Improve access to health care for tribal communities

By Lauren Eberly / For the Los Angeles Times

One of my patients who lives in Diné Bikéyah, the vast Navajo reservation in New Mexico, sleeps in an old Ford pickup that often doesn’t start. He has heart failure and relies on oxygen. But since he is without electricity, he spends his nights sneaking into the Walmart parking lot to charge his oxygen concentrator so he can survive another day.

For more than a year, he has needed coronary artery bypass surgery. But he can’t drive himself to the hospital three hours away, and his friends can’t afford the gas to take him. Each time his phone is out of service, I wonder whether it’s a coverage gap or an unpaid bill. Or something worse.

Such health concerns are common on the nation’s largest reservation. American Indians have the highest mortality and lowest life expectancy of any racial group in the U.S., according to the Centers for Disease Control and Prevention. My team’s research shows that nearly half of American Indians on Medicare suffer from a serious heart problem. And the life expectancy at birth for American Indian-Alaska Native people was 65.2 years in 2021; equal to that of the U.S. population overall in 1944.

Many treaties that ceded tribal lands to the U.S. required high-quality health services in return. That’s why the Indian Health Service was established. But the Indian health system remains grossly under-resourced and underfunded. IHS hospitals are four decades old on average, compared with the national average of 10.6 years; Veterans Affairs treats about 3.5 times as many patients as the IHS but employs 15 times as many physicians. The U.S. government budgeted $4,104 per patient enrolled in the Indian Health Service in 2018, compared with $8,093 per Medicaid enrollee, $13,257 per Medicare enrollee and $9,574 per VA patient.

https://www.heraldnet.com/opinion/comment-improve-access-to-health-care-for-tribal-communities/