Mary Clare Jalonick/AP
People sit in the waiting room of the Indian Health Service clinic in Crow Agency, Mont.

The Dark Side of Health Care on Native American Reservations

June 16, 2009 03:10 PM
by Cara McDonough
Recent accounts suggest the federal health service for American Indians on reservations is in crisis. Will President Obama’s stimulus plan and health care reform plans help?

A “Broken” Health Care System for Native Americans

On paper, the situation sounds good: Based on a 1787 agreement between tribes and the United States government, the U.S. has an obligation to provide American Indians with free health care on reservations.

But that’s not how it works, reports the Associated Press. Roughly one-third more is spent per capita on health care for felons in federal prison, according to 2005 data referenced by the AP. The system’s ineffectiveness has yielded a common refrain on reservations of “don’t get sick after June,” because that‘s when federal funds run out.
Some lawmakers have tried to bring attention to the serious issue, but “tightening budgets and the relatively small size of the American Indian population have worked against them,” reports the AP.

Jefferson Keel, lieutenant governor of the Chickasaw Nation and first vice president of the National Congress of American Indians, testified about the situation last week on Capitol Hill. "Perhaps nowhere in this country is the debate on health care reform more important, or will it have more of an impact, than in tribal communities," Keel said, according to Sioux Falls, S.D. newspaper the Argus Leader.

The story reports that tribal leaders have joined together to request several changes to the system, including increasing Native American participation in government programs, such as Medicaid; increasing long-term care options on reservations; and providing employee incentives to reduce shortages in the Native American health system work force.

"It's clear the federal government isn't fulfilling its trust responsibility to provide health care to Indian Country,” Sen. Jon Tester, D-Mont., who chaired the hearing, said. The Argus Leader reports that government-sponsored health care is available to some 1.9 million Native Americans living on or near reservations in 35 states, and that it’s been about ten years since the Indian Health Care Improvement Act was updated.

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Related Topic: Obama’s health care reform plan

Some tribal leaders say the time is right for a new bill now that Obama is talking about improving the health care system overall.

Obama delivered a speech on the subject to the American Medical Association (AMA) this week. The president’s proposal is for a government-run health care plan that would compete with private insurers, keeping prices low.

Obama has his supporters, but ABC News reported this week that the AMA—and others—have serious problems with his health care plan. "We don't think this is the best way," AMA president Nancy Nielsen said of the plan.

Some have voiced stronger opposition, such as former presidential candidate and Massachusetts Gov. Mitt Romney. "It would be terrible for hospitals, awful for doctors and ultimately it would be a disaster for the people in America,” Romney was quoted as saying by ABC News.

Reference: Health care; Indian Health Care Improvement Act


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