The Failure of the IHS

Flickr image by Chiot's Run.

Socialized healthcare for Native Americans is an example of socialism’s failure; whereas, the alternative of healthcare privatization leads to better health and less waste of tax dollars. The government bureaucracy that provides socialized healthcare for Native Americans is the IHS (Indian Health Services). For decades, it has been providing healthcare that is mediocre or worse and has been wasting our tax dollars (Hollis).

Actually, this socialized healthcare has led to a deterioration in the health of Native Americans. 2007 infant mortality rates among Native Americans in the US were 1.4 times higher than non-hispanic whites, heart disease rates were 1.2 time higher, HIV/AIDS rates were 30% higher, liver cancer and inflammatory bowel disease were 2 times higher, diabetes-related death rates were 4 times higher, and life expectancy on average was 4 years shorter for Native Americans than the population as a whole (“Native Americans”). In 2010, life expectancy for Native Americans throughout the US was 76.9 years, compared to 86.5 years for Asians, 82.8 years for Latinos, and 78.9 for whites, while African Americans had a worse life expectancy than Native Americans with 74.6. Further, 2010 life expectancies for just Native Americans living in Montana and South Dakota were the worst among all races in US states: 69.2 and 68.2 respectively. In other states that have substantial Native American populations, the life expectancies were the lowest among any race, except a year lower for African Americans than Native Americans who live in Oklahoma (The Henry J. Kaiser Family Foundation).

Similar to the IHS, the VA has similar inefficiencies and an ineffectiveness that has led to mediocre or worse healthcare for veterans. The presence of similar problems under the VA indicates that the problems under both the IHS and the VA are chronic of government-run systems; contrary to the beliefs of politicians and the media: that more accountability, funding, and more regulation can fix the ills of the bureaucracies (“Not Just the VA”). The government bureaucracy IHS is not well-known nor are its inadequacies well-known. More exposure leads to an understanding of why government-run healthcare doesn’t work but why private healthcare is the best solution to waste fewer tax dollars and have better health.

The IHS is just another government bureaucracy typical of unaccountability. In July 2008, the Government Accountability Office reported that IHS lost $15.8 million worth of equipment including: unusable Jaws of Life machines, ultrasound machines, x-ray machines, and trucks – as well as $700,000 worth of computers ruined by bat dung. (Hollis; “Not Just the VA”). With over 14,000 employees, including 8 assistant surgeon generals, 439 “Director Grade” bureaucrats, and 601 “Senior Grade” bureaucrats, it seems as if there are too many chiefs and not enough Indians. Really, is over 1,000 people “running” the IHS needed and worth the taxpayers’ money? (“Not Just the VA”). What the bureaucrats in charge of the IHS really do is scrimp when budgeting for the population of Native Americans, and set most of the money aside for themselves instead of for the IHS staff (“Not Just the VA”).

As of 2009, $6,000 was spent per person on healthcare across the US, while $2,100 was spent per Native American via the IHS (“Native Americans”). The common wisdom on reservations is “don’t get sick after June” because June is the month when the money that is supposed to be “budgeted” runs out (“Native Americans”; “Not Just the VA”; Hollis). In addition, “low salaries contribute to unfilled vacancies, poor retention, and low morale among staff, causing waiting lists and inferior treatment for patients. The IHS has job vacancy rates for healthcare professionals, ranging from 12 percent to 32 percent” (“Not Just the VA”). The patients should be expertly taken care of by such a planned system. However, this is not the case at all. The data points to a waste in tax dollars by the corrupt government bureaucracy.

The type of care known by Native Americans who use the IHS’s services range from misdiagnoses and improper treatments, to no care at all due to money constraints. Cataracts, cancer, gall bladder surgery, and frostbite are all crucial health problems that have been left untreated by IHS staff (Hollis).

Improper treatment suggestions include that of Jay Littlewolf, a Cheyenne staying on a reservation in Montana, who had a diabetic ulcer on his right foot – and at the time was told the solution was to simply cut off his toes. The out-of-pocket private treatments have cost Littlewolf $3,000 as of January 2014, but the total over time would reach $20,000+, an amount that the government agency did not want to pay (“Not Just the VA”).

