It is no secret to anyone in Indian country that American Indians continue
to suffer from gross disparities in their health and the medical care that
they receive. The unmet health needs of American Indians remain alarmingly
severe and the health status of Native peoples is far below the health
status of the general U.S. population.
A large part of the problem is that American Indians have greater
difficulty in accessing quality health care services. A recently issued
Government Accountability Office report highlights this fact. The report,
not the first of its kind, reveals that health care services are not always
available to American Indians.
This report once again exposes the growing divide in health care between
Native communities and the general population. In example after example, it
showed that American Indians still do not receive a level of service
comparable to other Americans.
Consider the case of primary care services. The GAO found that American
Indians are forced to overcome significant barriers in order to receive
care. Specifically, they can expect lengthy wait times -- anywhere in the
vicinity of two and six months, depending on the type of service needed.
Furthermore, the nearest health care facility could be between 60 to 90
miles away, a problem that is compounded by the fact that many American
Indians cannot afford their own vehicle and alternative means of
transportation are often times not available.
The situation grows bleaker with the case of secondary and specialty
services, which are far less accessible in Indian country. The GAO report
revealed that large gaps in ancillary and specialty services were common
among IHS facilities, concluding that "the most frequent gaps were for
services aimed at the diagnosis and treatment of medical conditions that
caused discomfort, pain, or some degree of disability but that were not
emergent or acutely urgent."
While these conditions may not be life-threatening at first, the lack of
early treatment could allow minor problems to grow exponentially worse and
exacerbate the severity of a patient's condition, thereby creating the need
for more intensive and expensive care.
This report simply validates what we have already known for far too long:
the divide between the health of American Indian communities and the
general population continues to widen. Unfortunately, the Bush
administration and the Republican-controlled Congress have done little to
bridge this gap.
This report should serve as a wake-up call to policy-makers who have
ignored health disparities for far too long. There are three steps that we
should take immediately in order to improve the current situation. First
and foremost, Congress needs to reauthorize the Indian Health Care
Improvement Act. While reauthorization legislation has been introduced in
the Senate, a companion bill has yet to be introduced in the House. Make no
mistake about it; we are short on time. Congress is rapidly approaching the
end of its first session, and if the legislation does not begin to move in
both chambers, we will fail once again to update this critical law.
Second, Congress needs to increase federal funding for the IHS, which has
been woefully underfunded for years. During the current fiscal year, IHS
funding is approximately $2.6 billion. This simply is not enough,
particularly since tribal leaders estimate that given the current health
care needs of Indian country, approximately $20 billion per year would be
needed to sufficiently improve the quality of health services for American
Earlier this year, I urged House appropriators to fully fund the IHS so we
can prevent IHS facilities from being forced to ration care.
Finally, we need to ensure that every American Indian who qualifies for
federal health programs, such as Medicare and Medicaid, is enrolled and
receiving benefits. Reimbursements from federal health programs play a
vital role in the funding of IHS facilities and their ability to provide
quality health care services.
Increased take-up of public health programs could augment revenue flows to
IHS facilities, thereby allowing them to purchase much-needed equipment, as
well as retain and recruit highly qualified medical specialists.
The GAO report is just the latest in a series of reports that highlight the
growing health disparities between Indian country and the general
population. American Indians will continue to suffer so long as Congress
and the Bush administration fail to take steps to bridge this gap. American
Indians have paid for their health care through the loss of life and land.
It is time for the U.S. government to start repaying that debt by making
real progress at providing the vital health services promised to American
Indians. The era of broken promises must come to an end.
Congressman Frank Pallone Jr. is currently serving his eighth full term in
the U.S. House of Representatives. Pallone represents New Jersey's Sixth
Congressional District, serving as a senior member of the House Energy and
Commerce Committee and on the House Resources Committee.