First Americans face their latest challenge: Indian health care meets state Medicaid reform
Article Abstract:
Many Native American tribal leaders are concerned that Medicaid reform will force them out of the Indian Health Service (IHS). The IHS was formed in 1955 to provide health care to Native Americans. Today it serves 1.4 million Native Americans in medical centers run directly by the IHS or in clinics run by the tribes. Up to 60% of Native Americans in rural areas use the IHS clinics as their only source of health care. If the federal government restructures the Medicaid program, many tribes might be forced to join managed care organizations run by non-Indians. Many IHS clinics in rural areas could not meet the qualifications to be a managed care provider unless their accreditation by the Joint Commission on Accreditation of Healthcare Organizations was accepted as an indication of their quality of care. Many tribes are more accustomed to dealing with the federal government than with their own state governments. An accord between the state of Washington and tribal leaders in 1989 may be a model for such cooperation.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1996
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New reports make recommendations, ask for resources to stem TB epidemic
Article Abstract:
The United Hospital Fund of New York published a report in Dec 1992 on the resurgence of tuberculosis (TB) in AIDS patients to coincide with the first conference on the subject. In New York City 600,000 to one million people are infected with TB, and 40% are also infected with HIV. The Centers for Disease Control and Prevention has included TB in the case definition for AIDS. Twenty percent of New York TB cases are resistant to many of the drugs used to treat the disease. This often occurs because many patients with HIV and TB are poor or homeless, and cannot take medication on a regular basis. The new Americans with Disabilities Act may protect TB patients from abusive treatment. However, an effective response to the TB epidemic may require quarantining patients who cannot or will not comply with treatment. Hospital workers will also need to follow proper infection control procedures.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1993
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