A.T. "Rusty" Stafne, chairman of the Assiniboine and Sioux Tribes of northeast Montana's Fort Peck Indian Reservation, said an issue experienced within their reservation is the common use of treatments such as pain killers or cough medicine when those methods do not help nor cure the real causes of the health problems (AP News).

In 2005, Ta-Shon Rain Little Light, a 5 year-old Crow Indian, was taken to an IHS clinic when she had stopped eating because her stomach was hurting. The doctors there diagnosed her pain as depression and neglected to perform tests that would have recognized terminal cancer. Several months later when she was airlifted to a hospital in Denver because her health had deteriorated drastically, cancer was discovered and would have likely been treatable had it been found earlier (“Native Americans”).

Within the Assiniboine and Sioux Tribes, A.T. "Rusty" Stafne said that people have died because they could not get the healthcare they needed (AP News). Dr. Dee Althouse, a physician of the Chippewa Cree Band had to focus on saving lives and limbs, while other health problems were put on the back burner (Native Americans).

Terree P. Summers, an economist and author specializing in healthcare and the federal budget, was able to get first-hand information about IHS healthcare by way of her grandfather, who was an IHS physician. Summers witnessed the effects of government healthcare: rationing, lack of access, inferior care, and long waits – the type of poor care Native Americans are used to (“Not Just the VA”).

Native Nations Institute’s research reported that “tribal management leads to better access and better quality healthcare than relying on the IHS-run system” (“Native Americans”). Private healthcare run by individuals within tribes could lead to healthier lives for Native Americans if they had such an option – the simple freedom to allow Indians to open doctor’s offices, clinics, and hospitals on their reservations would see improvements in the quality of healthcare: “when hospitals and physicians compete for patients, they provide better care. Private sector healthcare provides higher-quality services” (Hollis). However, Indians cannot even own private property on their reservations (“Unlocking the Wealth”).

The lack of healthcare options is a huge problem that affects millions of Native Americans. The ongoing healthcare failure’s real issue has repeatedly been ignored. The excuses made by the US Commission on Civil Rights in 2004: lack of qualified people, lack of funding, maintenance of aging facilities, and retention and recruiting of qualified healthcare providers – are all effects of the problem, not causes (“Not Just the Va”).

In 2008, the Indian Health Care Improvement Act was proposed that would enable tribal members choices, including being able to purchase private insurance. Senator Tom Coburn (R-OK) proposed this bill that was shot down 28-67 (“Not Just the VA”). Now, Native Americans do have the option like everyone else to sign up for Obamacare; but they get the same effects of government-run healthcare: few choices, declining quality of medical care, long waits for healthcare services, picking and choosing who “really” needs the services (older people vs. younger people, for example), and increasing costs of premiums (“Obamacare Rationing”). Both the IHS and Obamacare are options for Native Americans that end with the same result: poor quality healthcare. “The problem is not one of spending; it is one of structure. Care provided to Native Americans is poor not merely because of IHS’ inadequate funding, but because tribal members have few other options” (Hollis). The solution to the problem is to allow Native Americans the freedom to have private healthcare – which has been proven to be the best possible type of healthcare available. “Where there is no competition, there is no accountability. And where there is no accountability, there is no assurance of quality” (Hollis).

Anderson, Terry. "Native Americans and the Public Option." Wall Street Journal (2009): 1. web. 13 January 2015.

—. "Unlocking the Wealth of Indian Nations." Townhall (2013): 1. Web. 20 January 2015.

AP News. "As Tribal Health Care Woes Mount, Feds Get Blame." Townhall (2014): 1. Web. 20 January 2015.

Hollis, Laura. "The Real Lessons from the VA Scandal." Townhall (2014): 1. web. 15 January 2015.

Summers, Terree P. "Not Just the VA." The Freeman 12 (2014): 1. web. 13 January 2015.

—. "Obamacare Rationing: It’s Already Here." The Freeman (2014): 1. Web. 20 January 2014.

The Kaiser Family Foundation. "Life Expectancy at Birth (in years), by Race/Ethnicity." 2010. web. 19 January 2015.