Can Indian Health Service Referrals for Nonemergent Care Be Allocated Equitably?

Copyright

2021

This commentary responds to a case about a physician’s disappointment that a referral for nonemergent care is deferred for payment by the Purchased Referred Care Program. Jonsen et al’s 4-quadrant approach (a microethical case analysis model) is applied to suggest that deferring referrals is just only when the PRC Program operates fairly. This model, however, might inadequately account for structural inequities underlying referral care rationing by the Indian Health Service, a federal entity that is legally and ethically obligated to care comprehensively for American Indian Alaska Native patients.