The United States has considered American Indian health care to be part of its trust and fiduciary responsibilities towards Indians and tribal governments for a long time. The provision of medical care is mentioned in several treaties that tribes signed with the U.S.
Recently, some people (including an editorial in the Wall Street Journal) have attacked President Obama’s and the congressionial Democrats’ health care plan by pointing out how woefully the federal government has served Indian health needs.
This a completely unfair comparison. It is true that Indians suffer from the worst health issues and the shortest life span of any group in the U.S. but that’s because the United States Congress has always grossly underfunded Indian health services not because government cannot inherently provide services.
I forget the exact numbers but a study by the U.S. Civil Rights Commission from a few years ago stated that the United States spends like $7,000 a year on health for Americans on average, about $3,400 on federal prisoners, and about $1,800 on American Indians!! And that’s true even though the U.S. owes a trustee and fiduciary responsibility for Indians!
A recent article in the South Dakota press highlights some of the Indian health care problems. I will just list bullet points here:
* Federal, state, tribal and private efforts are being pursued to find solutions and improve an Indian health care system that many native people view as a historic failure.
* The Indian Health Service operates 15 hospitals and clinics in South Dakota, yet critics say the proof of the IHS failure is in the death rate for Native Americans – 1,642 per 100,000 people, according to the Centers for Disease Control and Prevention in 2007, which is among the highest anywhere in the country.
* Lawmakers and bureaucrats say the problem with Indian Health Service is that it’s underfunded by almost 50% and suffers from a vacancy rate among doctors, nurses and dentists of up to 33%.
* President Obama has said he will raise Indian Health Service’s budget 13 percent this year – a $454 million bump over last year’s $3.3 billion federal allocation. Stimulus money has poured another $500 million into construction, repairs and equipment for IHS facilities. And Congress is considering a bill that would permanently reauthorize Indian health care programs, ensuring their modernization and the improvement of health outcomes in Indian Country.
* discussions on improvements suggest making all native people categorically eligible for Medicaid, thus bringing more dollars into Indian health care and forcing IHS facilities to become more competitive if the agency wants to maintain its customer base.
* mandating more sharing of services and better integration of services among IHS, the Veterans Administration and other federal health care programs.
* Creating regional specialty facilities within IHS
* opening Indian Health Service facilities to non-Indian customers.
native.america.news 