For over 200 years, the government has provided free
health care to Native American reservations. Kathleen Sebelius, the Health and
Human Services Secretary, has received a 13% increase in funding
to provide this service as well as stimulus money to improve clinics.
The U.S. has an obligation, based on a 1787
agreement between tribes and the government, to provide American Indians with
free health care on reservations. But the troubled Indian Health Service only
has about half of the money it needs, leaving poor tribes in remote areas with
severely underfunded facilities and substandard care. Wealthier tribes are
often able to supplement the federal budget with their own dollars.
However, just because the government has been
obligated to provide Native Americans free health care doesn't mean that it's
actually done well. HHS's Office of
Minority Health lists grim statistics showing that Native American health fares
poorer than the average American in cancer, diabetes, heart disease, stroke,
HIV, and infant mortality. The only
bright spot that I see in the list is that they fare slightly better in
immunization rate. Sebelius is trying to
address the issue and states:
"One of my challenges to the new head of the Indian Health Service is
that we need a multiyear strategy, we need an end goal," she said.
She said health disparities between minority groups and whites are
"unconscionable."
"The most severe disparity between quality care and what goes on with
health outcomes is in the Native American population," she added.
One reason of many, which include cultural
misunderstanding and poverty, for the state of Native American Health include
that the health service provider for reservations, the Indian Health Service
has "only half the money it needs." A
13% increase isn't enough to erase years of neglect in their government
provided health care system.
Furthermore, doctors and clinic workers often do not
understand how most tribes see health care in general. Traditionally, health issues are
dealt with by treating the whole body instead of just the problem at
hand. Also, because they often are so steeped in tradition, individuals often
are averse to change. This ranges from trying new treatments to receiving
advice from doctors.
My wife works at an organization that helps sick
people get treatment and funds research to cure disease. One problem that
always crops up here out West is how hard it is to get Native Americans to get
treatment or see a doctor or talk openly about a disease. This problem cuts
both ways as doctors often underdiagnose problems with minorities. A really
detailed account of the history of government provided health care is here.
Obviously, the problems that plague
government-provided Native American health care are different than those we
will face in the fight for health care for all Americans. The plight of Native
Americans is often ignored by most Americans and our government. President
Obama campaigned at reservations and said that he would address these issues. I
think a 13% is a start, but a much more comprehensive plan is needed. Of course a nationwide, universal coverage, if extended to reservations, would probably render these problems moot.
