Analysis of the Indian Health Service: An Essay

Analysis of the Indian Health Service

According to the article “Indian Health Service: Creating a Climate for Change,” Dr. Michael H. Trujillo became the first full-blooded American Indian to get nominated to be the director of the Indian Health Service (IHS) by the president of the United States on April 9, 1994. However, even as Dr. Trujillo assumed his new position, he was well aware of the problems facing the HIS, having worked as an IHS physician and administrator. Therefore, Dr. Trujillo understood the IHS problem with financial constraints, shortage of professional staff, and the relatively poor health status of Indian’s growing and needy population in America. Additionally, the high mortality rate and lower life expectancy among Indians in America pointed out these problems (Bhaskar & O’Hara, 2017). In the short term, Dr. Trujillo needed to equip the hospitals well to deal with the American Indians/Alaska Natives (AI/ANs) and transform the IHS to be the global leader in rural health systems in the long term. Additionally, Dr. Trujillo had to determine the level of Indian Self-Determination that would allow the IHS to reach these long and short-term goals along with federal assistance. The IHS had unique problems, as exhibited by the relatively lower health quality among the AI/ANS. Solutions require knowledge of tribal philosophies to meet the staffing and funding shortages appropriately.

In America, the IHS faced problems in its staffing and the level of services it offered to the AI/ANs, which led to relatively poor health quality in the community. Dr. Trujillo knew he had to find a way to improve these health standards with the limited resources that the federal government had allocated to the IHS (Capper, Ginter & Swayne, 2002). Thus, the IHS first had to find a means to recruit professional staff to the hospitals while involving the communities and tribal members. Furthermore, the notion of health to the AI/NIs existed as a unique composition as individual wellness became based on body, spirit, and the environment. As such, an effective health service for AI/ANs had to consider these aspects of their heritage. Additionally, while the federal budget for the IHS had been constant for the past four years, the number of AI/NIs depending on the program grew by 2.2 percent each year (Capper, Ginter & Swayne, 2002). Consequently, the IHS needed to utilize its resources more effectively in its programs to increase health coverage and quality for the AI/NIs.

To solve the IHS’s problems, Dr. Trujillo requires cost-effective policies to address the system’s problems and deliver quality health to the AI/ANs. As such, Dr. Trujillo could increase funding for the IHS, deliver more cost-efficient programs, or push for more federal support in staffing. In one case, the interlocking program in the IHS integrated urban and tribal programs to reach the AI/ANs health requirements (Sequist, 2017). However, the component of the IHS could be enhanced to increase the federal government’s input into the health services of the IHS, including financing, equipping, and training staff to improve the system’s performance. However, this initiative could end up compromising the self-determination of the AI/ANs. Secondly, pushing the federal government to increase funding to the IHS will allow the tribes to remain more self-determinant. However, it might hinder the progress of the IHS since it limits professional staffing. Similarly, focusing on staffing assistance from the federal government could improve the quality of health while reducing the money spent on staffing. However, it limits the foreign staff’s promotion of tribal health philosophies.

The government of the United States and the IHS needed to collaborate in the future to improve the integrated approach to the AI/NIs health quality and deliver improved health service that considered the community’s beliefs. The IHS interlocking programs are crucial to the collaborative effort between the federal government and AI/NAS (Bhaskar & O’Hara, 2017). For instance, the program could get enhanced to promote the training of health staff locally among the AI/NI to meet their unique health aspects and reduce the dependence on the federal government staff. As a result, the input from the local communities and federal government to the staffing of the IHS will offer long-term cheaper solutions to the problems faced in resource and professional shortages. Short-term measures could also get implemented to meet the shortages, including allowing staff members to rotate between the federal health services and the IHS and educating foreign staff members on the local heritage regarding health.

The AI/ANs face unique health problems since they exhibit relatively lower health quality, and their solutions require knowledge of tribal philosophies to meet the shortages in staffing and funding. Among the tribal communities, the higher mortality rate and lower life expectancy among Indians in America exposed the challenges of the IHS and its director Dr. Trujillo. Consequently, allowing the interlocking initiative of the IHS to get extended to include training could improve the initiative’s performance in the long term by allowing the local member to contribute to staffing. Furthermore, the initiative could allow the trained staff to effectively meet the indigenous health philosophies and reduce the dependence on outside staffing. Thus, the AI/ANs could get equipped to handle their own health needs and reduce the economic burden on the federal government in the long term.

References

Bhaskar, R., & O’Hara, B. (2017). Indian Health Service Coverage among American Indians and Alaska Natives in Federal Tribal Areas. Journal Of Health Care For The Poor And Underserved, 28(4), 1361–1375. DOI: 10.1353/hpu.2017.0120

Capper, S., Ginter, P., & Swayne, L. (2002). Public health leadership & management. Thousand Oaks, Calif: Sage Publications.

Sequist, T. (2017). Urgent action is needed on health inequities among American Indians and Alaska Natives. The Lancet, 389(10077), 1378–1379. DOI: 10.1016/s0140-6736(17)30883-8