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Indian Health Service For All?

EAGLE BUTTE, S.D.— Kate Miner walked into the Indian Health Service hospital, seeking help for a cough that wouldn’t quit.

An X-ray taken of Ms. Miner’s lungs that day, Oct. 19, 2016, found signs of cancer.

What exactly the IHS doctor said to Ms. Miner about her exam remains in dispute. Notations in her medical file indicate the doctor told her to come back for a lung scan the next day. Her family says they never were given such instructions and weren’t told of the two masses the X-ray revealed.

What is clear is that no further tests were done. And no IHS provider followed up when Ms. Miner returned twice more to the hospital, the only one on the Cheyenne River Reservation, over the next six months, medical records show.

These are the opening paragraphs of a front-page story in the December 24 Wall Street Journal. In print it’s titled “A Tragic Journey Through The Indian Health Service.” On line it’s titled “Kate Miner’s Tragic Journey Through the U.S. Indian Health Service.” Unfortunately, it’s gated. The author is Dan Frosch.

I read a recent similar WSJ article on the U.S. Indian Health Service a few months ago. The basic idea in both articles–and there might be others in the series–is that the IHS is doing a bad job.

Why so?

One of the people quoted in the piece, Harold Frazier, the Cheyenne River Sioux tribal chairman, gets at it: “The sad thing is, our people don’t have a choice.”

In the debate among the candidates for the Democratic presidential nominations, various Democrats and one independent, Bernie Sanders, advocate some version of “Medicare for All.”

If we really got Medicare for All, then we would all be saying, correctly, that we have “no choice.”

Does that mean that Medicare for All would degenerate to the point where it would be as bad as the Indian Health Service? Probably not, for two reasons. First, the majority of Americans are less disvalued than people on Indian reservations. Second, there would be places where politically powerful people would probably get excellent medical services. And notice that I said “politically powerful,” not “economically powerful.” There’s an overlap, of course. But they are not the same. The local union leader might have more political power than the 30-year-old hedge fund decamillionaire. And Bernie Sanders and Elizabeth Warren would almost certainly have more political power than the 30-year-old hedge fund guy. What Ayn Rand called “the aristocracy of pull” would be in full swing.

Competition is good and getting rid of competition is bad.

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