Diabetes, tuberculosis, alcoholism, Fetal Alcohol Syndrome and increasingly, American Rehabilitation Association’s Diabetes Prevention Program, made possible …
Statement by Senator Ron Wyden on Indian Health Care Improvement Act
Today the Senate is considering the Indian Health Care Improvement Act
Amendments American Indians and Alaska Natives - along with all other
Americans — should receive modern, efficient and quality health care
Unfortunately, too many of those in the Indian health system do not receive
that care today This important legislation will change that
Reforming our nations broken health care system is one of my highest
priorities and I strongly support efforts to shore up Indian health care
services, such as those proposed in this important legislation Like all
Americans, American Indians and Alaska Natives cannot prosper without
access to modern, efficient and quality health care
The most recent census information available indicates there are 23
million American Indian and Alaska Native people in the United States In
my state of Oregon alone there are nine federally recognized tribes, and a
large urban Indian population Less than 40 percent of their people reside
on reservations It is a continuing failure of this nation that American
Indian and Alaska Native people rank at or near the bottom of so
many
social and economic indicators
Most striking of these indicators are the health statistics involving
American Indian and Alaska Natives Diabetes, tuberculosis, alcoholism,
Fetal Alcohol Syndrome and increasingly, AIDS, plague Americas Native
communities at rates far and above those of other Americans As of 2007,
there is a 1 billion backlog in unmet needs for health facilities,
contributing to the degenerating health of Native communities
The plight of Native American health care in this country is the result of
one simple and tragic fact: The federal government has failed to meet its
promise to Native Americans
Through treaties and statutes, the federal government has promised to
provide health care to American Indians and Alaska Natives A critical
aspect of this promise is sufficient funding for the Indian Health Service
IHS, part of the Department of Health and Human Services IHS arranges
health care services for Native Americans and provides some services
through direct care at hospitals, health centers, and health stations,
which may be federally or tribally operated When services are not offered
or accessible onsite, IHS offers them, as funds permit, through
contract
care furnished by outside providers
In addition, in the Indian Health Amendments of 1992, Congress specifically
pledged to assure the highest possible health status for Indians and urban
Indians and to provide all resources necessary to effect that policy
These combined commitments are absolutely essential to help the federal
government meet its legal and moral responsibilities to Native Americans
Sadly, we havent even come close to honoring these commitments Sufficient
funding has not been provided IHS is so underfunded and understaffed that
patients routinely are being denied care that most of us would take for
granted and, in many cases, would consider essential The resulting
rationing of care means that all too often Indians are forced to wait until
their medical conditions become more serious - and more difficult to treat
- before they can even access necessary health care The chronic under-
funding has only grown worse in recent years, as federal appropriations
failed to keep up with the steep rise in public and private health care
costs and expenditures
The results are startling and disturbing While per capita health care
spending for the general US
population is about 7,000, the Indian Health
Service spends only about 2,100 per person on individual health care
services The government also spends considerably less on health care for
Indians than it spends for Medicare beneficiaries, Medicaid recipients, and
veterans
It is appalling that we can live in one of the most prosperous nations on
earth, where most but by far not all Americans have access to health care
services, yet we provide woefully inadequate health care for our Native
American population
These resource shortcomings underscore the need to make the Indian Health
Service a priority in the Federal budget It is also why I am supporting
an amendment offered by my colleague from the State of Oregon, Senator
Gordon Smith, along with my colleague from Washington State, Senator Maria
Cantwell It would provide for innovative approaches in funding health
care facilities by providing a way to distribute funds more equally with
the establishment of an area distribution fund
Each year, I travel to every county in Oregon to learn firsthand the
challenges confronting my constituents I often find that my most
enlightening visits occur when I travel to Indian Country,
especially when
I hear or read compelling stories about Indian health care afforded to my
tribal constituents But I am also pleased that the Northwest region has
its share of success stories and examples of medical care for Native
Americans that have worked
With the support of the Native American Rehabilitation Associations
Diabetes Prevention Program, made possible by the IHS Special Diabetes
Program for Indians, diabetes patients are losing weight and improving
their lifestyle Im also pleased to note that The One Sky Center, a
National Native Resource Center for Substance Abuse and Mental Health
Services located at Oregon Health and Science University in Portland, is
the only National Resource Center of its kind in Indian Country Indian
Country is in a crisis in combating alcohol, substance abuse, and
methamphetamine There is a real need for such a center for not only tribal
