The shame of a nationAlthough the article is from September 2004, it is still relevant today.
...The health of American Indian tribes became the government's responsibility long ago, through treaties and other covenants signed in exchange for hundreds of millions of acres of tribal land. After generations of neglect, in 1955 the Indian Health Service took over, creating an independent, single-payer, government-funded system. After half a century, there have been small improvements, but the large picture, as described in "Broken Promises," the U.S. Commission on Civil Rights' July draft report evaluating the Native American healthcare system, remains bleak.
The health status of the more than 2.5 million tribal members is worse than that of any other U.S. minority or majority group. Native Americans have a life expectancy of 71, roughly 5 years less than all others. They face higher maternal and infant mortality rates and are many times more likely to die from tuberculosis, diabetes, and alcoholism. During flu season, they die far more often. Indian teenagers kill themselves at a higher rate. The rate of kidney failure from diabetes is staggering; heart disease is rising. Native American cancer patients have the poorest survival rates of any group.
The Indian Health Service is everyone's worst nightmare of what government healthcare would look like. The system is riddled with crumbling facilities, mindless regulations, ancient equipment, and far too few nurses, doctors, pharmacists, and dentists. Long waits choke clinics and emergency rooms. Patients have to fight to see specialists. Everything is rationed -- eyeglasses, dental visits, gallbladder operations, kidney dialysis, CT scans, basic psychiatric services. Almost half of "urban Indians" who have moved off the reservation to cities, usually in search of economic betterment, have no medical care because they are too far from a reservation and have little access to private insurance. Although the government's trust responsibilities extend to this group of about 1 million Native Americans, they have been largely abandoned by the health agency created in their name.
Via KevinMD, who also notes:
And spare me the argument that it's underfunded. What makes anyone think that a single-payer system applied nationally will be given the appropriate dollars? This is the government we're talking about.