Tuesday, August 21, 2007


SICKO told who ever didn't already know that the US healthcare system sucks.

Well,let me tell you something those living on reservations within the US borders only wish they had it so good.

For example, there could have been the story in SICKO of Avis Littlewind, a 14-year-old who lay curled in the fetal position for 90 days before killing herself because no treatment center existed to help her.

Or take the case of Josef Catches, 25, and Samantha Garnette, 20. Real Americans. They waited about two hours for a routine checkup for their 2-month-old son, Mason Catches, one recent morning at the Pine Ridge IHS medical center. After finally being called into a patient room, they were sent back out to wait again when another infant needed to be weighed on the hospital’s scale, Garnette said.

“It would be nice to have more scales,” she said, as Catches cuddled little Mason on his shoulder. “And more clinics.”

Yeah, wouldn't it ever.

Of course, like other Americans, the very first Americans get shafted for one thing because they are poor. Half the Top 20 Poorest Counties in America are included in Indian reservations.

And like African-Americans Indians get screwed because they are not white.

And unlike all other Americans Indians get the worst of care because they are INDIANS.

Back in 2002 at hearings held by Cheyenne River Sioux tribal officials tribal members detailed misdiagnosis, misconduct, failures by physicians to examine charts, the dispensing of medications deadly to those suffering from particular health conditions, pharmacy personnel dispensing the wrong prescriptions to tribal members and tribal members being given bags of Motrin and Robitussin to pacify them as a substitute for treatment. Some said they were given the over-the-counter medicines even if they did not need them.

Others complained of physicians refusing to see them when immediate
care was needed in life-threatening circumstances. Some said tribal members
sat waiting for hours before anyone would respond. Often the response was to
simply send them home. In some cases, just a few hours later they would have
to return for emergency care.

One tribal member told of a woman suffering from a brain tumor who
was denied contract care due to a lack of funds.

"The IHS hospital said, 'We're sorry Nina, we don't have the funds.
Come back next fall, and maybe we will have the money,'" she said. "Looks
like they are just letting all the elderly go."

Now the conservatives will tell you this is because healthcare for Indians is socialized medicine.

You and I know better.

The introduction to the 2004 report on healthcare for Native Americans put together by the U.S. Commission on Civil Rights and entitled Broken Promises stated:

If you’re a young Lakota woman with a big heart, an even bigger smile, but an immune system compromised to its brink by lupus—you know who the enemy is. If you’re a tribal chairman receiving a phone call in the middle of the night that another one of your tribal members has taken their own life—you know who the enemy is. If you are a teacher, attempting to prepare tomorrow’s leaders but knowing full well that a number of your students aren't capable of concentrating on school work because of alcohol related family problems—you know who the enemy is.

It ain't socialized medicine.

Chapter Two of that same report rather gives this answer:

• Racial and ethnic bias and discrimination.
• Patient health behaviors.
• Environmental factors.
• Delivery of health care in a culturally sensitive and appropriate manner.
• Language.
• Poverty.
• Education.

No mention of socialized medicine. Every one one of the above factors can be explained by the fact that these folks were talking about are not white, they are poor, and most importantly they are Indians.

The report states that the Indian Healhcare Service (INS) is woefully underfunded, the simple result of Native Americans falling low on lawmakers’ priority lists. IHS spends about $2,100 per patient annually, while Medicare, the federal health plan for American’s senior citizens, pays almost $8,000 per patient, according to the government’s own statistics. Medicaid, the state-federal coverage for the poor, spends nearly $4,500 per patient.

Is that the fault of socialized medicine or something more insidious.

It is more the result of the fact that those in power simply don't consider Indians to be real Americans. They're an other.

In hearings last year to reauthorize the Indian Health Care Improvement Act, Bush Administration officials stated that the Act is a race-based measure. The purpose behind those statements were not apparent to the media and congressional staffers.

They should have been. The Administration doesn't want to live up to all the treaties the US signed that agreed to provide decent healtcare to Indians.

By the way, the Administration also removed language from the bill providing federal health care services for urban Indians.

So what was bad, should only get worse, if the Prez has his way.

