With the stroke of 22 pens, President Obama on March 23 signed health insurance reform into law. Capping a lengthy and bitterly fought battle over what should or would constitute actual reform in American health care, the signing ceremony was momentous for Indian country because it permanently “authorizes” the Indian Health Care Improvement Act.
The act had not been reauthorized since 2001, necessitating constant lobbying by tribal health officials and leaders. It wears on even the most dedicated champion – and there are many in Indian country – to have to go to Congress year after year and remind them of their responsibilities to American Indian and Alaska Native peoples. It wears on Indian people, who have worked hard to make the best of an outdated health care system, but who will continue to find new ways to make improvements for better community health.
Addressing root causes of health disparities has become a priority of President Obama’s administration. In a statement, he explained his reasons for supporting Indian health care: “I co-sponsored this act back in 2007 because I believe it is unacceptable that Native American communities still face gaping health care disparities. Our responsibility to provide health services to American Indians and Alaska Natives derives from the nation-to-nation relationship between the federal and tribal governments. And today, with this bill, we have taken a critical step in fulfilling that responsibility by modernizing the Indian health care system and improving access to health care for American Indians and Alaska Natives.”
Many opportunities for closing the health disparities experienced by American Indians lie within this new law.
Many opportunities for closing the health disparities experienced by American Indians lie within this new law. Moving away from a “treatment only” system toward more holistic prevention care that attacks the roots of epidemics like obesity, diabetes, alcoholism and suicide means a chance to build stronger Native families, communities and nations.
Eliminating disparities plays on the minds of local clinicians as well. Professionals at every level of the Indian Health Service point out that consistent and dependable funding would make a huge difference in modernizing their practices and programs. Tribes throughout Indian country are desperate to train their own practitioners. Funding that will help steer a new generation into health professions not only makes for positive change from within, but it also helps drive tribal economies. It’s also time for Indian health care to evolve technologically, using advances in tele-medicine and social networking to reach out to both urban and rural patients. These are just a few ways tribes can address health disparities.
Casting a shadow over this opportunity to improve the health of American Indians is an effort by Republicans to repeal the new health law. That opposition is not surprising. Far worse are the hateful protestations and racist rhetoric that have marred the debate. Shouting “baby killer” on the House floor during the vote? Or the “n-word” at a civil rights leader? Some might describe this as “passion,” but it’s really a disgrace. Supporters and advocates of Indian health care on both sides of the political spectrum have long demonstrated that class and a reliance on facts go a long way.
About a decade ago, one of the most vocal advocates for better health care was a Republican. Sen. Ben Nighthorse Campbell, R-Colo., wrote an op-ed for Indian Country Today that plainly laid out the facts, without attacking anyone or anything. “America is the richest and most powerful country the world has ever known,” he wrote. “We are indeed fortunate to be citizens of this great nation, but we must also recognize that most Indians live in abject poverty and that much needs to be done.” With the passage of health care reform, much has been done. It’s time to begin a new era in Indian health.