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Dorgan decries Indian health services at Mont. field hearing 8-07

By Matthew Brown
Crow Agency, Montana (AP) - Sen. Byron Dorgan decried Indian health services in the U.S. as scandalous during a congressional field hearing Wednesday, saying care is often denied unless life or limb is threatened.

“We are rationing health care to Native Americans,” Dorgan told officials from the federal Indian Health Services agency. “Stop telling us things are pretty good and tell us exactly what is happening.”

The North Dakota Democrat chairs the Senate Indian Affairs Committee, which held a nearly three-hour hearing Wednesday on the Crow reservation. Witnesses testified of cancer victims who could not get a diagnosis until it was too late for treatment, yearlong waits for surgeries and trauma victims turned back from tribal clinics not equipped to handle their problems.

Dorgan’s comments followed testimony from Indian Health Services officials, who said they make funding “go as far as we can” despite complaints it regularly runs out halfway through the year. Pete Conway, a local director for the agency, said members of some tribes in the Dakotas receive only 40 percent of the health care funding they need.

Conway’s boss, Indian Health Services Acting Chief Medical Officer Dr. Charles North, said the agency attempts to focus its care to reflect limits on resources. He said he was putting up a “good struggle” to improve services and that the Senate also bears some responsibility.

“The administration makes a budget that’s dead on arrival. The Senate controls the funding. We don’t control how much we get,” North said.

The hearing comes as the Senate Finance Committee prepares next month to take up the Indian Health Care Improvement Act, last reauthorized 15 years ago. The bill includes new programs to offer after-hours care on reservations and expands some mental health services. It would not appropriate new money, but merely authorize its spending if additional funds were given.

While mortality rates among Indians have improved in recent decades, death and disease rates still exceed that of the general population. Rates of diabetes, North said, are 200 percent higher than among the general population. Alcoholism rates are 550 percent higher and suicide rates 57 percent higher.

A procession of Indian leaders said such disparities have crippled their communities – and mark a betrayal of the treaties in which tribes gave up ancestral lands in exchange for a pledge of federal protection.

“It makes my heart sick when I remember all the good words and all the broken promises,” said Julia Davis-Wheeler, a member of the Nez Perce tribal council. “Good words do not stop my people from dying.”

North said other government programs – including Medicare, Medicaid and local indigent care providers – also share in the health care burden for 1.9 million Indians and Alaska natives. He added gaps in care among Indian Americans are similar to those seen elsewhere, such as Medicare for the elderly.

“There’s always a need for more,” he said. “Ask elderly folks who depend on Medicare, how far their Medicare dollars go. There’s never enough.”

North did say there was “room for improvement” within his agency when it comes to collecting money through Medicaid reimbursements.
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