Montana Paper Documents Failures of Socialized Medicine on Indian Reservations

Something tells me Karen Ogden doesn't have a future in health care reporting in any large mainstream media publication or network. In the July 23 edition of her paper, the Great Falls Tribune editor took a sobering look at painkiller addictions and the black market for the narcotics on American Indian reservations in Montana. "Free" socialized medicine and the long wait times for surgery were partly to blame, she found. :

A perfect storm of factors is feeding the pill problem: grinding poverty coupled with handsome prices for contraband pills (a methadone tablet sells for up to $20 on the Blackfeet Reservation), a long history of addiction in American Indian communities and the fact there is no charge for patient visits or prescriptions at IHS clinics.

Some allege that crushing workloads for IHS doctors and political pressure on physicians from tribal officials and relatives — a function of life in close-knit reservation communities — also are to blame.

Another culprit, they say, is a budget crisis within the IHS that is forcing patients nationwide to wait months and often years for hip replacements, knee repairs and other badly needed surgeries.

There were 5,170 Indian patients on the waiting list last year in Montana and Wyoming combined. To tide them over, doctors prescribe painkillers that are feeding the epidemic, health officials say.

"It does create addiction, but also it creates another economy on the reservation that people are able to sell these drugs," said Jim Kennedy, service unit director at the Blackfeet Community Hospital in Browning. "The drug problem is so rampant here with the pills."

Pshaw, liberal critics might say. Sure, that would happen in the United States, but not a country like Canada where no one falls through the cracks from the government's universal coverage. To the contrary, it's just as much a problem there, one of the hidden costs of "free" drugs:

Canada's public health agency also faces criticism for overprescribing painkillers on Indian reserves.

Richard MacLachlan, chairman of a Health Canada committee investigating the problem, called prescription drug abuse the "No. 1 health issue" on the country's Indian reserves in a March interview with the Halifax Chronicle Herald in Nova Scotia.

On the province's Indian Brook Reserve, at least 300 of the 1,400 residents are addicted to prescription drugs, estimated Chief Alex McDonald.

"Everybody thinks we have it so good because we get free drugs," McDonald told the Herald. "People got to know the truth."