Covid-19 bares impact of broken promises on Indian country

WASHINGTON – The lack of funding for the federal Indian Health Service is a function of the failure to honor treaty obligations never more evident than in the disproportionate and extreme impacts of the Covid-19 pandemic in Indian country, according to testimony offered to the U.S. Commission on Civil Rights on July 17.

National Indian Health Board (NIHB) Acting Chair William Smith from the Valdez Native Tribe of Alaska testified before the commission in a virtual public briefing, entitled: Covid-19 in Indian Country: The Impact of Federal Broken Promises on Native Americans.

“The indigenous experience with Covid-19 affirms that colonization continues to function according to its design,” Smith said. “The most obvious problem is the underfunding of the Indian Health Service, which is the only federal healthcare system created as the result of treaty obligations and is the most chronically underfunded federal healthcare system.”

Smith spoke on a panel including Geoffrey Blackwell, Chief Strategy Officer, AMERINDRisk; Chief Lynn Malerba, Secretary, United South and Eastern Tribes, Inc.; Jonathan Nez, President, Navajo Nation Office of the President and Vice President; Fawn Sharp, President, National Congress of American Indians, and Francys Crevier, Executive Director, National Council of Urban Indian Health.

He did not limit his criticism to IHS funding shortages, but also discussed the government’s, paternalistic reluctance to expand self-determination and self-governance policies across the spectrum of federal agencies.

“This coronavirus disease continues to disproportionately ravage the disempowered among us and Indian country is right at its center. But to understand what is happening to tribes, America must first insist on an honest reckoning of history, for what we are seeing today, is indeed, the offspring of colonization,” Smith said.

“The United States must revolutionize its approach to tribal nations and break new ground by truly honoring its trust and treaty obligations. A good first step is making massive and sustained investment in rebuilding tribal communities and health systems in its response to Covid-19,” he said.

The U.S. healthcare system spends about $9,409 per year for one American’s health – unless that American be native. The system spends just $3,779 per year for one American Indian or Alaska Native person’s health, he noted.

According to the Government Accountability Office, from 2013 to 2017, the IHS annual spending increased by roughly 18 percent, while spending under Medicare and Medicaid increased by 22 percent and 31 percent, respectively.

Similarly, during the same period, the Veterans Health Administration, which is the only other federal healthcare delivery system, increased its spending by 32 percent. The VHA has a service population that is only three times that of IHS, but the agency’s annual appropriations are nearly 13 times higher, Smith revealed.

“Limited funding means rationed health care. We, first Americans, remain last in health care opportunity. This is unacceptable and needs to be remedied,” Smith insisted.

“When compounded over time, the impact of destructive federal policies towards American Indians and Alaska Natives, like involuntary assimilation, acts of physical and cultural genocide and forced relocation, have resulted in higher rates of historical and inter-generational trauma, adverse childhood experiences, poverty and poor health outcomes across Indian country,” he said.

Smith also offered the Commission recommendations to remedy the systemic barriers and give tribes a chance to fight Covid-19, which included:

• Honor the treaties.
• Listen to tribes and act accordingly.
• Implement the Indian Self Determination Act in every agency of the federal government.
• Immediately invest $1 billion in water and sanitation.
• Provide emergency funding directly to tribes for Covid-19 intervention.
• Permanently reauthorize and fully fund the Special Diabetes Program for Indians.
• Make technical fixes to federal Medicaid law that would maximize third party revenue for the Indian health system.
• Address mental and behavioral health needs that have been exacerbated by the Covid-19 pandemic.
• Stop using a competitive grant mechanisms or other paternalistic funding models with tribes.
• Establish the Indian Health Service as an entitlement program that is fully funded.

“As the sole national organization committed to advocating for the fulfillment of the federal government’s trust and treaty obligations for health, NIHB is dedicated to bringing into fruition the day when our people can state with dignity that the United States held true to its solemn word,” Smith concluded.

 

(Contact Talli Nauman at talli.nauman@gmail.com)

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