Lawsuit asks for change in health care

DETROIT – David Stone, White Earth Band of Chippewa, suffers from a botched hernia operation that he alleges occurred because the IHS did not have the resources to pay for a proper operation.

Stone was told that the hernia would kill him if not treated. He traveled to his home reservation in Minnesota but was put on a waiting list that, he was told, could take up to a year. He found a private surgeon to operate on the hernia; later, after continued pain, doctors informed him the operation was not properly done.

Because of this type of inadequate health care, a federal class action lawsuit was filed against the Department of Health and Human Services and the IHS.

The complaint argues that the federal government breached its fiduciary duty and trust responsibility by failing to appropriately provide health care to the estimated 39,000 American Indians who live in the Detroit area.

Although the suit is specific to the Detroit area, it will have significant impact on the populations of all urban areas. More than 60 percent of all American Indians live in the urban setting and only one percent of IHS funding is for urban populations, according to the complaint.

“The disparity in the health care system is reflected in cities especially. We have to have some help,” said Dr. Kay McGowan, Mississippi Choctaw, an anthropologist for the National Urban Indian Coalition and board member of the American Indian Family Services of Detroit.

“People can’t go back to the reservations to get health care. They would have to establish residency, lose jobs and some are too sick,” she said.

Most American Indians in Detroit have never lived on the reservations. Their families were moved to or encouraged to move to the cities in the 1950s era of assimilation and removal from reservations.

“There are a lot of sick people not getting help whatsoever. Health care has deteriorated and little money is spent on it,” McGowan said.

The complaint stated that necessary and urgent services are being denied or impermissibly delayed to the plaintiffs as a direct result of defendants’ inappropriate and arbitrary actions.

“I think there’s definitely a moral obligation,” Diane Dawson, public affairs specialist at IHS in Washington, told the Metro Times of Detroit.

“I know what you’re asking, and certainly our answer is that there is a legal obligation.”

Dawson also said the reason for the problem is lack of sufficient funding. “We do the best we can with what we’ve got and we appreciate everything we get.”

Thomas Sweeney, public affairs official for IHS, said government agencies have a policy of not commenting on ongoing litigation.

David Santacroce, attorney for the plaintiffs, said that lack of funding is not a defense. He said the government has a legal obligation to fund it.

“There are people who are really sick and are entitled to know what is going on in their bodies,” he said.

Santacroce and law students from University of Michigan have been working on the complaint for more than a year. They were taken by surprise when the Bush administration budget for 2007 zeroed out the entire budget for urban Indian health.

“This is total politics, and they can do it because they are not politically accountable. If you lose the Indian vote it doesn’t matter to your election,” he said.

What the plaintiffs are asking for in the suit is a minimum of health care. There is no claim for money. What is asked for is equitable relief and to make the government provide health care.

“We are not talking Mayo Clinic health care or the Cadillac of clinics,” Santacroce said.

Santacroce said when he first was approached by the plaintiffs he was amazed and appalled.

“I was amazed at how bad it was. And this is not some fringe group pointing fingers at the federal government. I think of myself as pretty politically aware in my own state and nation, but here was this huge problem no one was talking about,” he said.

The plaintiffs assert that they want nothing to change with reservation health care. They argue that it is substandard and insufficient; but this case is not about reservation health care.

There is one health care facility in Detroit. Transportation to that clinic becomes a problem and it is limited in services that can be provided.

“We have serious health problems in Detroit, as there are across the country. This is a national problem and hopefully this will be an impact case and reflect change,” McGowan said.

“This is not just an issue of funding; it is also the way funds are distributed. We are advocating for additional funding but don’t want to hurt communities at home. We want health care for everybody; Indians across the board need better health care,” McGowan said.

The defendants are the secretary of Health and Human Services Michael Leavitt and HHS and IHS Director Dr. Charles Grimm.

The plaintiffs are David Stone, White Earth Band of Chippewa; Joseph Stewart, Sault Ste. Marie Band of Chippewa, who was diagnosed with an unknown liver disease but was told IHS lacked the resources to conduct a thorough examination; and Tonya Hammitte, also Sault Ste. Marie Band of Chippewa, who was diagnosed with a precursor to cervical cancer but was told the IHS lacked the resources to perform the removal procedure.

The complaint states that the defendants are unlawfully continuing to not provide the health care the plaintiffs need.