Once we get done with the health insurance reform, you know, that thing that has nothing to do with health care, maybe then we can concentrate on delivering a model of care that actually helps people be healthy, get healthy, stay healthy.  It seems so little to ask, does it not?

And yet....here we are.  What number are we now in the world in terms of healthy citizens?  I forget.  Doesn't matter.  It's all crap numbers anyway because health is not a damn contest.

Obviously, we need a different health care model because the one we have now ain't werkin' so hot.  I mean, we run around and fix this little outbreak and that little scourge and scratch our heads and wonder why there's a trend toward a certain kind of cancer in this area but not in that area and little kids are still getting brain damage from eating lead paint chips.  There's sick people all over the place and it's not necessarily from poor genes or bad luck.  Our atmosphere is sick.  Our soil is sick.  Our water is sick.  Our society is sick.  So, of course, we are going to become that in which we live.  Sick.

We need a different health care model other than the finger in the leaky damn one we have now.  There are all kinds of models to choose from.  Individual counties and states have developed programs to learn from and on a bigger level there are the Medicare/Medicaid programs as well as the Veterans Health Administration.  Active military has Tri-Care.  But there is another nationwide health delivery system model that is routinely overlooked.  One that is more holistic in its approach, taking extra steps to provide not only medical care but preventative care and spiritual care as well, incorporating the needs of the whole person...not just the blood and guts part.


This healthcare program isn't new.   It has been around in one form or another since, oh, about 1787, and in fact, is written into the Constitution. Article 1, Section 8, clause 3.   Somehow the SCOTUS figured it out.  I don't know how they did it...I'm not a lawyer....but, there it is.  So, any of the poopyheads that say they do not have to pay for health care because it isn't in the Constitution...HA!  Is too.  The Supreme Court said so.  And, so there.

If you have not yet clicked a link above, I will save you the agony and tell you the model I am talking about is the Indian Health Service.

The IHS has a long convoluted history that wasn't always necessarily devoted to Native American healthcare.  In it's first stages, in the 18th and 19th and even the early 20th centuries, it was not so great, and there are many skeletons in its closet, including genocide and assimilation.  In the beginning, it was basically taking care of the few NDNZ that managed to escape the new diseases brought from Europe.  (Yeah.  Jeffy Amherst.  Thanks for those blankets, dood.)

But that, as they say, is history.

Moving on...

Eventually, the IHS was detached from the Bureau of Indian Affairs and reattached to the Department of Human and Health Services.  Progress was being made!  Injuns were now officially human!  hahahhaha...that's an old Indian joke I heard from an old Indian.  Whoops, there's another one.  Oh, come on....where's yer sense of humor?

Anyhoo.  In the 1970's the IHS took a good look at itself and began to investigate causes of the disparity between the health problems of Native Americans and the rest of American society.  They didn't have to look very far to find causes.  Much disease and illness are simply symptoms of poverty, substandard living conditions, and a diet of unsustainable nutrition. 

So, the IHS began a program to bring clean water to the reservations.  Improved housing and basic sanitation was introduced.  Diabetic education programs were put into effect to help control the high rate of diabetes in Native Americans. Substance abuse programs were introduced to deal with the high percentage of alcoholism and drug abuse.  Other programs dealt with depression and domestic and sexual abuse.   And, to help fill the medical professions these programs need, college scholarships are given to those of NA descent that wish to pursue careers as doctors, nurses, etc.

But, the most significant change they made was the willingness to incorporate the spiritual into the model....cultural differences.  Yeah.  Medicine Men.  Life on the rez is different.  It just is.  Native American cultural practices are different.  They just are.  And instead of trying to combat these differences and make everything come out like it's been through a machine, the IHS absorbed these differences and made it work to the advantage of all concerned. 

Why couldn't these models be used to bring effective care to the differing cultures that exist within the one big American culture? 

I mean, life in the inner city is different from life in the 'burbs.  It just is.  Chinese-American cultural practices are different from those of Irish-American.  They just are.  All cultural groups, clustered here and there throughout cities and spread out in rural areas have differing needs, healthcare wise.

