Reinventing Government A Qualitative Inquiry into the Decision Making Process Good morning. I d like to first thank APHA for giving me the opportunity to present this paper. This paper reflects some of the preliminary work that I ve done in preparing my dissertation. As most of you know, the Indian Health Service is currently under a process of reorganization. In recent times, much has been said about the role that government should play in delivering services to the people.
Health care is an area of government that is under continual scrutiny.
The explosion of public expenditures on health care following the introduction of Medicare and Medicaid led to the emergence of cost containment as an independent policy objective. At the same time, government agencies have been challenged to adequately perform the social functions that they were designed to perform while confronting the constraints of shrinking budgets. Currently, the Indian Health Service is the primary provider of health care in Indian Country. They are not only the primary provider of health services, but also the administrative arm of the government here. They are the people charged with the task of examining how this bureaucratic agency works, and then to make recommendations on ways to improve performance.