STATE of INDIAN People's HEALTH

Sunday, January 22, 2006

Indians Call For Better Health Care

By Jackie Jadrnak
Journal Staff Writer
More than a half-century ago, federal Indian land was ceded to Bernalillo County to build a hospital.
The 1952 contract transferring that land said 100 hospital beds would be dedicated to Indians, and their care paid for by the federal government.
Now, Native Americans are asking what happened to those beds at the University of New Mexico Hospital.
"You have an unmet responsibility," Gidget McCook, of Sandia Pueblo and Northern Ute heritage, told UNM regents, hospital officials and Bernalillo County commissioners last week.
"If you won't provide the services, give us back the land," said Johnnie Belone, a Navajo from Window Rock. "Don't just look for money every time you see a patient."
Their comments came during a public hearing on health care access, particularly for low-income people, at UNM hospitals and clinics.
Steve McKernan, chief executive officer of UNM Hospital, declined to discuss what is required under that contract. Spokesman Sam Giammo said the issue is complicated.
"There have been four amendments to the 1952 document, two new leases and a new federal law since then," he said. "What was stated in 1952 would not necessarily stand today."
Native American attention has turned to that contract as they have had an increasingly hard time getting health coverage. The Indian Health Services clinic in Albuquerque, for example, has
stopped taking walk-ins.
Indians going to UNM for health care may qualify for indigent funds from their home county, or for the UNM Care program if they are residents of Bernalillo County and their income is low enough, according to Dr. Ron Lujan, a Native American and former UNM Hospital board member.
"But that deletes the obligation of the federal government," he said, adding that federal programs often deny coverage to Indians who move off the reservation. Their own tribes, in turn, may deny care at their clinics if a tribal member has lived off the reservation for a period of time.
Gregg Pohuma, a native of Taos Pueblo living in Albuquerque, said he has been struggling to pay for anti-rejection drugs after a kidney transplant. IHS won't pay for his medications, he said, and UNM won't, either. He has been trying to save money to buy them, he said, but sometimes faces the choice of buying food or medicine.
"One time, I'm ashamed I took the medicine, and took food out of my family's mouth," he said. "That's something I don't want to do ever again."
The health care system needs to be revamped for Indians who fall through the cracks, Lujan said.

------------------- blogger's commentary----------------------
when you think of healthcare for native americans, what comes to mind?

1. they are all insured?
2. they all have healthcare?
3. i never even thought about it?
4. the tribes provide healthcare with casino gambling money?
5. the united states government, by treaty obligation, provides healthcare for native americans?
6. there's something called the Indian Health Service, don't they take care of it?

There is only one truth to Native American health care in this country - the systems are underfunded, shutting down services, large segments of the Native American population cannot access specialty health services or urgent cares, Native Americans living off reservation in cities (even cities with large Urban Indian populations) are treated like second class citizens often bounced from system to system and funding stream to funding stream. The "system" is a mess and is harming people.

There are a few things to know if you are to try to understand the painful complexity of healthcare financing and access for Native Americans.

1. Native Americans are U.S. Citizens, just like everyone else.
2. The U.S. Federal Government, on behalf of all citizens, made treaty promises to every Native American person to provide healthcare, usually in exchange for land or end to hostilities years ago.
3. The Indian Health Service (IHS) is the U.S. bureaucracy that is charged with this task.
4. IHS has been severely underfunded year after year, not even receiving cost of living increases in the budget, let alone matching money for cost of inflation in healthcare. The process by which money is allocated to the IHS in the federal goverment budget is by BEGGING. Each year, IHS officials take a trip to Washington to BEG for more funds out of the Health and Human Services Budget. What i mean by BEG is that the amount allocated is not based on science, epidimiology, population health indicators, needs of the many tribal and urban communities. It is based on currying political favor.
5. Some Native Americans have private health insurance.
6. Some Native Americans have Medicaid.
7. Even with these "extra" monies counted towards Native American health, there is an average of $2 per capita spent on each urban Indian and $1500 per capita spent on each reservation Indian.
8. Compare this to the $4000 per capita average for citizens of the U.S. or $7000 per capita average for people living in Miami, FL.

Enough facts, here's how the reality breaks down:

If you are Native American and you live away from your tribal reservation for more than 100 days, you lose eligibility to receive health services there. Yet, if you approach a designated IHS clinic in a city like Albuquerque, they will now turn you away and tell you to go back to your tribal reservation. Catch 22? yep.

The United States Government is failing miserably on it's treaty obligations to the First People's of this continent. I am embarrased for my country. What has become of our word? What does a promise mean in a Christian nation that prides itself on integrity? Our broken words, broken promises are no surprise to any Native Americans i know.

more on the details of system complexity in a future post.

andru