I.H.S. is poor health care

This is an article by the Arizona Republic about Indian health care. Many non-Native people are under the false impression that Indians receive free health care when in reality, the Indians were forced to agree to health care and western education in exchange for the lands the United States forcibly took from the Indians. There were no conditions to the lands which the United States took. However, now it feels like there are conditions to the health care quality and education quality the American Indians receive.

Any Indian knows that the health care quality at Indian Health Services (I.H.S) is poor. (I.H.S. is the arm of the United States Federal Government charged with providing health care services to Indian Peoples) The quality of services at I.H.S. is bad when compared to the average medical facility in urban America. Often when a person is ill, I.H.S. doctors misdiagnose and mistreat sicknesses. Ill Indians usually just get sent home with some aspirin with instructions to rest. I always wonder if the federal government sends its new doctors to practice on the Indians first before being sent to more established institutions. Many Indians have died as a result of this poor health care. That’s been my impression and experience. I'm sure other Indian have similar experiences. Some of this experience also carries from the Phoenix I.H.S.

Sometimes, even today in 2007, Indians are test case dummies for new drugs. As an Indian, we get lots of questions about whether we would like to be a part of a “research study for John Hopkins Institute”, etc. In the past, Indian women were sterilized so Indian women would not give birth to more brown-skinned "devils". How crazy and racial is that?

Also,when Indians get health care from I.H.S., I.H.S. passes some of its medical bills to Arizona Health Care Cost Containment System (AHCCCS) which is like medical assistance for poor people in Arizona. When obtaining health care, an Indian patient must sign up for AHCCCS. So does that mean that only poor Indians receive service and the wealthy Indians must get their own private health care? Health care from the federal government is a right of Indians under treaties that Indian Tribes entered into with the United States. There was no distinction between poor or wealthy Indians. These treaty rights should not be substituted or confused with state benefits available for poor people. A right is something you are entitled to while assistance is more of a privilege.

These are just some of my gripes as an Indian in modern America. Correct me if I'm wrong on any of these topics, but we need to understand and pay more attention to our circumstances as Native Peoples. As complex as these health care arraignments may be, we need to understand our circumstances so that we do not get shortchanged.

Interestingly enough, this article also raises the Unites States’ creditability in living up to its word when it entered into agreements with Indian nations since the United State’s inception. This is a bigger subject (U.S. Trust Responsibility) which tribes are contending with.

Improved Indian health care discussed
Sadie Jo Smokey
The Arizona Republic
Jan. 16, 2007 12:00 AM

Health care is not a legal right at birth, unless you're a member of a federally recognized American Indian tribe. The U.S. government, which signed treaties promising health services in exchange for land and natural resources, provides health care to more than 1.5 million American Indians and Alaska Natives who belong to more than 557 federally recognized tribes in 35 states.

Dr. Don Warne, president and CEO of American Indian Health Management and Policy in Tempe, says Indian Health Service, the agency responsible for providing federal health services, receives inadequate funding and its resources suffer as a result.

AIHMP hosts the first American Indian Health Policy Conference on Thursday and Friday at the Fort McDowell Reservation to help Arizona tribes find creative ways to improve services and access to health-care funding.

Warne, 40, also teaches American Indian health policy at the Sandra Day O'Connor College of Law at Arizona State University.

Question: Why focus on American Indian health policy?

Answer: Many conferences either focus on specific diseases or specific issues in health care. Our goal is to work with tribal programs to improve access to quality health care. Policy determines what kind of funding is available and priorities. We have to know these to improve access.

Q: What is the funding for Indian Health Service compared with other federal agencies?

A: Per capita, for Indian Health Service, it's about $1,914 per person per year. Federal prisons is about $3,803 per person per year. Medicaid is $3,879 per person per year. If you're a convicted federal prisoner, you have double the (health) resources than if you're a Native American child. There's no way policymakers would accept this for their own families.

Q: Is one segment of the Native American population at more of a disadvantage than another due to underfunding?

A: We have unique issues for urban Indians. A lot of people moved to the cities for education and occupational opportunities. About 60 percent of American Indians live in urban settings; only 40 percent live on reservations. We have a whole segment, a majority, of enrolled American Indian members that have decreased access to health care because they live in cities. Nowhere is it written that once they move to the city, they forfeit their access to health care.

Q: What resources are available for urban Indians? Do they have to return to the reservation to receive health services or medical treatment?

A: You don't have to live on the reservation, but the funding for urban clinics is terribly low, about $1 million per year per clinic. There are currently 34 Urban Indian Health centers. Three are in Arizona - Flagstaff, Phoenix and Tucson. We have a lot more (tribal) members who have private insurance. We need to charge (private) third-party insurance, to charge Medicare and Medicaid. It's increasing resources to increase provision of care.

Q: Why should American Indians with health or dental insurance through their employer pay for services that are free for their relations who don't have insurance?

A: Basically, because of underfunding, IHS can provide primary-care services, but limited access to specialty care and long-term care. For example, oncology, intensive treatment cardiology, heart and lung specialists. Since we don't have specialists working in (IHS clinics), we have to contract with private sector providers. By charging third-party insurance, this frees up more dollars. This has tremendous impact on our ability to access specialty care.

Q: Why don't wealthier tribes with greater financial resources assist tribes without successful economic development?

A: I hear that argument a lot, especially from fiscal conservatives. What they're advocating for is socialism. I agree that we should help each other, but we shouldn't hold tribes to a higher standard than we hold everyone else. There are over 40 million uninsured people and another 40 million underinsured people in this country. Are wealthy non-Indian people responsible to pay for health care for all the impoverished non-Indians? The local tribes surrounding Phoenix have been very helpful in supporting the urban programs with grants, primarily.

Q: How much money does IHS need to adequately provide services for American Indians?

A: Some studies estimate, depending on the area of IHS, if we doubled the budget, we'd have adequate service. There's a federal employees benchmark, $3,800 per person per year. Funding for IHS should be equivalent. If we can come up with $80 billion to start a war, we should be able to come up with another $3 billion to improve the health of the first inhabitants of the nation.