Tim Giago: National health care debate and IHS

Opinion

Monday, June 22, 2009

Health care in America is a failing proposition. An estimated 47 million Americans do not have health insurance. And yet Health and Human Services Secretary Kathleen Sebelius calls the health care of Native Americans a “historic failure.” What about health care in the rest of America?

The new head of the Indian Health Service, Dr. Yvette Roubideaux, was not as harsh. She said, “It’s clear that there’s a call for change and improvement in the Indian Health Care Service, and it’s also clear the IHS has been significantly under-funded for many years. The staff of Indian Health Service has been doing the best it can with limited resources, and in some cases they are providing excellent quality of care with limited resources.”

Sen. Max Baucus (D-Mont.), the man in the Senate leading the way, said that Congress will pass comprehensive and meaningful health care legislation this year. He compared the legislation as the most sweeping since the New Deal of Franklin Delano Roosevelt. “It’s gonna pass. It’s gonna happen. There’s no doubt about it,” he said.

The efforts to introduce universal health care can be traced to the days of Woodrow Wilson and more recently to the political fiasco during the Bill Clinton administration in 1993 and 1994. The most powerful opposition to universal health care can be found in the medical profession and the insurance companies. They present a formidable lobby on Capitol Hill.

Those Americans opposed to it compare it to Canada’s or Britain’s health care systems, which they say are nothing but socialized medicine. The Indian Health Care system, deemed a “historic failure” by Sebelius, has also been labeled as socialized medicine, and the fact that she would label it as a failure does not place much faith in an even larger universal health care system. It just seems that every time the federal government takes total control over anything, failure is almost assured. Watch out General Motors.

Key senate committees will begin writing legislation this month. President Barack Obama expects to have a bill on his desk by the end of the year, and he is confident that universal health care will become the law of the land.

If this legislation passes, how will it impact the Indian Health Service? If all Americans are provided health insurance, will that include Native Americans? How will it affect the Indian hospitals in urban areas and out on the Indian reservations?

President Obama has called for an increase in funds for Indian health care of 13 percent in Fiscal Year 2010. This would bring the largest funding increase in 20 years to the Indian Health Service. Will the introduction of universal health care change any of this?

There is not a Native American alive today who has not witnessed the many shortcomings of the Indian Health Service, but as Dr. Roubideaux has said, most of the failures were due to an extreme shortage of funds.

An article in Time magazine asks some important questions. Will there be a big, new government system? How can a nation already deeply in debt afford healthcare reform too? Can we really cover everyone? And if so, what will be covered? How will we bring down the costs? With a deficit nearing $1 trillion dollars, this last question is very relevant.

I believe Secretary Sebelius and Dr. Roubideaux are stepping into a situation that, for the first time in the history of the Indian Health Service, will be dramatically swayed by what is happening on the national scene. Fighting for funding every year for the Indian Health Service was a given. It was an ongoing battle that never changed, and the IHS was often the loser. But with universal health coverage looming on the horizon, the funds now available will become even more stretched because the federal government will be looking for ways and means to cover health care for everyone, not just the Indians.

Some experts predict the cost of universal health care will be somewhere around $1.5 trillion. Drastic budget cuts in other areas will have to occur in order to free up more money to cover the costs. As I asked earlier, how will that affect the Indian Health Service?

This brings us full circle to the old saying, “If you think the government can solve all of our problems ask an Indian.”

Tim Giago, an Oglala Lakota, is the publisher of Native Sun News. He was the founder and first president of the Native American Journalists Association, the 1985 recipient of the H. L. Mencken Award, and a Nieman Fellow at Harvard with the Class of 1991. He can be reached at editor@nsweekly.com.