Bush, the cowboy, never met an Indian he had any use for.

The Pine Ridge Native American Reservation in South Dakota is as big as the state of Connecticut.

Life expectancy on the Pine Ridge Reservation is 48 years old for men and 52 for women. This is far from the 77.5 years of age life expectancy average found in the United States as a whole. According to current USDA Rural Development documents, the Lakota have the lowest life expectancy of any group in America. The infant mortality rate is the highest on this continent and is about 300% higher than the U.S. national average. The rate of diabetes on the Reservation is reported to be 800% higher than the U.S. national average. As a result of the high rate of diabetes on the Reservation, diabetic-related blindness, amputations, and kidney failure are common. The tuberculosis rate on the Pine Ridge Reservation is approximately 800% higher than the U.S. national average. Cervical cancer is 500% higher than the U.S. national average.

And yet these are the very first regular Americans to inhabit the place Bush calls home.

Just today we learn from Indian Country Today that a federal judge has said he would allow an emergency room on the Yankton Sioux Reservation to close.

''Dennis Rucker, Yankton Sioux tribal council member said someone is going to die as a result. Probably many someones, I'd say.

''When there is no available help they will go to the community hospital in Wagner; are they ready to take over? I don't think so. How are we going to pay them?" Rucker asked?

Again from Indian Country Today, ''We gave a large portion of our land away, and our way of life, that we would receive these benefits. Somehow they neglect their federal obligations to us. All this talk to the senators and Herseth [Sandlin]; they seem to neglect that there is a treaty obligation the federal government made to my people,'' Rucker said.

Rucker said that the IHS has allocated $2.2 million to build housing for doctors and nursing staff.

''They can build new quarters for new doctors, but yet they can't send down that $2 million to fund the emergency room? Where's the reasoning in that,'' Rucker said.

That's not the fault of socialized medicine. That's the fault of this country's leaders who simply can't be concerned with the lives of ordinary people living in an extraordinary place, we label reservations.

The following is from Native Times.

Crisis of Indian Health Care the Focus of Public Hearing in Montana
By- Shelley Bluejay Pierce 8/20/2007

Senator Byron Dorgan (D-North Dakota) who chairs the Senate Indian Affairs Committee, journeyed to the Crow reservation in Montana on Wednesday for a hearing which focused on the crisis of health care in Indian country. An elite panel of experts joined lawmakers in the public meeting that offered the tribal communities a chance to voice their grievances prior to a renewed effort to reauthorize the Indian Health Improvement Act that has not been renewed since 1999.
The hearing prepares the way for the Senate Finance Committee, which is addressing the act. The Indian Affairs Committee, which has primary jurisdiction over the bill, has given approval to it. Senate Finance Committee Chairman Max Baucus (D-MT), whose committee has partial jurisdiction over portions of the bill, stated that he would schedule a committee session to act on the bill September 12, 2007.

Indian Health Service, (IHS) is a program that provides health care to the tribes. In Treaties with the United States, provisions for health services to the Tribes became a federal trust responsibility. Despite these agreements made more than a century ago, current health care conditions on the reservations are described as being at “third world levels.”

Senator Dorgan has stated in earlier press that he “would not allow another Congress to come and go without acting to improve it. The Indian Affairs Committee approved similar legislation in the previous Congress, but the full Senate never considered it.”

According to IHS estimates, Indian patients receive $2,158 per person a year in health care services compared to the average of $5,921 for the general population in the United States. Senator Dorgan stated in testimony to Congress earlier this year, that even federal prisoners have more spent on them each year, at $3,900 per person.

For more than a decade, the reauthorization of the Indian Health Care Improvement Act has lain at lawmaker’s feet but Congress has taken no action. The act expired in 2000 and attempts to reauthorize it have been met with opposition by many Republican members of Congress.

Panel member, Dr. Charles North, Chief Medical Officer (Acting), for Indian Health Service told the attendees that while the mortality rates for Native Americans have improved in recent decades, death and disease rates still exceed that of the general population. Rates of diabetes are 200 percent higher, alcoholism rates are 550 percent higher and suicide rates 57 percent higher than those found in non-Native populations.

