U.S. Senate OKs Indian health plan

WASHINGTON — The U.S. Senate overwhelmingly passed a bill Tuesday to improve Indian health care, though even the supporters conceded that true progress would require substantially more money.

The vote represented the first time since 1992 that lawmakers have approved a comprehensive revision to the law that covers health services for nearly 2 million American Indians and Alaska natives; about 280,000 of those are in the Indian Health Service's Oklahoma region, which includes parts of Texas and Kansas.

Sen. Byron Dorgan, D-N.D., chairman of the Indian Affairs Committee, said the U.S. government has not kept its promises to Indians and that people suffer, and even die, because of the lack of adequate services.

"We have to do better,” he said.

The bill was approved 83-10. The House must still consider its own version of the bill.

Joe A. Garcia, president of the National Congress of American Indians, said, "It's about time, and I applaud the Senate for this historic vote. Federal prisoners continue to receive better health care than native people, and this is a major step in reversing that alarming statistic.”

•Sen. Tom Coburn

The Muskogee Republican, a physician, tried unsuccessfully to amend the bill to give Indians insurance policies that would allow them to seek care outside the Indian Health Service system.

He said the change would make the IHS more competitive and prevent Indians from having their care rationed.

Coburn also complained that the new legislation adds more burdens on a system that is already overwhelmed and underfunded.

"It's kind of like taking a loan out on a brand new car when you can't provide food for your family,” Coburn said in debate two weeks ago on the bill.

•Sen. Jim Inhofe

The Tulsa Republican said the bill wouldn't correct the "structural flaws” in the system.

"Tribal members would be better served by a competitive, consumer-driven health care market that provides an array of choices and opportunities to make individualized health care decisions,” Inhofe said.

But competitive options are extremely limited for tribal members in remote areas, where physicians and nurses are in short supply. And Indians experience unusually high rates of some diseases, including diabetes.

Suicide and alcoholism also are chronic problems on reservations.