It was 50 years ago this month that the Indian Health Service underwent a dramatic change that forever altered the way Native Americans receive health care.
In July 1955, the IHS was taken out of the Bureau of Indian Affairs and transferred to the then-Department of Health, Education and Welfare. The move was authorized by Congress a year earlier in what is commonly known as the Transfer Act, or Public Law 83-568.
Coming at the height of the termination era, the proposal was viewed with extreme skepticism among tribal leaders. They feared it was part of the federal government's wholesale dismantling of its trust and treaty responsibilities.
Even the Public Health Service and former president Dwight D. Eisenhower's administration opposed the move. They argued it wasn't cost-effective and wouldn't improve the delivery of health
care to American Indians and Alaska Natives.
But history proved otherwise. Fifty years later, the IHS is alive and thriving, an agency with a $3 billion budget that provides critical services to more than 1 million Native Americans through its own programs and those operated by tribes.
"This month, July 2005, marks the 50th anniversary of the Transfer Act," Dr. Charles Grim, the current director of the IHS and a member of the Cherokee Nation, said at a Senate hearing last Thursday.
"This transfer was more appropriate to the federal government in addressing the health care needs of American Indians and Alaska Natives," he said. "Since the Transfer Act, the health status of Indians has improved significantly."
To mark the occasion, the IHS will be hosting a program and reception next Tuesday, July 26, at the National Museum of the American Indian in Washington. Dr. Grim, Health and Human Services Secretary Michael O. Leavitt and Dr. Everett R. Rhoades, the first American to serve
as the IHS director, will speak about the agency's history and the challenges and opportunities that lie ahead.
There are many, tribal leaders noted last week. Citing decades of inadequate funding and substandard services, they said the U.S. government has a long way to go to meet its trust and treaty responsibilities.
"Health care reality in Indian Country compared to the general population is: Our people still die due to accidents 204 percent greater then the rest of the population, 666 percent more likely to die from tuberculosis, a preventable disease, [and] 318 percent more likely to die from diabetes," said Rachel Joseph, the chairwoman of the Lone Paiute Shoshone Tribe of California.
"The Surgeon General reports that Indian youth are dying at 3.1 times greater than the general population," she added. "Our challenges are escalating."
The IHS anniversary comes at a critical time. For the past two years, key members of Congress have been trying to reauthorize the Indian Health Care Improvement Act, first passed in 1976.
They agree with tribal leaders that the measure will improve services in Indian Country.
"This act is long overdue," said Sen. John McCain (R-Arizona), the chairman of the Senate Indian Affairs Committee
"I think we have a bona fide emergency in health care on Indian reservations," Sen. Byron Dorgan (D-North Dakota), the committee's vice chairman, said.
The Transfer Act and the Indian Health Care Improvement Act aren't the only important pieces of legislation in IHS history. The landmark Indian Self-Determination Act of 1975 ushered in an era where tribes began to exercise greater control of their own affairs. The law came after Congress repudiated the termination policy that contributed to the IHS transfer.
"It appears that every 20 to 40 years a pendulum swings, the pendulum of public sentiment and federal policy, Cherokee Nation Principal Chief Chad Smith said last year in Senate testimony. "At one extreme, this sentiment and policy is hostile to American Indian tribes. At the other end of that swing, it allows tribes to determine their own destiny."
(July 14, 2005)
IHS Transfer Act:Public Law 83-568
(August 5, 1954)
Indian Health Service - http://www.ihs.gov
National Indian Health Board - http://www.nihb.org