Witnesses testified at the hearing of their account of poor healthcare given which included examples of cancer victims received diagnosis long after they might have survived had they received earlier treatment; year long or longer waiting lists for needed surgeries; and trauma victims turned back from tribal clinics not equipped to handle critical cases.

Crow Tribal Chairman Carl Venne voiced his thoughts during the hearing and encouraged IHS employees and tribal leaders to call for more funding. He reveled to the attendees that the Pryor Mountain wild horses receive more annual funding than the Crow-Northern Cheyenne Hospital.

Testimonies at the hearing included information regarding the 1.9 million patients dependent upon the federal Indian Health Service, one comment was heard frequently. “Don't get sick after June 1.” This comment is referring to the fact that once the yearly funding is depleted, usually during the last quarter of the fiscal year, there is no available funding for health needs in the Native communities.

Other testimonies included patients needing specialized care for arthritis, heart conditions, complications from diabetes and other more involved health issues remain on long waiting lists and are left untreated unless they are in danger of losing life or limb. Basic care is available at local reservation clinics and extreme trauma patients often receive immediate attention as they are referred to emergency rooms or evacuated to larger hospitals. However, those patients who need specialists necessary for their health care but are not considered life threatening go without treatment.

Jonathan Windy Boy, enrolled member of the Chippewa Cree Tribe, a state Representative in the Montana Legislature, and serving as Chairman on the Committee on Health Care for Montana/ Wyoming Tribal Leaders Council discussed these issues with Native American Times and recounted the disparity in care for the more remote reservations. Since his home reservation is in a remote area, he explained that members with health needs were made to travel hundreds of miles per week to receive treatment in larger cities equipped to deal with their health issues.

In his testimony he restated the critical need for Congress to fund the health care at 100 percent and not at 40 to 60 percent that they have in the past. According to reports, funding levels in remote communities fair even worse when it comes to the needed levels of funding.

Rep. Windy Boy told the hearing attendees, “The medical inflationary rate over the past ten years has averaged 11 percent. The average increase for the Indian Health Service (IHS) health services accounts over this same period has been only 4 percent. This means that IHS/Tribal/Urban Indian (I/T/U) health programs are forced to absorb the mandatory costs of inflation, population growth, and pay cost increases by cutting health care services.”

Windy Boy further detailed the disparity in funding by explaining, “In Fiscal Year 1984, the IHS health services account received $777 million. In FY 1993, the budget totaled $1.5 billion. Still, thirteen years later, in FY 2006 the budget for health services was $2.7 billion, when, to keep pace with inflation and population growth, this figure should be more than $7.2 billion. This short fall has compounded year after year resulting in a chronically under-funded health system that cannot meet the needs of its people.”

Another of the panel speakers spoke with Native American Times prior to the hearing. Stacy Bohlen, Executive Director of the National Indian Health Board spoke of the critical need for orthopedic surgeons to address the critical needs of patients requiring such things as hip replacement surgeries. She stated that a patient from the general population in the U.S. will wait two to three months for an orthopedic procedure while Indians in Montana are waiting six years. During this time the patients are using large doses of narcotic painkillers that in the end may lead to substance abuse problems. Bohlen further explained that many of the joint treatments, if performed earlier, would not need the drastic repairs required when the conditions are left without proper and immediate care.

Senator Jon Tester (D-Montana) held a telephone press conference immediately before the public hearing began at Crow Agency. His opening remarks highlighted that Senator Dorgan was coming in from Washington D.C. to chair the hearing and highlighted the need to address critically important health care issues in Indian country.

“Improving health care on reservations is critically important to improving all conditions in Indian country. It seems that every time Indian leaders submit a budget for what they truly need to provide basic services, the government says there is just not enough money. This issue is not about money, it’s about priorities. If we can spend $3 billion each week in Iraq, then we can surely develop health care systems that live up to our trust responsibilities in Indian country,” stated Senator Tester.

“All the information we say and hear today will become part of the official record of the Indian Affairs Committee. This information won’t just be stored away in a library in some basement. Sen. Dorgan and I will be taking this information back with us to the Indian Affairs Committee and we will continue to work to change policy to improve Indian health care.”

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