To be healthy, the whole must be treated.  Not just the sick part.

Because of these programs being introduced by the IHS, the general overall health of Native Americans living on reservations improved, although poverty has remained to cast a pall. ( And that gubbermint cheese...hell, that ain't no good for nobody.)

Now, the IHS is far from perfect.  It is woefully, and I mean woefully, underfunded.  To receive any benefits from the IHS, you have to meet very strict requirements....less that two million U.S. residents qualify (Hint: the Indian part of IHS)  But, I'm not really holding it up as the perfect plan....I'm using it as an example of what can be achieved once we have health insurance in place for everyone and can then concentrate on health care.  Because, isn't the health of the people the entire point behind this HCR nightmare?

Oh.  Yeah.  I fergot.  It's really about making the insurance providers and the drug companies happy.  My bad.  I have a short term memory problem I guess, because it was only just this morning I read this.

Yeah, I fergot it was all about health industry profit.  That the uninsured and under insured will finally get a fair shot of coverage is just a tiny detail. A kind of side-effect.  A by-product.

Human beings are not important, but their money is.  I keep fergettin' that.

Poop.

Well, whatev.  This is my dreamscape so I can dream-write what I want.

And, what I want is this....

Since Big Insurance and Big Pharma will soon be pocketing even more of our dollars, tax and otherwise, why don't we make them responsible for helping us to not use our policies by investing in preventative programs like those created by the IHS?  

Instead of paying lobbyists, why can't they funnel their profit into programs that improve the standard of living?  Get rid of the lead paint once and for all.  Get rid of the asbestos.  Bring in water that doesn't blister your skin because it's loaded with chemicals that didn't get filtered out because sewage systems are inadequate.

Why can't they pony up some med school scholarships?
Why can't they fund a few diabetes education programs?
Why can't they fund tele-med to bring primary care to rural areas where doctors are scarce? 
Why can't they underwrite some exercise programs?  You know, come to the gym and do 25 jumping jacks or something three times a week and they'll knock some bucks off your premium. 
Attend a nutrition seminar and they'll acknowledge your new healthy eating habits by lowering premiums.
Same goes for smoking cessation classes. 
Anger management training so you stop slapping the crap out of your significant other.
Consciousness-raising classes so you stop letting your significant other slap the crap out of you. 
Classes on how to be accountable for your own health.

Health education.  That's what I'm talking about.  Learning how to be responsible for your own health.  Straight talk from people in communities that have the confidence of the community.  Yeah.  Medicine Men.  Medicine Women.  There are people in nearly every community, urban and rural, Indian and non-Indian,  that are looked up to....and they are not necessarily political leaders.  Give these folks an office, maybe within the Social Services programs, and let them focus on outreach and co-ordination.

I mean, the models are already there to follow.  There are social workers established in many places that do this kind of thing already, except their positions are being cut to trim budgets.  

And, if you're interested in some numbers, try these on for size.  The annual cost of preventative health measures plus the cost of needed treatment, including dental, per person, for the IHS is $2349.  Compare that with $6538 per person for the U.S. in general.  Yeah.  That's quite a difference.  Wonder who is pocketing that four grand per person....gee...I wonder who that could be?  *Cough, cough, Big Insurance, cough.*

Nasty cough there...maybe I should see a doctor about it.  

I dunno.  Maybe it's just because I'm an incurable tightwad, but I want my money to work as hard for me as I worked to get it.  I love a good deal.  Why can't the Bigs pay out some of that windfall they're about to get into already established nationwide programs that work towards improving the living conditions of all our citizens, and therefore improve our general health? I mean, they're safe...their continued gargantuan profit is guaranteed by our very own government.  In the long run, they'll be saving money as well as lives....and won't that look good on their resume?  You know...for when we finally get single-payer and we fire their sad asses.

Yeah.  I know.
I'm dreamin'.

But, some days, dreams are all I got.