve the health of Asian Americans, Native Hawaiians and Pacific Islanders (AA and NHPI). With strong values handed down from her parents, immigrants from China, Kathy's life’s work has built community institutions that contribute to a just and multiracial society. At an early age, Kathy's parents shared with her the truths about injustice in our society, instilling in her the impetus to give back to the country that has given her so much. Kathy heeded their words, and for 40 years, has worked to improve health services especially

Clients with complex needs could be left to navigate the health care system on their own, due to limited resources and over stretched health workforce (Charlesworth, 2015). The World Health Organisation (WHO) has reported that many chronic diseases such as stroke, diabetes and heart disease are preventable, creating a vast potential to develop a primary healthcare approach to address these issues (World Health Organisation, 2013). Studies indicate that Australian indigenous populations are over represented suffering with chronic diseases (Usher, 2011). In rural Indigenous communities, the life expectancy is ten years less than the non-indigenous populations, expressing the inequity of a health system that cannot supply the skill share needed to promote health access or provide comprehensive care to rural areas of Australia (Australian Institute of Health and Welfare, 2016).

The Indian Health Service (IHS) is a healthcare program within the Department of Health and Human Services. (Agency Overview n.d.) It provides federal health services to eligible American Indians and Alaska Natives at IHS facilities. (Agency Overview n.d.) Services that IHS provide include medical, dental and vision, ancillary services, such as laboratory and pharmacy, specialty care which include services provided by the physician or specialist. (Agency Overview n.d.) The factors that affect the type of health care depend on the community needs, level of funds and whether treatment is medically necessary (Marx n.d.) American Indians and Alaska Natives can receive direct care at hospitals, health centers and they may be federally or

The medical indigent population is falling through the cracks of our health care system. According to Health Affairs 2015 publication the estimated size of this population is currently way over 31 million of people. These numbers are a great evidence there is a need for a national response to this crisis. This problem has been exacerbated as a result of changes in our health care financial environment including the cost-shift model. Maybe the questions above stated are not as important as this one: Why the cost of health care is so high in the U.S.?

The healthcare employees are fundamental part of medical and clinical service these days. They are responsible for prevention, diagnosis, treatment and rehabilitation of patients. Therefore, it is crucial to provide them with an appropriate training and professional development plan which will help to improve the service offered to patients. Modernising Scientific Careers (MSC) is a UK-wide initiative which was established in 2008 by the Department of Health (DH) led by the Chief Scientific Officer (CSO) to address education and training needs to the whole healthcare workforce in the National Health Service (NHS) and associated bodies (MSC: The facts, 2013). Before MSC programme has been established healthcare science

“Access to comprehensive, quality health care services is important for the achievement of health equity and for increasing the quality of a healthy life for everyone” (Healthy People 2020). Access to health services means the timely use of personal health services to attain the best health outcomes.

It does not go unnoticed that India faces a large health care crisis. Oddly enough, the topic is not well discussed in politics although it being an serious issue within the country. The media does a poor job of expressing the situation at hand to those who are unaware and unprivileged. India faces deep inequities due to the lack of government funding. It is clear that health is not an issue to those who are privileged, but obviously it is troublesome to those who are not. The socio-economic inequality India is aware of their issue and is trying to find an answer to their long standing health issues. Consequently, the lack of advertisement for the pressing issue such as health, affects the children as well. India’s immunization rates are among the lowest in the world. That leads to early illnesses and diseases within the youngest generation of India. For as “developed” india is, it seems as if they should have higher rates than the undeveloped countries in sub-Saharan Africa. India just faces a massive inadequacy in health care. The three main causes in the inefficiencies of the health care system in India are access difficulties: geographical distance, socio-economic hindrances, and the gender gap.