Dorgan 'out of patience' with inadequate health care

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CROW AGENCY, Mont. - IHS officials were told - at the risk of losing their jobs - to tell their bosses that health care in Indian country is underfunded to the point that people are losing their lives.

Sen. Byron Dorgan, D-N.D., and Sen. Jon Tester, D-Mont., addressed IHS officials at a field hearing Aug. 16 on the Crow Nation Reservation.

''I am out of patience with the inadequate health care for Native Americans; we don't have a lot of time,'' Dorgan said.

Tester, the freshman senator and a member of the Senate Committee on Indian Affairs, said that tribes signed treaties with the federal government and gave up land in exchange for services like health care.

''American Indians got the bottom end of the deal. If this country can destroy Iraq and rebuild it, there has to be money to fund Indian health care,'' Tester said.

America was made aware of and was talking about the scandal created at Walter Reed Army Medical Center over the treatment of Iraq War veterans, but as Carl Venne, chairman of the Crow Nation, said, ''If they think Walter Reed was a scandal, they should all come to Indian country to see what it's all about.''

A top issue with health care is contract health - when funds run out mid-year, people have to wait for treatment until the next funding cycle unless they are threatened with loss of life or limb.

Contract health service funds are made available when a service unit is not equipped to handle a particular health issue. The patient is then referred out of the system and the contract funds will pay for the treatment. In most cases, this involves surgery and diagnostic tests.

The Crow Nation, according to Venne, was out of contract funds in the first part of June. Patients then must wait until November to receive special treatments. The wait for non-Indians to receive this type of care can be as much as three months, but for American Indians who use the IHS system, a 13-month wait is not unusual.

When Tester inquired about funds running out in June, Pete Conway, director of the Billings Area Office for IHS, said, ''Contract care is not funded adequate to cover all the needs.''

Venne told the crowd of nearly 400 people that health care was funded at less than 50 percent of the need and reminded the many tribal leaders present to stand up and speak out about it.

''We know the budget is not adequate. Go to your bosses and say, 'We need more dollars, people are dying.' If people are sick, there is no quality of life,'' Tester said to the IHS officials. He said someone in the IHS needed to stand up and risk their job to help improve the funding.

Dr. Charles North, acting chief medical officer, talked about the increased budget of $3.2 billion for health care. His overall message to the panel was that although disparities in health care exist, and that the death rate and rates of alcoholism and drug addiction are higher than the rest of the country, some positive strides have been made and plans are in place to reduce those disparities.

''Making significant reductions in disparity rates can be achieved by implementing best practices medicine, using traditional community values and building the local capacity to address these health issues and promote health choices,'' North said.

''Indian self-governance and self-determination and consultation are extremely important to this administration,'' he said.

''Indian tribes now administer 54 percent of our budget with IHS funds transferred through self-determination contracts and compacts.''

Tester said that the question of the budget's adequacy came up to IHS officials earlier and the response was that the budget was meeting most of the needs.

''Yet, when we talk to folks in Indian country, we get a very different answer. Do you think the budget request was sufficient to meet the needs?'' Tester asked North.

North said that the budget had increased to $3.2 billion for direct care and facilities; and in addition to that, he said, the third-party payee revenue increased to three-quarters of a billion dollars.

When asked again if the budget meets the needs, he said, ''There are always needs to be served in Indian country.''