Lawmakers Consider Indian Health Reforms

May 25, 2016

A United States Senator and a state lawmaker agree that the federal government is failing to provide adequate health care to Native Americans. United States Senator John Thune and South Dakota State Senator Troy Heinert see different solutions to ongoing problems with the Indian Health Service.

U-S  Senator Thune has legislation in Congress aimed at comprehensive reform for federal health services for Native Americans. He says the bill makes it easier to fire ineffective IHS leaders, examines whistle-blower protections, and requires fiscal accountability so patient care funds actually make it to patients.

"There are funding issues that are associated with all these things, but overall funding for the IHS, year-over-year since 2008, it’s up 35 percent. My sense is – and I listen and hear from tribal officials – they don’t generally raise funding as being the principle concern that they have. It has a lot more to do with accountability, transparency, effectiveness in how the funds are used," Thune says.

Accountability and efficiency are important, according to State Senator Troy Heinert, but the Rosebud Sioux tribal member says those improvements do not offer all-inclusive reform. He says money is an issue.

"There is not enough funds to provide a service unit," Heinert says. "I know the tribes have, I know I have personally, met with our leaders in Congress, you know, stating these facts, and nothing has ever been done."

Heinert says he knows he sounds skeptical, but he’s seen many people suffer from lack of access to quality health care.

Thune says those measures don't fix all of the problems IHS has in delivering effective care for Native patients, but he says these steps make a difference into the future.

“You couple that with improved hiring practices, enhanced recruitment and retention policies, try to make it easier to hire people there full-time, reward employees for good performance and for finding innovative ways to improve patient care,” Thune says. “We try to use incentives and we also try to use a sufficient amount of accountability measures, and we think the bill strikes that balance.”

Heinert says he supports the moves, but he says reservation health care can’t provide enough benefits through IHS right now.

"On the federal salary schedule of what they’re paying them, we can’t compete with other hospitals. And then you think about the amount of stress and rural location that we’re asking people to live in, and then if, by chance, we do get one that people like and really understands us, then they’re just bombarded. You know, everybody wants to see that doctor," Heinert says.

Heinert and Thune agree that the Indian Health Service needs meaningful, long-term changes to effectively serve Native American patients.