Fort Worth Star-Telegram, May 28, 2008: Tribes’ healthcare coming up short

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Progressive Media Project

How long you live should not depend on how rich you are. But recent studies show that the richer you are, the longer you live.

For American Indians, this is not news. Nearly a third of our people live in poverty, compared with 12 percent of the rest of the country, and we suffer alarming gaps in life expectancy. In Arizona, where I live, the average age at death is 72.2 years for the general population and 54.7 years for American Indians. Even people in Bangladesh and Ghana live longer.

Death rates from preventable causes such as diabetes, alcoholism and mental illness are dramatically higher among American Indians than in the rest of the population. Despite this gross inequality, American Indians are the only population born with a legal right to healthcare in this country.

The treaties between the tribal nations and the federal government involved exchanges of vast amounts of Indian land and natural resources for federal guarantees of social services, including housing, education and healthcare. The Bureau of Indian Affairs and the Indian Health Service were established to administer the federal government’s trust responsibility to provide healthcare and other vital services to American Indians. But today, the Indian Health Service is underfunded to the tune of $2 billion.

Relative to the entire federal budget of $3.1 trillion, $2 billion is a tiny investment in Indian health. This is not a question of money. It’s a question of priorities.

We can rapidly spend $150 billion to send taxpayers a $600 rebate to stimulate the economy, and we can spend about $2 billion per week on the war in Iraq. But we can’t fulfill our responsibility to honor our treaties with the country’s first inhabitants, even though that additional $2 billion could make life-and-death differences.

Opponents of this funding claim that tribal casinos make it unnecessary. But most tribes do not have casinos, and most casinos are not making significant profits. And even if that argument were solid, successful tribal economic development does not fulfill the federal responsibility to provide healthcare to American Indians.

Other opponents argue that successful casinos should fund the other tribes. Is this not advocating socialism? Until the rest of the nation is willing to socialize medicine and other services, tribes should not be held to a higher standard.

Each tribe is a sovereign entity, and it is not the tribes’ responsibility to provide healthcare to one another. It is the federal government’s responsibility.

It ought to live up to that.

Dr. Donald Warne (Oglala Lakota) is president and CEO of American Indian Health Management & Policy ( in Phoenix.

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