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Indian health bills criticized by Bush official

The Bush administration voiced opposition on Wednesday to a series of Indian health proposals that enjoy bipartisan support and have broad tribal backing.

Dr. William Raub, an assistant secretary within the Department of Health and Human Services (HHS), raised numerous objections to bills that advocates say will improve the delivery of health care to American Indians and Alaska Natives. The laundry list of complaints prompted some grumbling from Sen. Ben Nighthorse Campbell (R-Colo.), chairman of the Senate Indian Affairs Committee.

"What I want you do is not tell the committee so much about what's wrong with it," he said, "I want you tell us how to fix it."

Two of the bills debated yesterday have languished in Congress for several years because the Clinton administration also opposed them. Some of those concerns have survived the change in power at HHS.

One bill would make it easier for tribes to tap into existing alcohol and substance abuse programs. Citing "austere" budgets for the coming years, Dr. Charles Grim, the interim Indian Health Service (IHS) director, has urged tribes to do just that.

Raub said the Bush administration "supports the principle that Indian tribes know best how to meet the needs of their members." But he said the bill wasn't clear enough and lacks effective federal oversight. The department also opposes having the IHS designated as the lead agency for the consolidation of the mental health programs, Raub told the committee.

The second bill would elevate the Indian Health Service (IHS) director to an assistant secretary. Raub and Michel Lincoln, the deputy IHS director, said the change was unnecessary because Dr. Grim enjoys great "access" to Secretary Tommy Thompson.

The National Congress of American Indians (NCAI) and the National Indian Health Board (NIHB) have long backed elevation. Julia Davis-Wheeler, NIHB and secretary of the Nez Perce Tribe of Idaho, recalled a White House meeting where tribal leaders felt somewhat embarrassed because a former IHS director was forced to sit on the sidelines due to his status.

"It would be great to have Secretary Thompson leave a legacy . . . to honor that administrative Cabinet position," she said. "He could really do something for us if he supports that."

Grim, who has been officially nominated as director of the IHS, has drawn support from tribal leaders. His nomination will be considered by the Senate Indian Affairs Committee.

The third bill, the Native American Health and Wellness Foundation Act, escaped Bush criticism because Raub said the administration is still reviewing it. The bill would create a foundation whose focus will be to promote health and wellness issues in Indian Country.

Relevant Documents:
Written Witness Testimony (April 9, 2003)

Bill Text:
Native American Alcohol and Substance Abuse Program Consolidation Act of 2003 (S.285) | A bill to elevate the position Director of the Indian Health Service (S.558) | Native American Health and Wellness Foundation Act of 2003 (S.555)

Relevant Links:
Indian Health Service - http://www.ihs.gov
Department of Health and Human Services - http://www.hhs.gov

Related Stories:
Senate committee holds Indian health hearing (4/9)
Opposition mounts to Bush IHS initiatives (4/3)
GOP rejects IHS funding measure (3/26)
Budget measure would double IHS funds (3/25)
Bush scoring tool impacts Indian programs (03/07)
Omnibus spending bill gains Bush approval (02/21)
Bush initiative to be scrutinized by Congress (02/18)
Grim expects nomination as head of IHS (2/11)
IHS positions being eliminated (2/7)
'Austere' health care budget cited (2/5)
Thompson releases new IHS budget (2/4)
Senate approves $390B spending bill (1/24)
Indian Country receives diabetes grants (12/11)
Court rebuffs tribes on contract funding dispute (11/27)
Congress approves $750M for Indian diabetes (11/21)
Northern Plains tribes see high infant death rate (10/30)
Navajo Nation challenges contract policy (10/04)
Reports address long-term elder care (08/20)
Bush appoints interim director of IHS (08/05)
Bush delaying pick for IHS post (7/23)
Report stresses importance of health insurance (5/22)
Poor Indian health blamed on federal failures (3/21)
IHS pressed to include tribes in reform efforts (02/28)
IHS budget cuts construction funds (2/12)

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