Written by Wilma Howe-Bennett   

Have any of y’all ever heard of Congressman Joe Baca of California? No? Me, neither, until I got busy researching the $500 million that was supposed to be available to the Native American Health Care System. From his website:
“As a Member of the Natural Resource Committee that has jurisdiction regarding Native American issues, I am given the responsibility to protect the Native American community. As a member of the Native American Caucus, I have additional resources to make me fully aware of the important issues facing the Native American community. In Congress, I vote on and sponsor legislation that will help, encourage and support the Native American community. As a friend, I have dedicated much of my life to serve as an advocate for Native Americans, and will continue to champion for what is best for the community.

The American Recovery and Reinvestment Act, which became law this February (2009, that is), includes a number of key provisions and funding initiatives to benefit the Native American community. In total, the Recovery Act included $2.5 billion in direct funding to Indian Tribes and, $2.4 billion in tax bonding authority for tribal economic development and Indian school construction. Significant areas include:

$500 Million for Indian Health Services
$500 Million in funding for the Bureau of Indian Affairs
$510 Million for Indian Housing Block Grants
$327 Million for the construction and upkeep of roads on Reservations
$5 Million for Reservation Food Distribution Programs
$10 Billion for grants to school districts serving low-income children, including tribal schools
$1 Billion in Head Start program funding, including Indian Head Start Programs
$100 Million for Tribal school facilities under the Impact Aid program.”

This is terrific, but I’ve just got ONE tiny question here: where is the money, and why isn’t it being used?

The U.S. Department of Health and Human Services announced that the Indian Health Service will release $500 million for improvements in Indian health in the American Recovery and Reinvestment Act of 2009. “These Recovery Act funds will provide critical assistance to American Indian and Alaska Native communities,” said IHS Director Yvette Roubideaux. “These funds will help improve health care, create jobs and make our Native communities stronger. The Recovery Act funds are to be expended as follows: $227 million for health facilities construction (2 hospitals, one in Alaska), $100 million for maintenance and improvements, $85 million for health information technology, $68 million for sanitation facilities construction, and $20 million for health equipment that will improve health care in Indian country.”

I realize that I’m being a bit pesky here, but those funds were authorized released as of May 2009 – so, where are they?

Native Americans die of illnesses like tuberculosis, alcoholism, diabetes, pneumonia and influenza at substantially higher rates than the rest of the so-called civilized country that we all live in. In the vast, varied territory called Indian Country, healthcare is being defeated with the struggle. Native Americans struggle with too few doctors, too little equipment, most of which was old before I was born in 1950, and hospitals and clinics miles of hardscrabble and mostly unpaved roads away from the reservations that they are supposed to serve. In cities, where over half of the country's roughly three million Indians now live (and nearly five million including part-Indians), only 34 programs get Indian Health Service funding, providing mostly basic care and arranging more advanced care and coverage elsewhere – at the patient’s expense.

While some Native Americans have private insurance, mostly through employers or tribal businesses like casinos, at least a third are uninsured and most of them live in poverty – abject, grinding poverty - that makes Haiti’s poverty-stricken citizens look affluent. By all accounts, the Indian Health Service is substantially underfunded. Despite the Indian healthcare system improving nationally (I guess that a marginal improvement is better than none) and Native Americans living JUST a bit longer, there are still massive improvements that need to be made which would be extremely beneficial to them. Even if more Native Americans can become insured, it will not end the problems, especially if providers and insurers continue avoiding Indian Country.

Very few people have remembered throughout the course of the debate on health care reform in this country that the U. S. government already has a single-payer styled healthcare program, of a kind,(NOT Medicare, this is a different program) for Native Americans only. Unfortunately, as has been the case with every single, solitary program that deals with the Native American population, starting with the BIA, this health program has not done a very good job of serving the Native American peoples very well. As an example, it has recently been shown that the HIS “lost” over $20 million in high-tech healthcare equipment bought by the government and intended to be placed in clinics on the reservation to care for the indigenous population. Property “continues to be lost or stolen at IHS at an alarming rate,” the GAO reported back in January of 2009.

YOOOO HOOOO, Congressman Baca? What are you doing about this?

From October 2007 through January 2009, IHS identified about 1,400 items with "an acquisition value of about $3.5 million that were lost or stolen agency-wide. These property losses are in addition to what we identified in our June 2008 report.” Apparently, fraud, waste and corruption on such a grand scale is rewarded in a government-controlled healthcare system. See, gangers, when you work for the government, there’s really no incentive to be honest – especially when you, said government employee, are stealing from “the least of these” folks that you’re actually supposed to be helping. There is no punishment for fraud and stupidity, if you work for the BIA. Instead, the worse you treat the Native Americans, the bigger your budget is. There’s very little oversight, either.

Fraud, waste and corruption? Sound familiar? Perhaps Pelosi and company should read the 2004 study, "Broken Promises: Evaluating The Native American Health Care System (http://www.usccr.gov/pubs/nahealth/nabroken.pdf). Read it at your own risk – and make sure your stomach is empty before you start.

For those who might be tempted to dismiss this since it pertains only to the Native American tribes and population, and all the accompanying baggage of U.S./Indian history, I ask, do you honestly believe that the Feds will provide better coverage for your family?

And where’s Congressman Baca in this debate? H’mmm?