"We hate health care reform. The bill was too many pages, too complicated and didn’t fix all the problems right now, this minute. (One of America’s core democratic values is our impatience.)

But the why is fascinating. Many of us hate the reform bill because it went too far; but most of us are unhappy because health care reform didn’t go far enough. We wanted more action, a smarter health care system, even, more government to make our health care system work smarter.

Yet that voter angst – both for and against – set the stage for this November election and the Republicans’ Pledge to America. “In a self-governing society, the only bulwark against the power of the state is the consent of the governed, and regarding the policies of the current government, the governed do not consent,” the pledge says. (Except that some of us do give our consent.)

Elections are policy choices. And this GOP Pledge is a clear guide about what Republicans would do if given power. There are significant implications for Indian Country in this document (even though American Indians and Alaska Natives aren’t mentioned at all).

The Pledge says: “Because the new health care law kills jobs, raises taxes, and increases the cost of health care, we will immediately take action to repeal this law.”

But if that were to happen it would mean the repeal of the Indian Health Care Improvement Act. That law was just made permanent after nearly a decade of congressional inaction to reauthorize the 1976 act. This act was both symbolic and practical, setting the course for many improvements in the Indian health system ranging from improved funding to better training and recruitment."

Get the Story:
What the pledge to america means to Indian country (Mark Trahant 9/27)

Related Stories:
Mark Trahant: Indian Country voters should have Obama's back (9/20)
Mark Trahant: Shrinking government and Indian health spending (9/13)
Mark Trahant: Future of Indian health system up to Indian Country (8/30)
Mark Trahant: One year of lessons from the Indian Health Service (8/24)
Mark Trahant: Tribes taking more control of Indian health system (8/16)
Mark Trahant: Just who is an Indian for purposes of health care? (8/9)
Mark Trahant: Tribal Law and Order Act only one part of the picture (8/2)
Mark Trahant: Making the Indian Health Service into 'our' system (7/26)
Mark Trahant: Policy options needed as health reform goes ahead (7/19)
Mark Trahant: Becoming an early adopter for health care reform (7/12)
Mark Trahant: Indian health caught in middle of budget debate (7/6)
Mark Trahant: Community health centers a new funding source (6/28)
Mark Trahant: Expanding oral health access in Indian Country (6/21)
Mark Trahant: Sometimes less is more in health care system (6/14)
Mark Trahant: Indian Country deals with shortage of doctors (6/8)
Mark Trahant: A new debate emerges on health care reform (6/1)
Mark Trahant: Questions about tribes and health reform law (5/24)
Mark Trahant: IHS not threatened by health reform litigation (5/17)
Mark Trahant: An employee's view of Indian Health Service (5/10)
Mark Trahant: Measuring progress of Indian Health Service (5/3)
Mark Trahant: Health care reform brings more jobs to IHS (4/27)
Mark Trahant: IHCIA brings hope for urban Indian health (4/19)
Mark Trahant: Health reform debate to continue for years (4/12)
Mark Trahant: Should Native Americans buy own insurance (4/5)
Mark Trahant: Obama's exciting pick for Medicaid agency (3/30)
Mark Trahant: Delivering promises for Indian health care (3/22)
Mark Trahant: Health care reform vote as a litmus test (3/15)
Mark Trahant: Facebook group gathers IHS war stories (3/8)
Mark Trahant: IHS not mentioned at Blair House summit (3/1)
Mark Trahant: Reaching consensus on Indian health (2/22)
Mark Trahant: Alaska Natives create a model system (2/15)
Mark Trahant: Growing the IHS budget in tough times (2/8)
Mark Trahant: Transparency and Indian Health Service (2/1)
Mark Trahant: Transparency in health care reform bill (1/25)
Mark Trahant: Starting over on Indian health reform bill (1/20)
Mark Trahant: IHS Director Roubideaux on passing IHCIA (1/18)
Mark Trahant: Business model for Indian Health Service (1/12)
Mark Trahant: Some resoluting on Indian tobacco use (1/6)
Mark Trahant: IHCIA now a part of Senate health bill (12/21)
Mark Trahant: Projects improve Indian health care (12/14)
Mark Trahant: Work together for health care reform (12/8)
Mark Trahant: Health care system tied to economy (12/7)
Mark Trahant: Health reform bill tests democracy (11/30)
Mark Trahant: Health reform boosts Indian Country (11/23)
Mark Trahant: Health care reform dead in Senate (11/17)
Mark Trahant: New Republican 'interest' in IHCIA (11/2)
Rep.Hastings objects to IHCIA in health reform bill (10/30)
Mark Trahant: Send Medicaid funds right to IHS (10/29)
Mark Trahant: Health care debate drags on and... (10/26)
Mark Trahant: Guaranteed rights to health care (10/19)
Mark Trahant: Health care debate not over (10/12)
Mark Trahant: Effortless Indian Country care (10/5)
Mark Trahant: Tribal provisions in health reform (9/28)
Mark Trahant: Taxation of tribal health benefits (9/21)
Mark Trahant: Indian Health Service paradox (9/17)
Mark Trahant: Indian exemption and insurance (9/16)
Mark Trahant: Revive the public health hospital (9/14)
Mark Trahant: Grandma and health care reform (9/9)
Mark Trahant: Ted Kennedy steps aside for health (8/31)
Mark Trahant: Tribes, IHS and health coverage (8/25)
Mark Trahant: Ideas for health care reform (8/17)
Mark Trahant: Duality in Indian health care (8/10)
Mark Trahant: Health care from a different view (8/4)
Mark Trahant: Indian businesses and health care (7/28)
Mark Trahant: First Americans are last in health (7/21)
Mark Trahant: Getting into Indian health reform (7/14)
Mark Trahant: Lessons from Indian Country health (7/10)
Mark Trahant: IHS isn't broken, just underfunded (7/9)
Mark Trahant: Indian health care at the local level (7/8)