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.