people, but also for those who work and interface with Indian Country to
try to find solutions, leverage programs and build partnerships to address
these key health issues
In addition, on the national level, the recently reauthorized Special
Diabetes Program for Indians SDPI has had significant
success and is
viewed as a model for improving preventive care and disease management for
this significant chronic illness Tragically, Native Americans are 26
times more likely to be diagnosed with diabetes than the general US
population and diabetes mortality is believed to be 43 times higher in the
Native American population than in the general US population The
combination of this special program and the legislation before us today
could help make significant strides against this ongoing public health
threat that disproportionately hits Native Americans
Importantly, the SDPI has given Indian health programs and tribal
communities invaluable resources and tools to help prevent and treat
diabetes And it has had real medically measurable results In just 10
years, the mean blood sugar level has decreased by 13 percent Scientific
research demonstrates that such a decrease results in a 40 percent decrease
in diabetes-related complications, such as blindness and amputations
Furthermore, on the prevention front, it has also increased school-based
prevention programs for children, such as increased physical activity
programs, better school lunches, and removal of junk food-filled
vending
machines, and diabetes awareness education There are also more community-
based wellness centers offering exercise and nutrition programs for
individuals at risk for diabetes
Yet this program has been funded apart from the traditional sources of
funding for Indian Health Care, the IHS It is imperative that Congress
pass the Indian Healthcare Improvement Act Amendments so that our country
can begin to fill the many gaps in Indian health care and have more success
stories like the ones I just described
I want to just take a few moments to reiterate how important it is for all
Americans that the federal government move to reform our nations health
care system It is very clear, in my view, that our Nation faces a health
care crisis In fact, I think when we get on the floor debating any health
program, the Senate will see and the country will see that this debate
illustrates how broken our health care system is
Native Americans are not the only Americans who believed they would have
health care when they would need it, only to find that faced with a serious
or life-threatening illness the care or coverage available doesnt match
their need Despite paying more per person for
health care services than
any nation on earth, so many go without care or coverage For some
Americans, this happens when they have lost a job, and hence the coverage
that went with it, or they had minimal insurance that doesnt come close to
providing them the financial security needed to cover the costs of the
health care services they need For 47 million Americans, often through
no fault of their own and despite having tried to be able to afford or
purchase health coverage, they find themselves with no health coverage at
all These fellow citizens are at the mercy of hospital emergency rooms
should health care tragedy strike them or their families Plus, in an
unconscionably large number of cases, they are unable to pay for needed
care without risking personal bankruptcy, if at all
Many people agree with the need for change, but have a healthy skepticism
about whether real, meaningful structural reform is possible in our
lifetimes I understand these doubts and I do not underestimate the
challenge Yet I do believe we have the possibility of a real ideological
truce now in health care More and more Senators of both political parties
have come to understand that to fix health care
we must cover everybody If
we dont cover everybody, people who are uninsured shift their bills to
those who have insurance So colleagues on my side of the aisle who made
the point about getting everybody coverage, in my view, have been correct,
and clearly the country and citizens of all political persuasions have come
around to that point of view
There is also strong support for something the Republicans feel strongly
about, and that is not having the Government run everything in health care
There can be a role for a healthy private sector in universal health care,
one where there is a fairer and more efficient market And there ought to
be more choices; in fact, there can be an abundance of choices in a system
like Members of Congress enjoy today
I am very pleased that I could join with Senator Bennett of Utah, a member
of the Republican leadership, in offering a bill based on just those
principles It is S 334, the Healthy Americans Act, and it is the first
bipartisan universal coverage bill in more than 13 years The last
bipartisan, universal coverage health bill was offered by the late Senator
Chafee more than 13 years ago Now we do have the opportunity for the
Senate to come
together on a bipartisan basis and deal with the premier
challenge at home, and that is fixing American health care
My fellow Senators, it is my hope that we pass the Indian Healthcare
Improvement Act Amendments as soon as possible and live up to our legal and
moral obligations to provide health care services to our Native American
population Ive been proud to join efforts to increase funding for the
Indian Health Service, and I will continue to fight for more IHS funding
because it benefits all people, native and non-native people, in tribal and
surrounding communities Im pleased to support these needed improvements
and funding, which will move forward the cause of improved Indian Health
care
