Mark Trahant, a member of Idaho’s Shoshone-Bannock Tribes, is a Kaiser Media Fellow examining the Indian Health Service and its relevance to the national health care reform debate. Comment at www.marktrahant.com. His new book is “The Last Great Battle of the Indian Wars,” the story of Sen. Henry Jackson and Forrest Gerard. This column can also be read on the Missoulian website.
There’s an old joke: A Native American student comes home from a geography lesson, shows his grandfather a map, and then asks, “What did we call the United States before it was a country?” His grandfather answers, “Ours.”
I thought of this joke recently in the context of the U.S. Indian Health Service. Perhaps the agency’s history, its shortcomings and its chronic underfunding have all been acceptable to Indian Country because the system itself is “ours.” It’s been “ours” for most of our generation – a little more than five decades – where American Indian and Alaska Natives could receive health care in a system that was, and is, unique.
A quick look at the history: Since 1955 the Indian Health Service was transferred from a rickety network of hospitals and clinics run by the Bureau of Indian Affairs to a real health care system. In that same time frame, the agency went from being a slice of the BIA to being larger than the BIA with a budget of $4.4 billion and some 15,000 employees. During that time there were substantial improvements in Indian health, including reducing overall mortality by 28 percent in the past 30 years, while still falling short in health parity for Native Americans.
That brings me back to the definition of “ours.”