Going Native: Health care

I didn't get to everything I wanted to cover last week, so I'll keep posting until I'm done with my little series on Native Americans and disability.

From Indianz.com:

After 11 hearings, two administrations and countless hours of testimony, Congress has yet to reauthorize the Indian Health Care Improvement Act. The law was passed in September 1976. It expired in 2000 but was extended for one year. Since then, tribal and Indian health leaders have sought to reauthorize the act. But key members of Congress say the Bush administration has delayed the amendment and has objected to many of them. Anslem Roanhorse, the executive director for the Navajo Nation Division of Health, said the amendments are needed to improve services to Indian people. He said a recent attempt to bring the bill to the Senate floor failed.

More information from the Gallup Independent's Navajo Bureau shows that health services for Indians continue to fall behind technologically because of this failure of funding:

Officials have presented data that the Act must be reauthorized in order for health disparities that threaten the future of Indian Country. According to IHS statistics, American Indian and Alaskan Native populations have tuberculosis and alcoholism mortality rates six times higher than the rest of the U.S. population, and mortality rates in diabetes that are three times higher than the U.S. population.

From a July 2006 article by Catherine Komp in The New Standard:

Congress has continued to fund the act through budget appropriations of about $3 billion per year. But indigenous advocates say this sum is inadequate, and that without reauthorization, it also remains uncertain. They point to President Bush’s proposal to eliminate the Urban Indian Health Program in the 2007 budget. Funding for the program, which provides health care for Native Americans living in urban areas, was only recently restored by the Senate.

Health advocates also say that tribes need a new bill to address changing health problems and needs on reservations.

Jim Roberts is a policy analyst with the Northwest Portland Area Indian Health Board who has worked on reauthorization issues for the last six years. "It’s been particularly during this administration that we have met with a number of objections related to different provisions of the bill," he told The NewStandard. "Unfortunately we don’t have the political clout that a lot of other groups have to influence members of Congress, to put pressure on the administration to get these folks to the table to address our concerns."

Why is this Congressional funding so hard to pass and maintain? From Komp again:

"We have a federal government… [that] is essentially turning their head on a population of the US that is increasingly getting sicker," said Joe Finkbonner, executive director of the Northwest Portland Area Indian Health Board and member of the Lummi Nation in Washington.

.... The Indian Health Service also estimates that more than two-thirds of health care that is needed for American Indians and Alaskan Natives is denied.

A 2004 report on Native American health issued by the US Commission on Civil Rights connected these divergent realities to a continued climate of racism in the US.

“While some disparities result from intentional discrimination based on race or ethnicity, more frequently discrimination must be inferred from the continued existence of a chronically underfunded, understaffed and inadequate healthcare delivery system,” wrote the report’s authors. “For Native Americans, the existence of glaring disparities across a wide range of health-status, outcome and service indicators – combined with the manner in which the disparities mirror patterns of historical discrimination – makes a convincing argument that the current situation is in fact discriminatory.”

The report found that inadequate federal funding was a major obstacle to eliminating disparities in Native American health care. It stated that annual increases in funding for the Indian Health Service did not include adjustments for inflation or population growth and were significantly less than those allocated to other arms of the Health and Human Services Dept.

The lack of funding often means Native health providers can only offer so-called "life or limb" services to the most desperate.

Beyond ordinary discrimination, one professor finds suicide rates among American Indians is related to past genocide. From the Spokesman Review:

So far, there has been no such official acknowledgement from the U.S. government, said Maria Yellow Horse Brave Heart, a professor at the University of Denver Graduate School of Social Work.

"So much happened to our people, we didn't have time to recover from one trauma before another occurred," said Brave Heart, a Hunkpapa-Oglala Lakota who developed the theory of "historical trauma" among American Indians.

.... Historical trauma is the intergenerational post traumatic stress that is the result of the genocide perpetrated on American Indians, Brave Heart said. The resulting "cumulative group trauma" was aggravated by the boarding school system imposed on Indian children by both the United States and Canada, robbing them of their traditions, language and families, she said.

The children of the massacre survivors, the boarding school survivors, passed on this trauma to their descendants, Brave Heart said. Hope for Native American children lies, Brave Heart said, in recognizing that this historical trauma exists and reclaiming traditional culture and spirituality through the power of the tribal community and "grass roots healing."

I've been trying to find updated informtion on which what members of Congress have the power in which committees to push this past the lobbies that are proving powerful enough to continue stalling passage of the Indian Health Care Act and other necessary funding, but I haven't located that information yet. Here are some outdated links that will hopefully reflect the midterm elections soon.