Over the last few months, as Barack Obama’s plans to transform the health-care industry in America have proceeded, I have written extensively on the two existing government-run health-care systems and their myriad problems: Medicare/Medicaid and the VA.  It seems I missed a third that may be worse than either or perhaps both combined.  Mary Clare Jalonick of the Associated Press provides an eye-opening report on Indian Health Service, a single-payer system that rations care to Native Americans on reservations across the country — and kills them through neglect and a severe lack of resources:

On some reservations, the oft-quoted refrain is “don’t get sick after June,” when the federal dollars run out. It’s a sick joke, and a sad one, because it’s sometimes true, especially on the poorest reservations where residents cannot afford health insurance. Officials say they have about half of what they need to operate, and patients know they must be dying or about to lose a limb to get serious care.

Wealthier tribes can supplement the federal health service budget with their own money. But poorer tribes, often those on the most remote reservations, far away from city hospitals, are stuck with grossly substandard care. The agency itself describes a “rationed health care system.”

The sad fact is an old fact, too.

The U.S. has an obligation, based on a 1787 agreement between tribes and the government, to provide American Indians with free health care on reservations. But that promise has not been kept. About one-third more is spent per capita on health care for felons in federal prison, according to 2005 data from the health service.

Without a doubt, the people on the reservations represent some of the poorest of the poor in America.  Yet we already have a single-payer system in place to provide health care to Native Americans on these reservations.  Do we properly fund it?  Do we make sure that enough resources are applied to ensure good health care?  Not at all.  It is, as the agency itself describes, a system of rationing medical resources, and the end result is a poor population unable to seek out its own care locked into a system that only works when someone is on death’s door.

In fact, as Jalonick reports, it often doesn’t recognize when a patient faces death.  Jalonick profiles the heartrending case of Ta’Shon Rain Little Light, who began complaining of stomach pains at the age of 5, and stopped eating and playing.  The overwhelmed clinic diagnosed her as depressed, and ten subsequent visits to the clinic over the next several months while Ta’Shon’s symptoms worsened didn’t change the diagnosis.  Only when she suffered a collapsed lung did IHS airlift her to Denver, where Ta’Shon was diagnosed with terminal cancer.  Could it have been treated?  We’ll never know, thanks to a diagnostic service that appears to be just above the wild-guess level on the reservation.

When government owns the nation’s health-care system, we can all look forward to the same level of care.  After all, as Obama himself insists, a government-run system will “save costs,” but he never explains how those costs get saved.  We will all go into the rationing-system grinder, just as veterans do with the VA, seniors and disabled do with Medicare, and Native Americans do with IHS.