Dorgan: American Indian health care a national embarrassment Email this page Print this page
Posted: December 07, 2007
by: Sen. Byron Dorgan
Recently in North Dakota, a woman from the Fort Berthold Indian Reservation had severe chest pains and extremely high blood pressure. At a local IHS clinic, she was diagnosed as having a heart attack. The staff of the clinic insisted she go by ambulance to the nearest major hospital, 80 miles away. She resisted because she knew she would be billed for the trip and could not afford it, but the clinic insisted.
When she arrived at the hospital and was being transferred from the ambulance to a gurney, an envelope was found taped to her leg. In the envelope was a letter stating that the IHS lacked funds to pay for the health care she needed because a ''life or limb'' medical condition was not involved. Really? A suspected heart attack is not ''life or limb''? Fortunately, the individual survived. But she later received a bill for approximately $10,000.
This past August, the U.S. Senate's Indian Affairs Committee held a hearing at the Crow Reservation in Montana. The Crow Tribe's health director told this heartbreaking story about her 5-year-old granddaughter, Ta'Shon Rain Littlelight.
Between May and August of 2006, Ta'Shon was brought numerous times to an IHS clinic. She was treated for depression. During one clinic visit, Ta'Shon's grandfather pointed out the bulbous condition of her fingertips and toes, believing that this condition indicated a lack of oxygen to the body. The grandfather's concern was dismissed. In June 2006, the grandmother asked Ta'Shon's doctor to eliminate the possibilities of cancer or leukemia. Once again, the concern went unheeded.
In August 2006, Ta'Shon suffered a collapsed lung. She ended up in Denver, where she was diagnosed with an incurable form of cancer. She died on Sept. 1, 2006. Her grandmother believed that Ta'Shon's last two years of life were spent in ''unmedicated pain'' and wondered whether an earlier diagnosis would have made any difference.
These stories are repeated every day on Indian reservations across the country. Health care has become a hot issue. But as we work to improve the nation's health care system, we ignore the health care crisis affecting American Indians, the First Americans.
Why is Native health care not simply an indistinguishable component of the overall health care system? Because our country has an affirmative trust obligation toward American Indians. That obligation is grounded in numerous treaties and, more generally, in the moral responsibility for the negative impact over generations of changing federal policies.
The great Chief Justice John Marshall, in the 1831 decision of Cherokee Nation v. Georgia, recognized that the United States had a unique trustee relationship toward Indian tribes.
Statistics highlight the desperate condition of American Indian health care. Compared to the U.S. population as a whole, Natives have a 600 percent higher incidence of tuberculosis, a 189 percent higher incidence of diabetes and a 510 percent higher incidence of alcoholism. Suicides on reservations in the northern Great Plains are 10 times higher than the national average.
To improve the performance of the United States as trustee for the health care of American Indians, more funding and continuous innovation are needed. For 2005, the per capita federal health expenditure by the IHS was $2,130. By the way, that's about one-half the per capita spending for federal prisoners' health care, and it was far below the estimated per capita benchmarks of Medicare at $6,784 and the Veterans Administration at $4,653. It means we have full-scale ''health care rationing'' for American Indians, and it has to stop. We need to meet our obligations.
The U.S. Congress is now considering a reauthorization of the Indian Health Care Improvement Act. It has been eight years since the Congress has taken action to improve Indian health care. This new legislation will make some needed improvements such as developing a new type of convenient care clinic and authorizing a new effort to combat the clusters of teen suicides on Indian reservations. But this is just a first step.
Our nation has a trust responsibility for the health of American Indians, and it's long past time we own up to that responsibility.
Sen. Byron Dorgan, D-N.D., is chairman of the Senate Indian Affairs Committee.
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@ socialized healthcare not being a political topic.
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