And now:Ish <[EMAIL PROTECTED]> writes: via LadyScribe From: [EMAIL PROTECTED] Return-path: <[EMAIL PROTECTED]> Subject: Indian Health Service to Get Boost Date: Fri, 15 Jan 1999 16:44:05 EST Indian Health Service to Get Boost .c The Associated Press By LAURA MECKLER WASHINGTON (AP) -- The basic health care provided to millions of Americans is routinely denied to Indians as chronic financial troubles force their federal health system to deny services when money runs out part-way through the year. Now, after years of neglect and stepped-up lobbying from outside, the Clinton administration is set to ask Congress for major new spending. Sometimes, the lack of money means postponed gallbladder or cataract surgery. Other times, it means a doctor worried about a patient's weak heart can't send him or her to a specialist. ``They do know how to ration care,'' said Yvette Joseph-Fox of the Indian Health Board, a private group that represents the nation's tribes. American Indians and Alaskan native people are entitled to free health care under treaties signed with the federal government in exchange for land. But that care is far below what's provided to poor people in the federal Medicaid program -- not to mention what private insurance offers. The administration's plan comes after criticism from the Republican-controlled Congress and Indian groups -- and after increased lobbying from Indian groups who have become more savvy at working the system. President Clinton plans to ask Congress for an increase of about $175 million -- an 8 percent jump over this year's $2.2 billion budget, according to administration officials who spoke on condition of anonymity. The president also wants to increase the rates paid by Medicare and Medicaid to reimburse Indian hospitals -- spending that falls outside the regular budget. The White House had even considered a much-bigger $500 million increase pushed by Health and Human Services Secretary Donna Shalala. It's a striking request for an administration that asked for a meager 0.9 percent increase for 1999. ``They should have been embarrassed by what they did last year,'' said Rep. Ralph Regula, R-Ohio, who chairs the House subcommittee that appropriates the money. His committee upped the administration's request for a $19 million increase to $141 million. The Indian system saw healthy budget increases in the early 1990s, but its budget for the last several years has been stagnant. That amounts to cuts, given the growing Indian population and inflation, officials said. The ramifications are plain: In 1997, the health service spent an average of $1,382 a person -- less than half the $3,261 spent per person nationally. In 1982, there were nearly 100 doctors for every 100,000 Indian people; by 1994, fewer than 90. That compares with 229 doctors for every 100,000 people nationally. It's a group with many needs: One in three Indians lives below the poverty line. While tuberculosis has been treatable for decades, Indians are five times as likely to die from it than are Americans as a whole. They're more than four times as likely to die of liver disease and three times as likely to die of diabetes -- deaths preventable with proper care. ``People are suffering and dying premature deaths, due in large part to reductions in Indian Health Service spending,'' Buford L. Rolin, chairman of the National Indian Health Board, told a Senate committee last year. Even the most sophisticated Indian hospitals must refer patients with anything but routine troubles to outside hospitals and specialists -- an expensive proposition. Ten years ago, clinics would run out of money for referrals in the last quarter of the fiscal year, implementing something called ``Priority One.'' That means people needing nonemergency tests or operations had to wait until the next year. Now, the crunch is so bad that most clinics adopt Priority One in the year's first quarter. ``Pain has become the new standard for determining who can access basic surgery and other specialized care,'' Rolin said. In Gallup, N.M., the Indian hospital eliminated 20 of its 99 beds and closed an outlying field clinic that saw 5,100 patients last year. But Indians realized they needed more effective lobbying. They pumped up campaign donations to members of Congress and began reaching out to higher-up administration officials. But the health service has work of its own to do, its advocates acknowledge. It can supplement its federal money by making the effort to bill Medicare, Medicaid and private insurers for certain eligible patients. Clinics and hospitals have gotten better at this, but there's room for improvement. And the service needs to better monitor expenses so it can make the case for more money. In other words, it needs to run more like a business. ``I would certainly like for us to be able to justify ourselves,'' Dr. Tim Fleming, who heads the service's hospital in Gallup. ``We're not very good at that.'' AP-NY-01-15-99 1642EST Copyright 1998 The Associated Press. The information contained in the AP news report may not be published, broadcast, rewritten or otherwise distributed without prior written authority of The Associated Press. <<<<=-=-=FREE LEONARD PELTIER=-=-=>>>> If you think you are too small to make a difference; try sleeping in a closed room with a mosquito.... African Proverb <<<<=-=http://www.tdi.net/ishgooda/ =-=>>>> IF it says: "PASS THIS TO EVERYONE YOU KNOW...." Please Check it before you send it at: http://urbanlegends.miningco.com/library/blhoax.htm
